The Sugar Dilemma

| October 24, 2012 | 1 Comment

Sugar intake is increasing globally, corresponding with elevated rates of obesity, type 2 diabetes and certain forms of cancer. If these trends are not soon reversed, the world will continue to suffer from a host of non-communicable diseases.

The global burden of non-communicable disease has skyrocketed in the past decade. For the first time in human history, chronic non-communicable diseases such as heart disease, cancer and diabetes pose a greater health burden worldwide than do infectious diseases, contributing to 35 million deaths annually[1]. Developing countries must now bear the crippling double burden of both non-communicable and communicable disease. Although there are many drivers for recent surge in non-communicable disease, one of the biggest is undisputedly increased dietary use of refined sugar. In order to reduce the significant economic burden non-communicable disease represents, developing countries must find a way to regulate consumption of sugar and other unhealthy foods. A “sugar tax” on sweetened beverages like soda, currently the subject of much debate in the U.S., might be a way to curb global NCD rates. While the benefits of a sugar tax are clear from a public health standpoint, such a tax does present some ethical quandaries and drawbacks.

With the advent of globalization, sugary foods have become increasingly available in the developing world. Sugar consumption has more than tripled worldwide in the past 50 years[1]. Unlike the glucose sugar found in bread, potatoes and other starches, fast foods, deserts, juices and sodas contain high amounts of both glucose and fructose. When this dangerous cocktail hits the liver, it is immediately converted to fat, and can cause a condition known as insulin resistance[2]. Insulin resistance is now considered the fundamental problem in obesity, and the underlying defect in heart disease, type 2 diabetes and some forms of cancer[3]. Harvard researchers recently reported that women who drank one or more sugar-sweetened soft drinks per day were 83% more likely to develop type 2 diabetes than women who drank less than one a month. Due to increased sugar intake, the developing world is currently suffering from a double burden of communicable and non-communicable disease; only laws that work to regulate sugar consumption can help address this devastating burden.

Given that sugar’s effects on the human liver underlie many of the cases of obesity, diabetes and cancer, what can countries do to better regulate sugar consumption?  Denmark has taken a step in the right direction.  Denmark first chose, in October 2011, to tax foods high in saturated fat[4]. Now, the country is considering taxing sugar as well. Revenue generated from the tax will be invested into the national public health system.  A sugar tax has the potential to not only encourage healthy eating habits, but also to provide a much needed source of income for public health systems in both the developed and developing worlds.  Thomas Frieden director of the CDC claims that a penny an once tax could reduce sugar consumption by 10%, and raise 100 billion over 10 years [5].

Yet in the U.S., proposed sugar taxes have met with fierce opposition from powerful soda and fast food lobbyists.  These lobbyists claim that a sugar tax is unethical.  When asked about the tax Muhtar Kent, chief executive of Coca-Cola, responded: “I have never seen it work where a government tells people what to eat and what to drink,” Kent said, “It if worked, the Soviet Union would still be around.”[6] Yet taxes and regulations on alcohol and tobacco—substances that like sugar are also harmful in excess—already exist in the U.S. and around the globe.  Because refined sugar is not found in nature, has been shown to have addictive properties, and leads to metabolic disease, it needs to be regulated[1].  Already, Canada and some European countries impose small additional taxes on processed foods that contain added sugars, such as HFCS and sucrose[1].  However, there needs to be a more forceful global push to use alcohol and tobacco regulation strategies for sugary drinks and foodstuffs.

In addition to taxation, reducing availability of sugar, by controlling the location and density of retail markets, tightening licensing requirements on vending machines and snack bars, and limiting who can legally purchase sugary foods could help decrease consumption.  Finding a way to regulate refined sugar, which has been conclusively shown to be a drug similar to tobacco and alcohol, is crucial for both the health of developed and developing countries.  Failure to curb global sugar consumption will condemn the world to yet another decade of rampant obesity, diabetes and cancer.


  1. Lustig, Robert H., Laura A. Schmidt, and Claire D. Brindis. “The Toxic Truth about Sugar.” Nature 482 (2012): 27-29. Print.
  2. Feature, Katherine Kam. WebMD. “Sugar Health Effects: Is Refined Sugar Bad For You?” WebMD. WebMD, 10 Jan. 0000. Web. 22 May 2012. <>.
  3. Pasco MY, Léopold P (2012) High Sugar-Induced Insulin Resistance in Drosophila Relies on the Lipocalin Neural Lazarillo. PLoS ONE 7(5): e36583. doi:10.1371/journal.pone.0036583
  4. “Minister Defends Controversial Sugar Tax.” The Copenhagen Post. Web. 22 May 2012. <>.
  5. Neuman, William. “Proposed Tax on Sugary Beverages Debated.” The New York Times. The New York Times. Web. 22 May 2012. <>.
  6. Koch, Wendy, and USA TODAY. “Soda Makers: Don’t Tax Our Soft Drinks.” ABC News. ABC News Network, 17 Aug. 2009. Web. 22 May 2012. <>.

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Category: NCDs, Online

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