No sugar coating: what should we do?

Welcome to our first interactive HiveMind exploration on the important topic of 'sugar and obesity' in New Zealand. We have provided some background to this issue and identified six potential perspectives below. Is your view represented? Do you have anything to add? Have your say at the bottom of the page.

Background

While most people agree that increased sugar consumption is a major cause of too many New Zealanders being overweight and obese, what we should do about this remains a matter of debate and argument. Whatever the nature of the disagreements, there does seem to be a consensus that this problem needs to be addressed fairly urgently. Because of the negative downstream effects on public health, the public health system and even economic productivity, doing nothing doesn’t seem to be an option.

How then should we approach the connection between high levels of sugar consumption and these issues? Given that the effects of excess body weight will affect us all, either directly or indirectly, it seems reasonable that we should have an opportunity to influence what is to be done. Like most public policy issues, it is rarely the case that there is a win-win situation; usually there are losses and gains along the way. HiveMind invites you to help figure out where these losses and gains lie and who, if anyone, should carry them.

There’s no sugar coating the current statistics

New Zealand is the third most obese and overweight nation in the OECD with 31% of the population obese and a further third overweight. Thirty years ago, only 10% of the population was obese. Māori, Pasifika peoples and low-income communities are all over-represented in the obesity statistics. Obesity affects lots of New Zealand children too; in 2013, 11% were obese and 21% overweight.

The World Health Organisation recommends a daily sugar intake of 6 teaspoons of sugar for adults and 3 teaspoons for children. New Zealanders consume, on average, about 37 teaspoons of sugar per day. The number one source of sugar in the New Zealand diet is from sugary drink.

Increased sugar consumption is not the only factor contributing to these statistics. The rapid rise of obesity is also about changes in the way we live and in what we eat. Factors include more sedentary lifestyles, increased snacking, more eating out, larger portion sizes, and the increased availability and marketing of cheap, calorie-rich food.

High-levels of sugar in drinks and processed food coupled with excessive consumption are major causes of obesity, type 2 diabetes, heart disease, tooth decay, and premature ageing. Sugar is used in these products for flavour, texture, as a filler and as a preservative. The use of sugar increased significantly about 2 decades ago. Some claim that this was an industry response to concerns about excess fat in processed food: sugar was added to make low-fat products more palatable. Others suggest that the food and beverage industry added excess sugar because it it is a cheap filler.

What is being done about the number of obese and overweight people?

Current initiatives aim to encourage individuals to lead healthier lifestyles and the food and beverage industry to voluntarily provide healthier products and consumer information. The industry has responded by producing more low- and no-sugar products, which now make up a significant proportion of sales.

What more can be done?

Sugar consumption is too high and most New Zealand experts say that the government should be using stronger measures such as a tax on sugary drinks, mandatory labelling requirements and controls on the marketing of unhealthy food and drink, particularly to children. They argue that other developed countries are using these measures now, which are recommended by the World Health Organisation, and that New Zealand should too.

The Issues

Should New Zealand introduce these measures? Are there other ways of understanding this issue or other approaches to solving it? Should other measures such a tax on saturated fats and removing GST from fruit and vegetables also be considered? What impacts would such measures have? Would they be effective or could they make things worse? We invite you to explore these questions on HiveMind with a range of fellow New Zealanders.

Differing Perspectives

To help you work through the issues and identify ways forward, we encourage you to consider the issue from multiple perspectives. Solutions are more likely to work if they take all interests into account - so we have sketched out six simplified perspectives below. These are ‘ideal types’ offered as a starting point and do not represent all the possible ways of looking at this issue.

To get things rolling, we have seeded this HiveMind exploration with a few statements from each of these perspectives. Please vote on these and then add your own perspectives for others to vote on.

Please come back to this HiveMind exploration over the course of the next three weeks to help shape what emerges. We intend to close this exploration on 20 December 2016 and look forward to reporting the results back to you when it is over.

Simplified Perspectives

1. Free to choose

Individuals should be free to decide whether and to what extent they consume products with high levels of sugar as long as they don’t harm others. Intervening in people's lives to take away personal choice is to treat them as children and disempower them. We should never lightly take away people's autonomy to make decisions.

‘Paternalist’ interventions such as taxes and regulation are often counterproductive and make things worse. For example, taxes on sugar simply make it even harder for poor people to afford to buy things they prefer. People and governments shouldn’t be able to impose their personal tastes, preferences and likes and dislikes on others.

The government should not limit an individual’s freedom to choose unless those choices are seriously harming others. Any interventions must be shown to be effective at stopping the harm without causing negative unintended effects.

Possible actions for the ‘Free to Choose’ perspective

• Design policies which a focus on preventing harm to others, not self-harm

2. Personal responsibility

People should be responsible for their making their own decisions about what and how much they eat and drink as long as accurate information and appropriate education is provided. If things clearly state what the risks are and if you choose to do that risky activity then you can’t blame others for any negative consequences.

