Monday 22 April 2019

Beating the sugar rush: can a levy on soft drinks work?

As Ireland prepares to levy a tax on fizzy drinks, our reporter asks if - given the prevalence of junk food and reduced activity - the measure has any chance of slowing the rise in levels of obesity

Taking a pop: last year the average Irish family with children spent more than €1,000 on fizzy drinks, crisps and sugary treats and just €346 on vegetables at the supermarket
Taking a pop: last year the average Irish family with children spent more than €1,000 on fizzy drinks, crisps and sugary treats and just €346 on vegetables at the supermarket
John Meagher

John Meagher

Earlier this week, Alva O'Sullivan made a vegetable soup for her family from scratch. The Dublin-based fitness trainer and health coach takes the food she puts into her body - and that of her children - very seriously, so she was dismayed when one of them suggested that pleasant as the soup was, it didn't taste nearly as nice as the supermarket-bought soup she had had the week before.

O'Sullivan immediately understood why. "Sugar," she says. "It's in absolutely everything nowadays, even supposedly healthy foods - and the problem is it's changed our taste buds. We now expect our food - and all kinds of food to taste sweeter - and if we adults find it difficult to make the adjustment, can you imagine how hard it is for children?

"And sugar plays a huge part in the rise of obesity in this country," she adds. "There's no doubt about it."

From Tuesday, the war against sugar gets under way in earnest. A tax on added sugar on the country's favourite fizzy drinks comes into effect after years of campaigning by health experts. The price of a small can of Coca Cola, for instance, will go up by 10c, while a litre of soft drinks will see 30c added to its price.

Alva O'Sullivan isn't sure what impact it will have but believes anything to make people think more carefully about what they're putting into their bodies can only be a good thing. "Too many of us are eating highly processed foods," she says. "They're convenient, cheap foods with few nutrients and are high in sugar, salt and fats. They're made to taste good, and to appeal to people who feel they are time-poor. But not only are they not good for our health, they're actively doing us harm. And too much sugar is going us a great deal of harm."

Our increasing infatuation with sugary processed foods goes hand in hand with Ireland's new and stark reality - the country is tipping the scales when it comes to Europe's obesity chart. Six out of every 10 of us are either overweight or obese and a staggering 10pc of children are now classed as obese.

By contrast, in 1975, just one per cent of Irish children were obese - but over the past 20 years, especially, the weight of the average child has crept up and up. A perfect storm of eating too much food - especially processed snack-food and ready meals - and a decline in physical activity has ensured that a generation of Irish children are facing a future that could include diabetes, cancer and obesity-related early death.

Health advocates worry that by 2030, Irish children could be the fattest in Europe. And it's been projected that as many as 85,000 of the children on the island of Ireland today will die prematurely due to the effects of obesity. It's a stark change from the 1950s, when Irish people were among the slimmest in the western world.

Pure, White and Deadly

Sugar may have been getting a bad rap for the past couple of years, although health experts have been calling it lethal for the best part of half a century.

In the early 1970s, the English nutrition professor John Yudkin wrote a groundbreaking book, Pure, White and Deadly - but few listened to his prophecies that we would become more dependent on sugar, and overconsumption of it would lead to an obesity epidemic as well as associated diseases, such as type 2 diabetes.

Yudkin is hailed as a nutritional visionary today, but in the 1970s the powerful foods industry dismissed him as a crank. In 2018, there are far more Yudkins who say that sugar is public health enemy number one, including Dr Donal O'Shea.

The epidemiologist is one of the country's leading obesity experts and was one of the key figures pushing for a sugar tax on fizzy drinks. He believes it is a significant step in the right direction if "the country is serious about tackling this problem".

O'Shea says the tax will encourage a national conversation about sugar and the sort of worthless foods that have started taking up more of our weekly shop - as well as all those convenience store visits where chocolate, crisps and soft drinks sell in greater quantities than ever before. And the figures are sobering. According to a report jointly published earlier this year by Safefood, the HSE and Healthy Ireland, the average Irish family spends 20pc of its food budget on 'treats' that are full of sugar and fat and devoid of nutrition.

The report shows that families with children spent on average €1,037 in 2017 on highly processed food such as crisps, chocolate and sweets and just €521 on fruit and €346 on vegetables.

Chocolate and sweets made up the largest portion of the treat spend on €228, while a further €199 was spent on sugary drinks. Some €161 went on biscuits, with our love of crisps coming in at €129. And those figures only comprise the big supermarket shop - spend in convenience stores is not counted.

They are findings that echo a study published earlier this year in the Journal of Public Health Nutrition which found that the Irish shopping basket contained 45.9pc ultra-processed foods, making it the third-highest after Britain and Germany.

It's data that may have shocked many, but not Donal O'Shea, who has long argued that our dependency on processed, sugary foods is a ticking time bomb.

"It's something that we just can't sweep under the carpet and accept as the norm," he says.

