THE HEALTH ISSUE: Beyond bags of sugar
BY ZEENAT MOORAD, APRIL 30 2015
THE Coca-Cola Company has long been in the firing line of the anti-sugar, quinoa crowd.
Over the past few years, health-conscious consumers have cut back on sugar-rich soft drink glugging, leading to a decline in sales, particularly in developed markets.
The company’s counteroffensive has been to extend its product range to include low- and no-calorie iterations such as Coke Light and Coke Zero, and even pricey lactose-free milk Fairlife, bottled water, and juice. Marketing has switched gears, too, as king-size servings give way to smaller cans, nutrition labelling moves to the front of the can or bottle, and efforts to reduce ads that market to children under 12.
About three-quarters of the company’s volume still comes from soft drinks, including energy drinks, with Minute Maid orange juice and other beverages such as ice-tea accounting for the rest.
Even with this diversity in range, as far as the sugar-shy movement goes, Coca-Cola is damned if they do and damned if they don’t.
The company’s recent launch of Coca-Cola Life, sweetened with plant extract stevia, a sugar substitute, hasn’t had much love yet. Aimed at “balance seekers”, a can has 89 calories fewer than the 140 in a regular Coke. It was developed in part as an alternative to Coke’s sugar-laden line of drinks but also because there’s a growing aversion to artificial sweeteners like aspartame, found in Coke Light and Coke Zero. Apart from bemoaning the altered taste of diet drinks, consumers have become wary of sweeteners as unhealthy contributors to weight gain.
Across its more than 200 markets, Coca-Cola’s physical activity drives, with the maxim “balance the kilojoules you take in with the kilojoules you burn each day”, are labelled as thinly veiled schemes to deflect the group’s part in creating obesity endemic. Coca-Cola has a bad rep and it can’t catch a break.
But obesity is a complex, systemic issue with no single or simple solution, as the company argues. Disproportionate blame is not one of them.
Part of the big, fat problem seems to be that the big red has been “Scarletted” as the sole peddler of sugar.
“Polarising the obesity epidemic and blaming one thing for obesity is scientifically wrong,” says Dr Georgia Torres, regional head of global initiative Exercise is Medicine. “Physical inactivity is a large contributor to the global obesity epidemic and to the global health risk. The policy should rather focus on changing that.”
A recent McKinsey study says no country reduced its obesity prevalence between 2000 and 2013. During the same period, sales of sugary drinks at Coca-Cola Company and rival PepsiCo have actually been declining — a clear indication that there are contributors other than fizzy drinks.
The global economic cost of obesity amounts to around US$2trillion annually, or 2,8% of global GDP — nearly equivalent to the global impact of smoking or of armed violence, war or terrorism.
In SA, the most obese country in sub-Saharan Africa, 42% of women and 14% of men are obese. Most worrisome is that this is starting at a much earlier age: 25% of female rural teens are obese or overweight in SA.
Local research last year suggested a 20% tax on sugar-sweetened beverages could cut the number of obese South Africans by almost 250 000. The tax, which would make sugar-sweetened beverages more costly, is aimed at deterring consumers from buying these products altogether or less often.
“A tax is not a silver bullet; it would be one nudge towards helping consumers make healthier and more sustainable choices,” says Wits School of Public Health researchers Prof Karen Hofman and Aviva Tugendhaft.
Sugar-sweetened beverages don’t only include the usual cooldrink suspects, but also energy drinks and fructose-laden fruit juices, misleadingly advertised as healthier alternatives. Brightly coloured kiddies’ 200ml juices, punted for lunchboxes, contain about 17g of sugar, the equivalent of more than four teaspoons. A 250ml Yogi-Sip contains 26,8g (five teaspoons) of sugar.
Liqui-Fruit Red Grape, Sparkling Berry Superjuice, and even Scheckter’s Organic Energy Drink all have a higher sugar content than a can of Coca-Cola’s 35g or seven teaspoons of sugar.
The World Health Organisation recommends a daily limit of fewer than six teaspoons of sugar.
Hofman and Tugendhaft say drinking one sugar-sweetened beverage a day increases the chances of being overweight by 50% for children and 30% for adults and puts people at risk of chronic diseases. “These types of drinks contain an average of eight teaspoons of sugar, which is a lot to be consumed in one go and regularly. Drinking them occasionally as treats do not have the same risk as long as other free sugars in the diet are also kept to a minimum,” they say.
This is where it gets sticky. Since people consume calories from different kinds of beverages and foods, many of which contain hidden sugars, it seems somewhat lopsided to think a tax solely on cooldrinks and other sugar-sweetened drinks would necessarily lessen obesity or its associated diseases.
Mexicans are the world’s biggest consumers of soda per person and carbonated beverage sales at its biggest soft drink bottler, Coca-Cola Femsa, fell by 6,4% during the first half of last year. This was after a one peso per litre tax on full-calorie sodas, ice-tea, and juices were instituted — but also because of the cold weather (when less soda is drunk) and a weak economy. For the full year, however, declines reversed, with volumes dipping just 0,3%, suggesting the levy might be having less of an impact on dissuading consumption.
Even if a tax harms volumes, how people spend the money they save from buying fewer sugar-rich drinks is difficult to predict, as there are always cheaper, fizzier, and sweeter beverages on offer, specifically marketed to price-sensitive, lower-income consumers who anyway struggle to get quality health care.
“Evidence shows consumers switch to alternatives of the same or similar foods instead; we do not believe that discriminatory taxation of sugar-sweetened beverages is an effective measure,” the Beverage Association of SA says.
Perhaps a wider net than just singling out the sugar-sweetened drinks companies should be considered as a more efficient, effective method of lowering caloric intake.
Economics professors from Iowa State University might be on to something. John Beghin and Helen Jensen in a 2011 study argue a better way is to tax companies on the number of caloric sweeteners added in the processing or the supply chain phase before the product hits the shelves. In other words, an input tax. This is essentially “placing the tax as close to what you want to reduce as possible”.
But there’s no precedent in SA and its unlikely health minister Aaron Motsoaledi would enforce such an extreme measure. Though he signed salt regulations into law in 2012, after which local manufacturers cut the amount of salt in products such as bread and cereals, he believes taxation may not be needed if “industry finds equally effective solutions”.
The obesity crisis, tooth decay, or even diabetes cannot be laid at the door of one single snack, chocolate, or beverage group, any more than it can be shouldered by video game makers.
Convenience and clever ads are not the chief culprits either. Tackling dietary ills probably requires a collective probe by companies, government, and educators on what (aside from the taste) drives people to consume more calories.
Balance remains an ever-elusive goal but assertions that today’s grab-and-go routine lends itself to overindulgence and a sedentary lifestyle is a bit of a cop-out. Greater personal responsibility, it seems, must be fostered.
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