Joe's Diabetes

Not so sweet after all. Sugary drinks cost lives. But who should pick up the bill?

Recently there was a report from scientists at Harvard, Washington, and Tufts Colleges in the US, and Imperial College in London on sugary drinks. It concluded that in the 51 countries studied, 184,000 people died every year due to consumption of sweet beverages. Of those deaths, 133,000 were due to type 2 diabetes.

One of the popular ideas linking sugary drinks and type 2 diabetes goes like this.  If you eat a lot of carbohydrates in binges over a long period of time (a few years or more) you induce a lot of insulin surges. With every surge you start to become used to higher levels of insulin in your system, until eventually you lose your sensitivity to it. That’s when you become type 2. It's not scientific fact, but it's an interesting theory, and although I don't believe it works quite in this way - see 'Open diabetes: what it means to them' - for sake of argument let's say it's right.  

How do sugary drinks come in to this? Well, they are the quickest and easiest way to consume large amounts of carbohydrates without even realising it. For example, if you go to McDonald’s and get a medium meal of a burger, fries and a ‘full-fat’ coke, the drink will have more carbs than either portion of food. When you think how easy it is to drink a few cokes in a day (certainly easier than eating a multiple burgers or hundreds of fries), you can see how sugary drinks allow a massive and somewhat stealthy intake of carbs.

Related to the report on deaths due to sweetened drinks, doctors from the British Medical Association (BMA) released a report calling for better regulation of ‘junk food’ marketing as well as a 20% tax on all sugary drinks. They claim that such a tax would dissuade people from consuming such drinks and that

“the use of taxation measures on unhealthy food and drink products has consistently been found to have the potential to improve health, with relatively high taxation levels (in the region of 20 per cent) needed to achieve positive health outcomes”

At first sight it seems to be a good idea: increase the price to stop people buying so many drinks, and use the income to help pay for the treatment of type 2 diabetes. But wait a moment. As a type 1, I sometimes need sugar in an emergency. And sugary drinks are the fastest way to treat a hypo. Would the type 1 population be exempt from this tax? It doesn’t seem fair to increase the price of something which I depend upon for my health and well-being.

Also, if we’re going to tax unhealthy products, why should it be the consumer that bears the burden? Why not tax the companies that are making vast amounts of money at the expense of our health? Also, why are the drinks themselves unregulated? Couldn’t we put a limit on the percentage of sugar in drinks, nothing over say, 7% (coke is 10% and some ginger beers are as much as 14%)? Or could we force such drinks to have plain packaging and carry health warnings as we do with tobacco products? Surely all of these are measures worth exploring before we penalise the consumer.

 

Before we consider these ideas though, why aren’t we looking at why people choose to consume sweet drinks? Isn’t it obvious, Joe, it takes good, you might say. Sure. But why is that? Evolution, you say. I agree, but there is also a link between the desire for a sweet taste and stress, it makes you feel better (http://www.medicaldaily.com/does-stress-make-sweet-food-taste-better-stress-hormone-found-among-sweet-taste-cells-286436). The most stressed people in society are the poorest, those who struggle to make ends meet. They are also the people who consume the most sugar, as not only are they stressed but also cheap, processed foods are full of the stuff. So what would a tax on sweet drinks achieve? Well, it would probably just end up making the poorest people poorer, and so more stressed, and so more likely to keep on consuming sugar.

So what’s the answer? Well, I think to address a problem on the scale of type 2 diabetes you have to think big. Taxing the consumer will not work. Taxing the companies might have an effect (so long as the tax wasn’t passed on to the consumer in raised prices). Education might help a bit: if people knew the dangers, they might not have as many sweet drinks. But that comes with a caveat: just because you know something is unhealthy doesn’t mean you won’t do it. But more than any of those, we need to make sure that the poor aren’t quite so poor. Money worries are the greatest source of stress for the people, and it is stress that leads to a desire for sweet things. Raising the minimum wage to the Living Wage standard of at least £7.85 per hour outside London would help. (Actually this figure needs to be revised upwards since it is judged reasonable only when it includes tax credits… which are being cut.) Increasing the amount of social housing would help as well since it would stop people having to pay large chunks of their already low income on market rents.

To become a healthy nation, we must act become a politically healthy nation and make sure everyone is provided for, or our social disease will continue to be manifest physically.