Possible actions for the ‘personal responsibility’ perspective

• Retain current policy settings based on voluntary measures

3. Consumer interests before profit

Sure, sugar has some practical uses such as flavour, texture and as a preservative. But the significant increase in sugar in our food and drinks is there to make food and drink more appealing and addictive hence increase sales revenue.

Hugely expensive marketing campaigns for sugar-rich food and drinks, especially those aimed at children, are just another example of an industry more interested in profit than the health and wellbeing of consumers.

Possible actions for the 'consumer interests before profit’ perspective

• Ban or restrict the marketing of sugary drinks and food to children and teenagers

• Regulate the food and beverage industry to force them to lower the amount of sugar in food and drinks

• As a first step, tax a sugary drinks as they are a major cause of excess weight amongst children and teenagers

4. Health science

The evidence is clear: the overconsumption of sugar in drinks and processed food is a major cause of the obesity epidemic and associated health problems. This is placing a heavy burden on the health system and economic productivity and things are getting worse.

Governments in other countries are taking an active role to ensure that the amount of sugar in food and drinks is significantly reduced and a lot has been learnt about how to do this. The NZ government needs to act much more boldly and with much more urgency.

Reducing the intake of sugar should be Government policy goal. This is especially important for children and teenagers, and those parts of the community with very high levels of consumption.

Sugary drinks should not be cheaper than healthier choices like water and milk. A tax on sugar and/or price controls would fix this problem and help cut obesity levels. A ban on point of sale promotion of high sugar items in supermarkets would be useful.

Possible Actions for the ‘health science’ perspective

• Impose a tax on sugar in drinks

• Use food taxes and subsidies to encourage the consumption of health food and discourage the consumption of unhealthy foods

• Use price controls to ensure that sugary drinks are not cheaper than healthy options

• Impose restrictions on junk food marketing, particularly to children

• Impose a ban on point of sale promotion of high sugar items in supermarkets

• Invest in better information and education about the health impacts of sugar

5. Correct the drivers of inequality

The sugar problem is just part of a wider set of complex issues to do with deprivation and poverty, which are linked to social and economic structures. A range of initiatives are needed to solve this including raising incomes and improving working conditions. People must be able to afford healthy food and drinks and families must have enough time to prepare healthy meals.

Wealth inequality per se is detrimental to individual health. As distressed individuals have repeatedly been found to alter their eating habits and behaviour in favour of easily digestible, caloriedense foods, rising levels of stress caused by growing inequality have contributed to the rise in obesity.

It would be better to focus on affordable, dry, warm housing than sugar and obesity as this would have more positive impacts on health and wellbeing, and on costs to health system and economy.

Possible actions for the ‘correct the drivers of inequality’ perspective

• Interventions need to go beyond the regulation of sugar and address the drivers of inequality

• The government should correct inequalities using progressive taxes, regulation and initiatives to improve the lot of communities

• Initiatives to improve the lot of communities need to be developed in collaboration with communities so that they are effective and not paternalistic

6. Tangata whenua perspective

Colonisation and repeated breaches of the Treaty of Waitangi, resulted, in amongst other things, the loss of land resulting in high levels of poverty and lack of access for many Māori to traditional food.

The Government’s structural reforms of the 1980s and 1990s were accompanied by increasing levels of unemployment and poverty for Māori. Overall, the health of Māori got worse during this period compared with New Zealand Europeans.

The Treaty of Waitangi makes clear references to Māori health and places obligations on the Crown to protect Māori and their health. The Crown also has a duty to ensure this is done in partnership with Māori.

Māori dietary patterns reflect their lower socioeconomic status. Healthier foods cost more, so Māori tend to eat the cheapest foods, which are usually high in fat, sugar and salt.

Understanding that the current levels of obesity amongst Māori are a result of history, means moving beyond the ‘blame game’; the current situation is not about a lack of effort by Māori or about ‘inferior genes’. When you take into account the history and the barriers Māori face, you can identify appropriate interventions to address obesity, bad health and inequalities. Long-term, coordinated, multi-sectoral and structural policies and actions are most likely to reduce weight-related health issues.

Possible actions for the ‘tangata whenua’ perspective

• Health services will better meet the needs of Māori by allowing Māori greater autonomy in the design and delivery of those services.

• Don’t harm low income Māori financially by using taxes to increase the price of food and drink

• Encourage Māori to set up māra kai (vegetable gardens) and teach gardening and cooking skills with a wider range of healthier methods

• Support Māori educational achievement which correlates with better diets and better health.

Have your say here: Agree/Disagree/Pass on the statements and see where your view fits

For more information and instructions about participating in this HiveMind exploration please see the following links:

Click here for facts and research on Sugar and obesity

Click here to find out more about Hivemind and the Pol.is software