Zosia Kmietowicz: One policy to reduce sugar intake—what would you do?

zosiakThe anti-sugar crusader Robert Lustig blew through town this week to film a documentary with chef Jamie Oliver, but stopped off on the way to take part in a panel discussion on the white stuff, which he launched with a talk entitled “Processed Food: An experiment that failed.”

Lustig, who is professor of paediatrics at the University of California, San Francisco, is an engaging orator, combining the charm of Bill Clinton with the dogged enthusiasm granted to Tigger by AA Milne. His views on the causes of the obesity epidemic—that the body’s feedback system for satiety is broken from over consumption of sugar, especially fructose—are becoming increasingly heard and argued over in the scientific and medical communities. What was interesting about his talk on Tuesday night was his favoured solution for tackling sugar consumption levels, which in the United Sates rose from 73lbs per person per year in 1970 to 113lbs in 2000 (if fruit juice is included).

Lustig did not go down the expected road of a tax on sweetened food items, but said he would like to see a wholesale withdrawal of the subsidies granted to food producers. Everyone assumes the price of food would go up, according to Lustig. But in fact the price of everyday commodities would go down, except for sugar whose cost would increase by 35%. Job done. And a far more powerful leverage than the 10% tax introduced by Mexico in January 2014, which has already led to a fall in the sales of sugary drinks. And why tax the very thing that we have been subsidising, asked Lustig.

Other panel members had different ideas. Aseem Malhotra, an interventional cardiologist and scientific director of the campaigning group Action on Sugar, said he would like to see hospitals banned from selling junk food. “The hospital environment should be healthy, but it has become a branding opportunity for the junk food industry,” he told the audience.

Philip Whalley, director of research at brokerage and investment firm CLSA London, said he favoured a sugar tax and accurate labelling of food. Earlier in the evening, we heard from Malhotra that a can of cola contains nine teaspoons of sugar—150% of the amount that we have recently been told should make up our diet every day. But the nutritional labelling on the can says the contents provide 39% of GDA (guideline daily amount) sugar.

Jack Winkler, emeritus professor of nutrition policy at London Metropolitan University, took a more pragmatic view, claiming that while removing agricultural subsidies would undoubtedly go towards the heart of the problem, “we have to look at what we might feasibly do.” His one policy change would be a reformulation of mass market foods. “We have to start with the foods that people are eating now and try to improve their nutritional quality,” he said.

I also liked another point made earlier by Lustig. Because Mars is a wholly privately owned company and not beholden to shareholders, it does not have to keep a watchful eye on its margins in the same way as other large food manufacturers, such as Kraft, Kelloggs, and Coca Cola. It is looking at how it can remove some of the sugar in its products in advance of what could be a consumer backlash against overly sweetened foods. According to Whalley, shareholders should be asking similar things of other manufacturers by attending their AGMs, asking what they are doing about the sugar content of their products, and pushing for accurate and user friendly labelling. And by disinvesting if they don’t like the response.

The panel discussion was organised by Digital Science.

Zosia Kmietowicz is news editor at The BMJ. You can follow Zosia @zosiamk.

Competing interests: None declared.

  • CynicalEng

    I never understand these labelling protestations – I don’t think I’m hallucinating when I look at a label and it tells me the grams of sugar per 100g, 100ml etc. Am I ? The GDI on EU labels is 90 grams a day of sugars from all sources. The WHO were talking about 10% of calories from “free sugars” which would be 50 grams a day at 2000 cals. With the other 40 grams from intrinsic sugars in vegetables (and fruit) there is no clash with the current RDI.

    Even if the RDI is to be changed, that has yet to happen hence the labels are accurate and in line with current regulations.

  • Margaret Fleming

    About hospitals – I was an inpatient at 3 of them a few years ago. In one, I was too weak from surgery to eat. In the last, I had lovely meals and was required to eat a large percentage of each! I shudder now to think how much sugar was involved.

  • Ian Lake

    Another option would be to allow supermarkets to claim some tax incentives if they could show reduced sugar sales through storecards. 75% of food is bought through 4 chains. Supermarkets own the data on storecards, it would be in their interests to claim. |they might of course think it is not worth it. On the point raised by Aseem Malhotra, if hospitals are selling inappropriate food surely CCG’s could not justify contracting dietetic and diabetes education programmes because of the environment they are set in.

  • Adam

    I think it would help to reduce sugar (like it did alcohol) by introducing legislation for free water where drinks over a certain sugar content were sold – at McDonalds, KFC, Burger King it would still be more expensive to by water than Coke/Pepsi with a 20% tax, though I suppose a subsidy from that tax would help.