"Even in the run up to the Government deciding that it would introduce a sugar tax, it was a topic that was in the public consciousness. That's a good thing. It's making people think about sugar in a way they hadn't before. And it's not just the fizzy drinks - but that's a good start because there can be up to 12 teaspoons of sugar in a pint of Coke - but about added sugar in so many of the foodstuffs we eat. There are people now who are thinking, 'What is the price of all this convenience?' They're looking at their lifestyles and thinking that now's the time to make a change."

O'Shea is disappointed that the Government is refusing to ring-fence this extra tax - which could generate as much as €40m in its first 12 months - for use in a major promotional campaign. "It could be done with the plastic bag levy and it was done when it came to battle smoking years ago," he says. "It's a missed opportunity because it would probably make people much more accepting of why the tax is being imposed."

It is not, he insists, about generating more money for the Exchequer. "One of the problems is that the consumption of highly processed foods and very frequent snacking has become normalised," he says. "It's something that people - adults and children - are doing without giving it much thought. But the health problems that have ensued are very real and you can see the evidence with your own eyes.

"Thirty years ago, it was unusual to see a chronically obese person - if you did, you might have thought that they were American tourists. Today, it's commonplace, and so too is being overweight - and yet many overweight people do not realise that they are overweight."

Prof Francis Finucane, consultant endocrinologist at Galway University Hospital, runs an obesity clinic in the city. He rejects the narrative that adults who become overweight and obese are entirely to blame. "That's exactly what the food industry would like us to think," he says, "but some of the most intelligent people I've ever met - and people who work in this field and understand why obesity happens - have problems with their food and put on weight themselves. There's much more than personal responsibility in all of this."

Finucane says manufacturers of processed foods, snacks and sugary drinks have relentlessly marketed their products to us. They've been allowed to sponsor child-centric events. And every supermarket checkout area in the country boasts walls of confectionery - much of it at the perfect height to tempt children.

"The sugar tax is a step in the right direction," he says, adding that much has to be done to ensure that these manufacturers don't get to market as freely as they have done before. Treat culture has to be stamped out, he says, but changing the habits built up over the past 20 or 30 years will be hugely challenging.

Britain - like Ireland - is facing its own obesity crisis. The chef and food advocate Hugh Fearnley-Whittingstall is fronting a new BBC series, Britain's Fat Fight, and the first episode aired this week.

In his sights are some of the world's largest food companies, Kellogg's and Nestlé, as well as retail giants like WHSmith - the stationery and newsagent chain that sells mountains of discounted chocolate in the 'corridor' that people walk down before they pay for their purchases.

"Human nature hasn't changed in a generation but the food industry has," Fearnley-Whittingstall insists. "The food industry is incredibly sophisticated, the way they design junk food is incredibly sophisticated and the way it's marketed, it's like an arms race."

Donal O'Shea says the industry's tactics are sometimes ingenious - and sometimes blindingly obvious. "I told the Oireachtas committee the other day about a new promotion that McDonald's are doing. It's called the Monopoly Prize Vault and it revolves around receiving stickers when you purchase stuff. Those stickers can be used to win prizes. It encourages you to spend more - and to eat and drink more. You get one sticker for a drink and two stickers for a large drink.

Fast-food promotions

"It's a promotion that is running for six weeks, and McDonald's have a €1.5m budget for it in Ireland. Compare that to the budget for [Government-led initiative] Healthy Ireland - it's got €5m to spend for the entire year."

O'Shea says a healthy food message has to effectively reach a wider demographic than is currently the case. "The message isn't getting to disadvantaged areas," he says, "and one-size-fits-all approach simply won't work. It has to be tailored effectively."

But the odds can be stacked against people - children, especially - from lower socio-economic backgrounds. Besides a prevalence of fast-food outlets and convenience stores in their areas, there's also the problem of insufficient recreational and sporting facilities there, too.

It's a phenomenon that was thrown into sharp relief in March when the Government's Sports Capital Programme - ostensibly designed to support disadvantaged areas - saw money allocated to a trio of prestigious south Dublin schools, including the fee-paying Wesley College.

Sports minister Shane Ross was widely criticised for tweeting about his pleasure that that school could use the €150,000 awarded on the resurfacing of one of its hockey pitches while large swathes of Dublin's inner city don't have a single football pitch for use by the densely populated communities there.

Meanwhile, Alva O'Sullivan believes that while adults can take significant steps towards reducing their sugar intake, cooking their meals from scratch - "it really isn't as difficult or as time-consuming as some would have you believe" -and exercising more, it can be very difficult to ensure that children are getting to do the same despite best intentions.

"You could be taking this seriously at home and prepare all meals in the traditional way and refuse to buy sweets and crisps as much as before, but everywhere they go, that treat culture is in the way. It's just become normalised for them to get soft drinks and chocolate - even after sports events - or to go to restaurants and be confronted with especially large, so-called child portions."

"That treat culture didn't happen by accident," Francis Finucane says. "It's something that's been perpetrated and propagated by big companies for years and it's something that needs to be confronted. Anyone who works in this field would accept that it's very hard for people - there are mixed messages out there about what's healthy and what's not healthy. And the message seems to change all the time - something that will suit big business just fine. But we can't afford to not do something."

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