The only good news about sugar is that people are now talking about it loudly, often and with one voice. There is one clear message which says lets decrease our sugar intake. As far as we aware there are no DIRECT effects of sugar consumption on the development of cancer development but what about indirect effects?
In the 2007 WCRF report on Diet, Physical Activity and the Prevention of Cancer recommended that we should avoid consumption of sugary drinks and this advice has been communicated by many (but not enough) cancer agencies. In 2013, The European Code against Cancer added further weight to this guidance highlighting that “we should avoid sugary drinks” defined as “those that have a substantial amount of calories from sugar – naturally, as in fruit juices or smoothies, or added, as in many soft drinks or fizzy drinks”. This recommendation is made because of a large body of evidence which shows that higher consumption of sugar sweetened beverages results in weight gain and an increase in body mass index.
Weight gain is the route that leads to excess body weight and obesity. We do not start life with excess body fat. The creep of body fat might start in early childhood (associated with feeding breast milk substitute and early weaning), or later in childhood as sugary drinks and fast food became popular or in busy adult life or mid-life or later. Weight gain, like cancer is a disease that may have origins in early life and but is also influenced by actions throughout the life course.
Excess body fat is associated with cancer of the bowel, breast, endometrium (womb), ovary, prostate (advanced), gallbladder, kidney, liver, oesophagus and pancreas. Keeping calorie intake down whilst burning calories through physical activity is easy to say but harder to achieve, especially if we are uncertain about what our food contains and when it is superbly marketed and sold in many tempting forms. The campaigning for plain packaging of cigarettes by CRUK provided clear information on how children can be influenced by shiny colours and designs. If brown sugary liquids were sold in plain bottles (no swerves, curves and stylish swirls), with no iconic colours or insignia and no magic tunes to sing along with, would we still be persuaded this was the purchase of our dreams? If those plain bottles had a government warning on weight gain would this make us think twice about purchase?
Reducing sugar intake to 10% of total energy intake (with further reductions to below 5% also being suggested) is the recommendation from the World Health Organisation in their Guidelines for Sugar intake for adults and children released last month. This recommendation stems from the evidence on sugar and dental caries as well as weight gain. Many commentators have said that a (responsible) food industry will alter the composition of products to decrease sugar. We need to remember however that the magnitude of change needed is big and we really need significant action to make a difference. One question we would like to ask is “What is the reduction in sugar that our iconic, national (Commonwealth games) drink aims to achieve?”
Professor Annie S Anderson BSc PhD RD FRCP (Edin)