UK: a nation addicted to sugar.

29/01/2022
Steps of chocolate chip cookie being devoured. Isolated on white background.

Close your eyes and for a moment imagine a world without sugar. What would it look like?

How did it feel? Uncomfortable or amazing? Sugar is now our go-to for celebrations, gifts and treats but is a treat something that we consume on a regular basis? When was the last time that you consumed this treat? Weeks, days or a few hours ago? Do you control sugar, or does it control you?

In 1704 each person in UK on average consumed about 2 kg of sugar per year/1 teaspoon per day. Today on average each person consumes well over 55 kg per year/38 teaspoons per day.1 More than half of these sugars are in ultra-processed foods.2

Sugar has very recently made its way back into the UK media following the publication of the National Food Strategy, headed by Henry Dimbleby, co-founder of the Leon restaurant chain and co-author of the school food plan.3 The most eye-catching recommendation is a levy of £3 a kilo on sugar and £6 on salt which would put 7p on a Mars bar. This report is part of an overall plan which is innovative and creative as it connects diet to food companies, schools, agriculture, and culture. It also suggests using some of the generated tax to help get fresh fruit and veg to low-income families. It does not go so far as to mention or address the nations addiction to processed foods and how we guide people to break their ‘habit’.

Hopefully the government takes the report seriously, adopts all the recommendations and does not cherry pick the headline grabbers and opt for the easy option of taxation.

In 2016, it was announced that 28% of the UK adult population and 20% of children were obese and to reduce these shocking levels (and hopefully dental disease), a Childhood Obesity plan was released which involved a sugar tax.4 Companies pay £0.24 if a drink contains 8g per 100 mls or £0.18 for 5-8g per 100 mls.5 The two key parts were to remove 20% of sugar from products by 2020 and for clearer food labelling. In the latest government report published in October 2020, the average overall sugar reduction across all food categories stood at 3%, missing their target by 17%.6

 

Regarding our nation’s health, we are now entering unchartered territory and I am wondering who is going to support our sick when only half the population is healthy enough to work? This is not an exaggeration. In 2018/2019 in England alone, over 59 thousand children were admitted to hospital to have carious teeth removed under general anaesthesia. More than 13,000 of these children were aged 0-5 years.7  There are now 4.7 million people diagnosed with diabetes in the UK, that is nearly 8% of the population.8  By 2035/36, Type 2 diabetes is projected to cost the NHS £15 billion a year, or one and a half times as much as cancer does today.9  According to Cancer Research UK, healthy diets could prevent 1 in 10 cancers and poor diets contribute to 64,000 deaths per year. 10,11 There are one thousand new cancer cases every day in UK and UK is ranked higher than 90% of the world for developing cancer. UK has the 5th largest economy in the world, so we can afford to do something! 12

In my own recently published research I discovered that, for a variety of reasons dental hygienists and dental therapists struggled to stop eating sugar. Many were unaware of the new and different names for sugar found on a list of ingredients. Are you familiar with diatase or diastatic malt? There are now over 75 different names for sugar, so despite the government’s attempt for clearer food labeling, the sugar industry will find a way to confuse shoppers, including health care professionals. These dental professionals also did not expect how stress, boredom and various emotions would prevent them from eating a no-added sugar diet. The biggest surprise for many was to discover that they were addicted to sugar and were subsequently unable to kick the habit. Those who were addicted and succeeded, had to suffer many days of uncomfortable side effects. One of the biggest outcomes was that all research participants, having experienced an attempt to stop consuming sugar, indicated they would change their approach to dietary counselling and patient behaviour change.13 Maybe all healthcare professionals with a role in diet, politicians and civil servants involved in public health and all the contributors of the National Food Strategy should attempt to stop consuming added sugar. They may learn something.

According to Joan Ifland, Fellow of the American College of Nutrition and author of Processed Food Addiction, “the loss of control for processed food addicts can be as profound and consuming as addiction to drugs and alcohol.”14 Given that half the sugar now consumed is wrapped up in processed foods and considering the power of the sugar industry, Joan and many of the top international nutritional experts who contributed to Processed Food Addiction do not believe any government interventions will be completely successful until we change the dialogue. Imagine if we swapped ‘obese’ for ‘processed food addict’ and then introduced a system for a professional diagnosis, assessment, and recovery as we would for any other addiction. That would really change the narrative if it was sitting alongside the National Food strategy and may put us on a road to a healthier nation.

Now, close your eyes and imagine a world without sugar.

References

  1. Diabetes.co.uk. Sugar intake increase over the years. Available from: https://www.diabetes.co.uk/forum/threads/sugar-intake-increase-over-the-years.157076/ (accessed July 2021)
  2. BMJ Open. Ultra-processed foods and excessive free sugar intake in the UK: a nationally representative cross-sectional study. Available from: https://bmjopen.bmj.com/content/9/10/e027546 (accessed July 2021)
  3. National Food Strategy: an independent review for Government. Available from: https://www.nationalfoodstrategy.org/ (accessed July 2021)
  4. Nuffield Trust. Obesity. Available from: https://www.nuffieldtrust.org.uk/resource/obesity (accessed July 2021)
  5. UK. Soft Drinks Industry Levy comes into effect. Available from: https://www.gov.uk/government/news/soft-drinks-industry-levy-comes-into-effect (accessed July 2021)
  6. UK. Childhood obesity: a plan for action. Available from: https://www.gov.uk/government/publications/childhood-obesity-a-plan-for-action (accessed July 2021)
  7. UK. Hospital tooth extractions of 0 to 19-year old’s. Available from: https://www.gov.uk/government/publications/hospital-tooth-extractions-of-0-to-19-year-olds (accessed July 2021)
  8. Diabetes UK. Diabetes Prevalence 2019. Available from: https://www.diabetes.org.uk/about_us/news/new-stats-people-living-with-diabetes
  9. Hex, N. et al. Estimating the current and future costs of Type 1 and Type 2 diabetes in the UK, including direct health costs and indirect societal and productivity costs. Diabetic Medicine, 2012, 29(7), pp.855–862. Available at: https://pubmed.ncbi.nlm.nih. gov/22537247/; Hofmarcher, T. et al. The cost of cancer in Europe 2018. European Journal of Cancer, 2020, 129, pp.41–49. Available at: https://ihe.se/publicering/the-cost-of-cancer-in-europe-2018/ (accessed July 2021)
  10. Cancer Research UK: cancer incident statistics. Available from: https://www.cancerresearchuk.org/health-professional/cancer-statistics/incidence#heading-Zero (accessed July 2021)
  11. Tigbe, W. W. et al. A patient-centred approach to estimate total annual healthcare cost by body mass index in the UK Counterweight programme. Int Journal of Obesity, 2013, 37 (8), 135–139. Available at: https://pubmed.ncbi.nlm.nih.gov/23164699/ (accessed July 2021)
  12. World Population Review. GDP ranked by country 2021. Available from: https://worldpopulationreview.com/countries/countries-by-gdp (accessed July 2021)
  13. Ives, T. An investigation into what dental hygienists and dental therapists would discover if they attempted to stop consuming added-sugar for 28 days. Annual Clinical Journal of Dental Health, 2021, 10, 11-15.
  14. Ifland, J. Processed Food Addiction: Foundations, Assessment and Recovery. CRC Press, New York: 2020

Originally Published in Dental Health Volume 60 No. 5 of 6: September 2021