Yuletide: Experts warn against overconsumption of sugary drinks

Experts have warned against consuming excessive Sugar-Sweetened Beverages (SSBs), commonly known as soft drinks this festive season.

The experts said the warning became necessary owing to the prevalence of non-communicable diseases (NCDs) linked to consuming these sugary drinks.

The World Health Organisation (WHO) defines SSBs as all types of beverages containing free sugars, and these include carbonated or non-carbonated soft drinks, fruit/vegetable juices and drinks, liquid and powder concentrates, flavoured water, energy and sports drinks, ready-to-drink tea, ready-to-drink coffee and flavoured milk drinks.

WHO notes that these sugary drinks have no nutritional benefits and are neither an essential nor desirable part of people’s diets.

In its guidelines, the international health organisation recommends that adults and children reduce their consumption of free sugars to less than 10 percent of their daily energy intake (equivalent to roughly 12 teaspoons of table sugar for adults with a diet of 2000 kcal, and 9 teaspoons for children with a diet of 1500 kcal).

Consumption of sugary drinks has been known to increase the global burden of obesity and other associated diseases. When taken excessively, these drinks increase the risk of dental caries, type 2 diabetes mellitus, excess weight and obesity, which in turn increase the risk of heart disease, stroke, other cardiometabolic conditions and some cancers.

These NCDs pose a threat to the public health of every country that is known to consume sugar-sweetened beverages, and Nigeria is not an exception, as NCDs account for nearly 30 percent of deaths in Nigeria in 2019, according to the world health organisation’s Country Disease Outlook of August 2023.

Ali Pate, coordinating minister of health and social welfare, at a sugar-sweetened beverages conference recently, said that Nigeria faces a rising health burden resulting from high consumption of SSBs which are a major cause of NCDs

Represented by Olubunmi Aribeana, director of the food and drug services department of the ministry, Pate explained, “The consumption of SSBs has been linked to numerous health risks, including obesity, heart disease, weight gain, type 2 diabetes, kidney diseases, non-alcoholic liver disease, tooth decay, cavities, and gout.

“The health burden of SSB consumption is particularly significant in low- and middle-income countries, where rates of obesity and related health problems are on the rise. In Nigeria, we face a growing health crisis with SSB-related diseases such as obesity and diabetes. The associated healthcare costs are escalating at an alarming rate.

“Recent reviews and meta-analyses by the International Diabetes Foundation (IDF) show that as of 2021, over 3.6 million people are diabetic with 53 percent of these citizens undiagnosed; and this number is expected to rise to about 5 million by the year 2030. The cost of treating diabetes per person has surged from an average of N60,000 in 2011 to N800,000 in 2021, and it is projected to exceed N1,000,000 by 2030.”

Speaking on the cost implication of treatment, the minister said Nigerians would be spending N1 million per person to treat Diabetes by 2030.

Francis Fagbule, a public health dentist at the College of Medicine, University of Ibadan, Oyo State, noted that while there is no certainty of a direct increase in sugar-related hospital visits immediately after the yuletide season, excessive consumption of these products during the festive period contributes to worsening health conditions for many people, as these issues tend to develop slowly over time.

Explaining further, Fagbule said that in the case of energy drinks that contain alcohol, the effects could be immediate, adding that overconsumption of such beverages often causes intoxication and poor decision-making, leading to risky behaviours such as accidents and injuries. “During the yuletide season, we do observe an increase in emergency cases linked to these problems.

“In summary, people should be mindful of their consumption of sugary and alcoholic beverages during festive periods to protect their health and avoid preventable emergencies,” he said.

On the reason why many Nigerians consume a lot of sugar-sweetened beverages despite knowing the dangers, the public health practitioner said advertising, cultural and social traditions, and cheapness of price and availability remained enabling factors.

He also mentioned that consumption of sugary drinks had become a habit hence the need for continuous public health awareness messages to help break the habit.

To help reduce the consumption of sugar-sweetened beverages, Fagbule said a multi-pronged approach with practical and impactful measures would be required.

