The ‘sweet poison’ called sugar

SUZANNE BELLING

Tugendhaft is the deputy director of PRICELESS SA (Priority Cost Effective Lessons for System Strengthening) at the Wits School for Public Health, a research institution providing evidence on the best buys for public health to help the country set better priorities.

Being overweight puts individuals at great risk for lifestyle diseases like diabetes, heart disease and cancer.

“A 20 per cent tax could reduce the number of obese adults by about a quarter of a million,” she says.

But the Beverage Association of SA says a “discriminatory tax” is not an “effective measure because evidence showed that consumers switched to different alternatives of the same or similar foods instead”.

The Association said it is working together with the Department of Health in an awareness programme, “Healthy Food Options”. This is to encourage a balanced diet, exercise and a healthy lifestyle.

Health Minister Aaron Motsoaledi has yet to make any statements regarding a sugar tax, says spokesman Joe Maila.

“The Minister of Health and the Department of Health have not pronounced on that kind of tax. We are aware that there are people in the country and elsewhere in the world who have been calling for a sugar tax, but we have never said that as the Department of Health. We are not Treasury so we cannot be pronouncing on things like that in terms of tax. We can only be talking about the Department of Health.”

The DA says it does not agree with the tax proposal. The party’s shadow minister of health, Wilmot James, says it was regressive and would affect the poor by putting up food prices.

Cope said the party is in favour of a tax on sugar-sweetened drinks, provided all products reflect sugar in grams and teaspoons; there should be intensive education of the public and then the 20 per cent tax could be imposed, says spokesman Dennis Bloem.

Tugendhaft said a tax is not enough. It needs to be part of a broader, comprehensive approach that includes things such as easy-to-understand food labelling, work site and school-based interventions, advertising regulations and educational campaigns.

“Without preventive measures there will be another 1,2-million obese adults in South Africa by 2017.”

SSBs are not only high in sugar – about eight teaspoons in a can – but they were also liquid sugar, which had an even worse impact on the body. It caused sugar levels and insulin to rise rapidly, eventually leading to fat storage in the liver.

“We are probably eating too much chocolate too, but the difference is that we know it’s a treat, while sugar-sweetened beverages have become an everyday essential. What’s even worse is that some of these drinks are considered healthy. They have no nutritional value.”

She added that fruit juices had as much and sometimes even more sugar than soft drinks.

“Once the juice is removed from the intact fruit – even if freshly squeezed – the liquid has as much ‘free sugar’ as a drink that has sugar added to it.

“Think of how many oranges are needed to make one orange juice. None of the healthy fibre is left intact. That changes the way orange juice interacts with your body, as opposed to eating the whole fruit. Eat your fruit, don’t drink it.”

Jews drink sweet wine or grape juice on Shabbatot and festivals. Is this also harmful?

“A few sips of grape juice on Shabbat and on Yomtov are not going to lead to these negative long-term effects,” Tugendhaft says.

“Sugar-sweetened beverages in moderation are okay if one is not diabetic.

“But we no longer consider these drinks as treats to be enjoyed on special occasions. We need to move back to that mindset,” she says.

One criticism of the proposed tax is that it would affect the poor in particular.

“The poor are much more vulnerable to obesity and associated lifestyle diseases, as they do not have access to quality disease screening and healthcare,” she says.

These diseases place a huge financial strain on the poor.

“SSBs are cheaper than healthy food options and we want this to change.

“Mexico implemented a sugar tax last year and it did have the biggest impact on the lower income groups – but for the good, freeing up household income for healthier options,” she says. 

Physician and endocrinologist Dr Hilton Kaplan, of Cape Town, who is affiliated to the Centre for Diabetes and Endocrinology, says people should be encouraged to reduce their sugar intake and also carbohydrates, “unless they are good quality carbohydrates”.

He said there were very good alternatives for soft drinks and while a 20 per cent tax on soft drinks might be a good idea, he was sceptical as to whether it would solve the problem.

Even overseas, there are rumblings about sugar tax, especially on fizzy drinks.

British ministers have written to Prime Minister David Cameron urging him to impose a levy as part of an anti-obesity strategy. He has so far resisted to impose a sugar tax fearing its unpopularity with the poor. But last month he hinted he might be considering a sugar tax after research revealed obesity rates could be significantly lowered.

A study in Mexico, where a tax has been imposed on fizzy drinks since 2014, found that the sales of these had been reduced by 12 per cent.