Extend the Sugar Tax
The Soft Drinks Industry Levy – popularly known as the ‘sugar tax’ – has resulted in a flurry of product reformulation. Sugar is out. Artificial sweeteners are in.
Many of our favourite soft drinks, from Irn Bru to Tango, have been re-engineered and sales in this category are on the rise [1]. Our public health czars are duly placated, seemingly content for us to guzzle aspartame, acesulfame K and sodium saccharin to our heart’s content, so long as we stay away from the dreaded white stuff. Unfortunately, this is no way to win #BritainsFatFight.
This is Hugh Fearnley-Whittingstall’s hashtag, associated with his BBC One series. On Wednesday’s episode I glued a handlebar moustache to Hugh’s face and took him for dinner at Nando’s. This was as part of the Soil Association’s Out to Lunch campaign, which is investigating the food and drink served to children at popular high street restaurant chains. Working with Hugh we secured commitments from Pizza Hut and TGI Fridays to discontinue the promotion of refillable sugary drinks across their adult and child menus – we estimate that this will take over two hundred tonnes of sugar off the menus at these chains annually. While this is a step in the right direction, both chains are now plugging artificially sweetened drinks in their place, and they are promoting these drinks to children.
Sweeteners are controversial
The debate over their benefits and risks rumbles on in popular press and academic literature. Leaving aside the concerns over their safety, their potential contribution towards diabetes, their purportedly harmful affect upon gut health and metabolism, one important issue, often overlooked in the debate, concerns their influence over our behaviour and expectations, particularly in childhood.
“Artificial sweeteners are not the answer to childhood obesity,” states psychologist Susan E. Swithers of Purdue University, bluntly. “Exposure to hyper-sweetened foods and beverages at young ages may have effects on sweet preferences that persist into adulthood."[2].
It’s partly an issue of what we train our palettes to enjoy. We are born with a sweet tooth and we learn to enjoy more bitter flavours, such as those found in many vegetables, as we grow up and begin to eat a more diverse diet. The excessive consumption of artificially sweetened foods and drinks in childhood, even those that are ‘low calorie’, can inhibit this learning, meaning we fail to develop a taste for those bitter but nutritionally-important leafy greens [3].
“In the real world, artificial sweeteners are not specifically helpful at reducing sugar intake,” Swithers continues, for they create “altered preferences and thresholds” for sweetness. We consequently seek out the very sugary foods we’re meant to be avoiding – studies have shown that high levels of sweetener consumption are associated with excessive sugar consumption [4]. Perhaps flogging children artificially sweetened fizz isn’t as benign as public health guidance seems to suggest.
Our public health authorities probably know this. While they’re doing their best at maintaining a pretence at consensus agreement on the benefits of sweeteners, one doesn’t have to dig far beneath the surface for this pretence to begin to crumble.
The Health Select Committee, presenting recommendations for the Childhood Obesity Plan in 2016, notes that “Public Health England does not reach a clear conclusion on whether a reformulation programme should be with or without sugar replacements.” Public Health England has endorsed the use of sweeteners, but with a quietly-spoken caveat: “There may be advantages in businesses not adding sweeteners to their products and gradually reducing the overall sweetness of their products because this allows for people’s palates to gradually adjust to less sweet food.”
Such an approach was successfully employed to reduce salt consumption in the UK. Our salt intake has been reduced by 15% in the past decade through a carefully managed reformulation programme that has allowed our palates and preferences to adapt [5]. This is perhaps harder to achieve with sweet foods, but such an ambition has not been adequately explored. Soft drinks manufacturers have conceded that consumers do not seem to detect reductions of around 4% in the sugar content of drinks, where these have not been replaced with sweeteners, but there is no incentive to build on this insight to progressively re-educate our tastes.
We need to rediscover the joy of real, fresh, unprocessed food
The French Government recently took the bold move of banning refillable soft drinks – sugary and artificially sweetened – in restaurants nationally [6]. As our Government gears up to publish the second chapter of the Childhood Obesity Plan, it should be aspiring to be equally bold. This means looking beyond reformulation and the succour of sweeteners to policies that help us rediscover the joy of real, fresh, unprocessed food. Such an ambition is particularly important for children growing up in Britain, where we consume the most ultra-processed diet in Europe [7], who need nourishment and a connection to good food, not a diet of calorie-reduced artificially sweetened junk.
It also means looking for fiscal incentives that reduce the use of sweeteners in parallel with sugar. Extending the sugar tax to include sweeteners is one option that should be explored. The unpalatable truth is that so long as we remain hooked on sweeteners, our best efforts to tackle childhood obesity and win #BritainsFatFight are likely to fail.
[2] http://www.appstate.edu/~steelekm/classes/psy5300/Documents/Swithers2015-obesity.pdf
[3] https://www.health.harvard.edu/blog/artificial-sweeteners-sugar-free-but-at-what-cost-201207165030
[4] http://www.appstate.edu/~steelekm/classes/psy5300/Documents/Swithers2015-obesity.pdf
[5] http://www.actiononsalt.org.uk/uk%20salt%20reduction%20programme/145617.html/
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