Why sugar is the new health worry

New evidence implicating sugar for the rise in lifestyle diseases has governments and international agencies scrambling to forestall a future epidemic.

The increased use of sugar — one of the most popular sweeteners at home and in the use of processed food and drink — formed part of the discussion this week at an international conference in Russia, which ends on Saturday.

And last Thursday, the US government announced sweeping new guidelines that seek to limit the advertisement of sugar products aimed at children.

Citing an epidemic of childhood obesity, regulators are taking aim at a range of tactics used to market foods high in sugar, but also fat or salt to children, including the use of cartoon characters.

“It is no exaggeration to describe the situation as an impending disaster; a disaster for health, for society, and most of all for national economies,” said WHO Director-General Margaret Chan in a statement after launching the Global status report on non-communicable diseases in Moscow, Russia.

Dr Chan addressing the 191 WHO member countries, called for immediate and aggressive action against tobacco, alcohol, foods rich in salts, fats and yes — sugar — to stop what it called “globesity”

The world body is advocating for the lowering intakes of sugar, salt, and saturated fats and limiting the marketing of food to children, and using tax and pricing policies to influence food consumption.

WHO says, for example, that 36 million people died from conditions such as heart disease, strokes, chronic lung diseases, cancers and diabetes in 2008.

Most of these, who included about 800,000 Kenyans, are from developing countries and most under the age of 70.

Two weeks ago, Gary Taubes an author and contributor to the New York Times kicked a huge debate with his article, “Is Sugar Toxic.” Citing extensive research, he concluded that the excessive consumption of sugar was a cause for many of these killer lifestyle diseases.

Taubes argued that increasing evidence suggests that the granulated sugar we put in our tea or tart on that morning cereal, or corn syrup, much used in the soft drink and confectionary industry are a contributory factor to the increasing incidence of lifestyle diseases.

While the WHO started to develop guidelines on how to reduce sugar in processed foods as early as 2003, evidence adduced in the new global report has galvanised the world into action.

According to the minister for Medical Services, Prof Anyang’ Nyong’o, who attended the Moscow meeting, almost half of all hospital beds in the country today are occupied by people suffering from lifestyle diseases, and this is getting worse.

Within the next nine years, he estimated, those seeking medical care for lifestyle diseases will have by far outstripped other ailments in the country’s healthcare system.

The world, he says, is concerned and will meet again in New York in September to draw attention to the grave danger posed by non-communicable diseases.

Every country and individual, says Prof Nyong’o, will be asked to make a lifestyle choice and walk away from risks that could lead to early obesity or heart problems. Such choices include, proper diets that are low in sugar, salt and fat while rich in fruits and vegetables.

The head of the non-communicable diseases unit at Kenya’s Ministry of Medical Services, Dr William Maina, says the situation is alarming.

More people, he says are consuming unhealthy foods, which are high in salts, fats and added sugars consequently putting their lives at risk of health complications and early death.

Are we consuming too much sugar? According to the US Federal Drug Agency, if one is consuming 18kg of added sugar per year, above what naturally comes from fruits and vegetables, it may be too much.

WHO figures indicate Kenyans per capita sugar consumption has averaged 21kg annually since 1991 — more than twice as much as Tanzania and Uganda.

Affluence seems to determine how much sugar is taken in a particular homestead or country, in Sweden or Australia for example the per capita sugar consumption average 50kg.

Despite growing public pronouncements and awareness that the intake of too much sugar is bad for health, the availability of sugary snacks is on the increase in Kenya.

According to the Kenyan Snack-Foods Market Report released in March by the United States Department of Agriculture, the situation is getting worse but a few people are also changing habits for the better.

“Kenyans increase their snack-food consumption year-over-year at a current rate of growth greater than the growth in population,” say the report prepared by Souleymane Diaby.

The trend, it is forecast, is likely to continue as more of them attain middle class status and as retailers increase the variety and accessibility of these highly sugared products.

Diaby says imported snack-foods are growing much faster than those generated locally. The country imports 30 per cent of snack-food products from Europe, 28 per cent from Egypt and 11 per cent from India and about one per cent from the US.

The snack-foods considered in the report include: chocolate confectionery; sugar confectionery; gum; and, sweet and savoury snacks (fruit snacks, chips/crisps, extruded snacks, tortilla/corn chips, popcorn, pretzels, nuts, and other sweet & savoury snacks).

According to Euromonitor International market data, the retail sales for snack-foods in Kenya increased at an average annual growth rate of eight per cent, rising from $34.2 million in 2005, to $44.4 million last year.

Chocolate, according to Euromonitor report, remained the largest segment of the snack-food being marketed in Kenya in the last five years.

But on a positive note, the Euromonitor market report says Kenyan consumers are increasingly becoming more aware of the link between obesity and sugar, which is slowly being reflected in selecting their preferred soft drinks.

“Although it has not yet impacted on volume sale of carbonates, it shows a greater awareness of the health risks between soda and obesity,” says the Euromonitor brief.

Last year, the market report says, fresh juice registered high growth as well as bottled water as consumers turned to drinks deemed healthier for them.

Also noted is a trend where more consumers last year preferred to buy fruits and vegetables and blend the juices at home. It was also a good period for fruit kiosks, which blend fresh juices to sell.

James Wambire who vends nuts, sweets and all sorts of snacks, at South C shopping centre in Nairobi says the business had been doing well until November when the Mututho alcohol Bill drastically reduced drinking hours. This has correspondingly reduced the number of hours Wambire can interact with his customers.

Describing how sugar turns into a “poison” Taubes wrote: “In animals, or at least in laboratory rats and mice, it’s clear that if the fructose hits the liver in sufficient quantity and with sufficient speed, the liver will convert much of it to fat.”

This, he says, apparently induces a condition known as insulin resistance, which is now considered the fundamental problem in obesity, and the underlying defect in heart disease and in the type of diabetes, type 2, that is common to obese and overweight individuals. It might also be the underlying defect in many cancers.

Taubes’ article was based on a lecture “Sugar: The Bitter Truth,” by Robert Lustig, an expert on paediatric hormone disorders and posted on the YouTube two years ago. It has since been visited by almost a million viewers.

Dr Lustig concludes that excessive consumption of sugar is the primary reason that the numbers of obese and diabetic people has skyrocketed in the past 30 years.

Kenyans have cause to be interested in this debate considering that Dr Maina estimates that non-communicable diseases are responsible for almost a third of all deaths in the country. Citing World Health Organisation statistics, Dr Maina says NCDs contribute over half of the top 20 causes of illness and death in Kenya.

He attributes this to a change in lifestyle. He says as Kenyans move to urban areas they change to some unhealthy diets, are likely to spend more time sitting in a car, office or just watching television.

Now he says the government is planning to orientate its health workers on the handling of non-communicable diseases and redeploy them where they may be needed most.

There are also plans to improve facilities at medical centres but stressing prevention through public awareness.