He said, “Targeted and consistent health campaigns must clearly explain the dangers of excessive sugar consumption. These messages should be simple, culturally appropriate, and shared widely on platforms like radio, television, and social media to reach everyone, including rural and urban populations.

“Strict regulations should be enforced to stop misleading advertisements that promote sugary drinks as healthy or essential. Marketing aimed at children and vulnerable groups must be limited to protect them from being influenced by these tactics.

“Encourage the production and affordability of healthier drink options like clean water, infused water, and unsweetened fresh juices. Promoting these alternatives can offer people better choices.”

He stressed the need to add nutrition and healthy lifestyle education to school curricula to teach children to develop good habits that last a lifetime. He also recommended the inclusion of clear and easy-to-understand labels showing sugar content and the health risks of overconsumption — similar to warnings on cigarette packs.

He highlighted some healthier and accessible alternatives that should be adopted to include water; infused water — adding natural flavours to water using fruits like lemon, cucumber, mint, or berries to make it more appealing; unsweetened fresh fruit juices; coconut water; unsweetened teas and milk or fortified non-dairy alternatives.

Corporate Accountability and Public Participation Africa (CAPPA), a pan-African organisation, highlighted its findings from research and advocacy campaigns against the normalisation of SSBs as staple foods in Nigeria.

Abayomi Sarumi, senior manager of Healthy Food Policy for CAPPA told BusinessDay that findings showed the SSB industry, its allies and front groups consistently undermined government policies aimed at protecting the Nigerian public.

“In this effort, the industry deploys different tactics to deny, delay, and dilute the instruments put in place by the government,” said Sarumi.

As part of the findings, he added that recently, the Global Health Advocacy Incubator (GHAI) launched a report titled ‘Sweetened Profits: The Industry Playbook to Fight Sweetened Beverage Taxes’ which exposes the SSB industry’s increasing efforts to destroy public health measures that reduce sweetened beverages consumption and protect public health.

Sarumi said the report revealed that the SSB industry used various underhand tactics to protect their markets at the detriment of the health of their consumers — the same playbook as the tobacco industry.

He said the report highlighted other tactics, “including using of false narratives to sell products, cries of economic woes to get the government to remove taxes, threat and blackmail of pulling out of the market, and even more recently, fake promises like a 1 billion investment that a multinational has promised the FG 3 times in the last 5 years.”

The healthy food policy manager said he believed that the public understood the dangers and impact of excessive sugar consumption. He however expressed worries that the public didn’t realise that sugar-sweetened beverages were loaded with excess free sugar that is dangerous for their health.

According to him, “This is because SSBs have been marketed to them as a way of enjoying their lives, a taste of luxury, and likely some beverages to give them superpowers as we have seen in the marketing of these products to kids. So, the case of awareness is about the perception and narrative built around sales of these products.

“In Nigeria’s northern region, the industry latches on the people’s cultural use of sugar to sell these products while also claiming the sugar helps them to withstand the intensity of the sun whereas in the south of Nigeria, same products are marketed on the guise of affluence and ‘something must kill a man’.

“Unfortunately, we are contesting against a multi-billion-dollar industry that understands how to use the media to shape perspectives, this makes it a hard conversation to have.”

Responding to whether or not there were sufficient regulatory policies on the part of government, Sarumi said there were different kinds of policies and regulations in Nigeria on unhealthy diets but nothing specific to the marketing of SSBs. This, according to him, underscores the reason for CAPPA’s holistic campaign for SSB tax.

In 2021, Nigeria joined over 100 countries that have introduced taxes on sugar-sweetened beverages. This tax, embedded in the Finance Act of 2021, levies a N10 tax on each litre of all non-alcoholic, sweetened, and carbonated drinks — a strategy to improve public health and healthcare financing by discouraging the consumption of sugar-laden beverages. The tax is also believed to reduce the prevalence of obesity and diabetes and, in turn, alleviate the financial burden on Nigeria’s overburdened healthcare system.