Health war on sugar is about to turn bitter
This week's fuss about the dangers of processed meats is only a starter compared to the looming battles between food giants and governments over the 'toxic' sweetener.
Finance Minister Michael Noonan ducked the issue of slapping a tax on sugar in the Budget, but health campaigners hope that it is only a matter of time before it is introduced. The battle over sugar could soon turn bitter as food and drink industry lobbyists slug it out with doctors.
If the campaign against tobacco was the great health issue of the final decades the last century, and alcohol has been targeted more recently, sugar is next on the health hit list.
Fears of the effects of processed meat on public health may have dominated the headlines early this week, but the campaign to impose levies on sugar is ongoing. It is now on the health agenda before every budget.
The Minister for Health Leo Varadkar supports a tax, but his recent proposal for a levy died at the gates of the Department of Finance. This government is cautious about introducing radical health and environmental initiatives.
There have been few landmark decisions comparable to the ban on smoking in the workplace and pubs, or the plastic bag levy. Michael Noonan may have scuppered the sugar tax, but the support that it has attracted from Varadkar, Fianna Fáil, Sinn Féin and bodies such as the Royal College of Physicians and the Irish Heart Foundation mean that the vested interests may eventually have to give way.
This has become an international issue, with a long-delayed English public health report recently calling for a tax of up to 20pc. The idea of a levy is backed with crusading zeal by the TV chef Jamie Oliver.
The priority for the Irish Heart Foundation is a tax on sweet fizzy drinks, which are linked with obesity and diabetes, with alarming consumption rates among young people. Some 15pc of people consume sweet fizzy drinks every day, but consumption rates are much higher in the 15-24 age bracket. 29pc of young men drink these high-sugar drinks daily, and consumption is highest in lower income groups.
When you look at the sugar content of some of these drinks, it is not hard to see why doctors are concerned. A typical small bottle of cola, for example, contains the equivalent of 12.5 teaspoons of sugar. More shockingly, a 500ml energy drink can contain up to 21.5 teaspoons of sugar.
Dr Francis Finucane, consultant endocrinologist at Galway University Hospital, supports a sugar tax, and believes the evidence linking sugar-sweetened drinks to diabetes is much stronger than it was five years ago.
He highlights this year's study from Cambridge University, showing that the drinks may have given rise to nearly two million diabetes cases in the US over the past decade, and 80,000 in the UK.
Professor Robert Lustig, a leading anti-sugar campaigner, has argued that sugar is toxic because it results in leptin resistance, which means our brains don't know when we're full - possibly an evolutionary throwback to our ancestors' need to gorge on ripe fruit in the autumn before food supplies dried up in the winter.
Sugar also overloads our liver, resulting in overproduction of insulin, blood-sugar crashes, cravings for more and eventually insulin resistance and diabetes, argues Prof Lustig.
When we think of sugar, we think of the white granules in a Siúcra packet, but most sugar does not come in that form. The food industry now prefers high fructose corn syrup, which is commonly added to processed food and fizzy drinks, including breakfast cereals, cereal bars, yoghurt and biscuit.
Most consumers are probably unaware that sugar is also added in this form to foods such as bread, ketchup, salad dressings and processed soups.
The World Health Organisation said recently: "Much of the sugars consumed today are 'hidden' in processed foods that are not usually seen as sweets. For example, one tablespoon of ketchup contains around 4g (around one teaspoon of free sugars)."
Dr Francis Finucane says the problem with corn syrup is that it has a higher level of fructose (sugar is made up of glucose and fructose).
"The higher level of fructose is bad for you because it is handled differently by the liver. It can overwhelm the liver, and that can cause problems with diabetes."
For now, the focus of health campaigners is on sugar-sweetened drinks. The sugar tax would work in similar ways to levies on alcohol and tobacco, but the drinks would be taxed by volume.
The Irish Heart Foundation commissioned research from an economist, and found a 20pc tax would reduce consumption by 18pc, and would yield about €44.5m in revenue.
Chris Macey, head of advocacy at the Irish Heart Foundation, says: "The money raised by the tax could be used for a Children's Future Health Fund, and this would magnify the beneficial effects."
In Mexico, where families commonly have fizzy drinks for breakfast, the government slapped a 10pc tax on fizzy drinks last year, and it cut consumption by 6pc in 12 months. More than 30pc of the Mexican population is classified as obese and the average Mexican drinks the equivalent of half a litre of cola a day. France brought in a tax of 5pc on sweetened drinks in 2012, and this led to a 3pc drop in consumption. A recent Ipsos MRBI poll showed that support for the tax has risen recently with 58pc now in favour.
Support may be growing for a sugary drinks tax, but the food and drinks lobby is likely to put up stiff resistance to the measure. Paul Kelly of Food and Drink Industry Ireland says: "A tax would affect lower income groups disproportionately, because they spend more on beverages.
"It would be a blunt instrument that penalises all consumers, regardless of their lifestyle."
Opponents have also warned that it would inevitably lead to a rise in cross-border shopping.
None of this is likely to deflect health campaigners.
Professor Donal O'Shea, director of the weight management clinic at Loughlinstown hospital, says: "All the estimates show a sugar-sweetened drink tax would have a greater effect on child obesity than any other single measure."