Oxford researchers have estimated that a 15% reduction in sugar consumption through such a tax would prevent 180,000 people in the UK from becoming obese within a year and a larger number from becoming overweight. But the scientific evidence reveals that the positive health benefits for the whole population of such a tax goes beyond a mere reduction in calories:
An econometric analysis of 175 countries (considered the highest quality of study with the exception of randomized controlled trials) revealed that for every additional 150 sugar calories available for consumption, there was an 11-fold increase in the prevalence of type 2 diabetes in the population. This is compared with 150 calories from another source such as fat or protein and independent of body mass index (BMI) and physical activity levels.
The prevalence of type 2 diabetes in the US population between 1988 and 2012 increased by 25% in both obese and normal-weight populations, which goes to show that type 2 diabetes is not a condition related purely to obesity.
A high-quality prospective cohort study revealed a trebling in cardiovascular mortality among US adults who consumed more than 25% of calories from added sugar versus those who consumed less than 10%, with consistent findings across physical activity levels and BMI.
The positive health effects of reducing sugar intake appear to be quite rapid. In a study of 43 Latino and African American children with metabolic syndrome, keeping total calories and calories from carbohydrate identical, a reduction from a mean of 28% of calories from added sugar to 10% significantly reduced triglycerides, LDL cholesterol, blood pressure, and fasting insulin within just 10 days.
Big Tobacco, Big Sugar
The fact that it took 50 years before the first links between smoking and lung cancer were published in the British Medical Journal and before effective regulation was introduced is testament to how Big Tobacco was able to defend its practices. Key to the strategy was denial, planting doubt, confusing the public, buying the loyalty of scientists, and giving ammunition to political allies.
The similarities between Big Tobacco and the sugar industry are disturbing. As a recent publication in JAMA Internal Medicine showed, the sugar industry paid three influential Harvard scientists to downplay sugar’s role in heart disease and to shift the blame to fat. Last year, the New York Times exposed that the Coca-Cola Company paid millions of dollars to fund research that downplayed the role of sugary drinks in obesity and push lack of exercise as the main factor. And, according to one former UK shadow health minister, the incorrect advocacy of a low-fat, high-carbohydrate, and high-sugar diet by “morally corrupt scientists and politicians who allowed themselves to be manipulated by food suppliers” is to blame for global obesity.
The recent calls by the WHO to tax sugary drinks are very welcome news for health campaigners. The public health messaging, however, has to be more clear. There is nothing wrong with the occasional treat, but sugar has no place as part of a “healthy balanced diet.” Similar to smoking, any further regulatory measures to reduce sugar consumption, such as banning of sugary drink advertising and dissociating sugary drinks with sporting events, will have a further impact on improving population health within a short time. The science is more than sufficient; the case against sugar is overwhelming. Sugar is the new tobacco, so let’s start treating it that way.