Social Impact created by High Consumption of Sugar Sweetened Beverages

Sugar Sweetened Beverages (SSB) refers to water-based beverages that has added sugar which are energy dense with no nutritional value to the daily diet. SSB’s are carbonated or non-carbonated, non-alcoholic and contain naturally derived sweeteners such as sucrose and glucose, or artificial sweeteners such as aspartame.

Packaged fruit juices, soft drinks, energy drinks, cordial and sports drinks fall under this category. The World Health Organization (WHO) states daily consumption of SSB’s increases overall energy intake and displaces healthier foods from the diet, potentially leading to weight increase and higher risk of non-communicable diseases.

Sugar sweetened beverages is a major contributor towards the increasing incidence of obesity and metabolic syndrome, a cluster of circumstances associated with insulin resistance, including hypertension, dyslipidemia, non-alcoholic fatty liver disease, central adiposity, impaired glucose metabolism, and polycystic ovary syndrome. Due to the large quantities of sugar and highly acidic nature of SSB’s, it is a critical risk factor for adverse oral health, progressing to dental caries and tooth erosion.

Prior studies have found a positive correlation between increased consumption of sugars and its adverse health outcomes including overweight or obesity, high blood pressure, type 2 diabetes and cardiovascular diseases.

More than 2.1 billion people, or nearly 30% of the global population is overweight or obese, leads to potential health and socio-economic costs. The global economic effect of obesity alone is estimated to be approximate 2 trillion US dollars, or 2.8% of global gross domestic product.

There is a loss of 8.5 million disability adjusted life years (DALYs) every year which is related to the intake of sugar sweetened beverages, predominantly associated with low and middle income countries [10]. Despite the recent signs of a trend reversal towards  non-diet carbonated soft drinks in North American and European countries, the worldwide demand is still increasing. Australian consumption is similar to global trends where sports and energy drinks are on the rise.

SSB’s are the most consumed source of free sugars in the Australian diet and fifty percentage of the population exceeds the daily recommended intake. The World Health Organisation has recommended to limit free sugars to 10% of daily intake, however this accounts to 14 teaspoons (approx. 60 grams). An average 375ml soft drink can contains 8-12 teaspoons of sugar.

Australia stands 15^th in the global sugar-sweetened beverage consumption. The Australasia region stands second in the artificially sweetened beverage sales which is double the amount of all other regions excluding North America. Australian soft drinks have a 22% higher glucose concentration than the United States formulations.

As obesity increases as a result of increased SSB consumption, it impacts direct health care cost which makes health insurance unaffordable for the low income population. If the obesity crisis continues governments have to spend a further $29.5 billion for the direct healthcare cost of obesity in Australia.

Factors affecting the influence of sugar sweetened beverage consumption includes availability in social settings, pricing, influential celebrity endorsed advertisements, bundled purchase of soft drinks with fast food, easy accessibility at home, workplace and sporting venues.

Studies in Australia have shown that increased consumption of sugary drinks often co-occurs with higher levels of social and economic disadvantage and lower levels of parental education. Australians drink at least 2.4 billion litres of sweetened beverages every year, i.e. approximate 90 litres per capita consumption.

Sugar sweetened beverage consumption was found more prevalent among adolescent population. The high consumption of soft drinks correlates with adolescent males having more weekly spending allowance. The easy availability of soft drinks through vending machines at a cheaper price even at educational institutions lure the adolescent population to become high soft drink consumers. Energy drinks are an enticing new class of beverage, with a special marketing focus on their stimulant effects often targeting the adolescents.

Low fruit intake, extensive interactive gaming, binge eating on snack foods greater than 14 times per week and sleeping for less than eight hours per school night are the behavioural factors impacting higher levels of consumption among adolescents.

According to Australian national nutrition surveys an approximate 15% of  adolescent energy intake came from added sugars in SSB’s and more than three quarters of the adolescents exceeded the WHO recommendation.

Modelling using consumption in Australia has estimated that a price increase of 20% on sugary drinks would result in a decrease to the obesity epidemic and incidence of Type 2 diabetes, cardiovascular disease and some cancers, leading to thousands of healthy life years gained and millions of dollars saved in healthcare costs. 

In Australia, the Victorian Government had mandated that schools should be devoid of beverages high in sugar since 2007 but a follow up in 2010 found that beverages continue to be present on the menus.

Multidisciplinary analysis around the world shows that levies on SSB’s can be influential in improving diets across the population by encouraging companies to reformulate their soft drinks or making healthier alternatives more affordable, raising revenues for governments to spend on obesity prevention, or both. In-depth analysis of behaviours of Australian consumers found that 69% participants supported sugary drinks tax if the revenue was used to discount healthy foods.

On a global spectrum, school based interventions conducted in China over a one year period found beneficial effects more in younger children rather than adolescents. The amount and frequency of consumption decreased after this period and the knowledge pertaining to the ill effects of SSB’s increased.

México introduced 1 peso per litre tax on any non-alcoholic beverage with added sugar which would cost a 10% increase in the price. This resulted in a reduction of 7.6% in the purchase of SSB’s in the first two years, with the most impact on lower socio economic groups. In the UK, levy has been applied on soft drinks and majority of producers have reformulated products, while reducing sugar content.

Restrictions along with ensuring the right options is the key to limiting the consumption of SSB’s in institutions and communities. Water consumption should be encouraged with easy accessibility to water fountains and dispensers. Collective approaches on removing sugary drinks out of institutional events, school canteens and vending machines is part of an Australia wide school based initiative.