The global diet is getting sweeter
People all over the world are consuming more sugar, putting millions at risk for health complications including heart disease, diabetes, and stroke, according to a new report. Guzzling more sugary drinks is helping to drive the trend.
Researchers from the University of North Carolina, Chapel Hill, and City University London analyzed nutritional data from around the world and found that trends in sales of sugar-sweetened beverages are increasing in terms of calories sold per person per day and volume sold per person per day. The paper was published in The Lancet Diabetes & Endocrinology journal.
Past studies have found that the consumption of sugar-sweetened beverages, such as sodas and fruit drinks, is directly linked to obesity, heart disease, hypertension, diabetes, cancer, and an earlier death.
One study from earlier this year estimated that sugary drinks lead to 184,000 deaths each year worldwide.
The new report shows that consumption is rising fastest in low- and middle-income countries in Latin America, the Caribbean, Africa, the Middle East, Asia, and Oceania. The four regions with the current highest consumption of sugar-sweetened beverages include Latin America, North America, Australasia, and Western Europe, though intake is beginning to decline in the latter three.
"There's a large increase in marketing and sales of caloric beverages in low- and middle-income countries throughout the globe," study author Professor Barry M. Popkin, PhD, distinguished professor of nutrition at the School of Public Health, Carolina Population Center, University of North Carolina, told CBS News. "Now that there are retail outlets in every village in every country in the world, we are going to see the same types of rapid increase we've seen elsewhere. This is of particular concern to those in public health and the medical community because drinking our sugar has a much greater effect on our risk of heart disease and a number of cancers."
The researchers also looked at the U.S. food supply and found that 68 percent of packaged foods and beverages contain caloric sweeteners, 74 percent include both caloric and low-calorie sweeteners, and just 5 percent are made with low-calorie sweeteners only.
As modern supermarkets and packaged foods become increasingly common in low-income and middle-income countries, the study authors say that if things don't change, the rest of the world will move towards a similar pervasiveness of added sugars in the food and beverage supply.
"We're talking about any type of sugar," Popkin said. "They're all equally bad. At one point we speculated that high fructose corn syrup was worse than other sugars, but research has shown that every sugar -- whether that's corn syrup, sugar cane, or high fructose corn syrup -- has an equally negative effect on our health."
The researchers point out that while there is substantial evidence that added caloric sweeteners to beverages and foods are harmful to health, the evidence surrounding the effects of low-calorie sweeteners such as saccharin and aspartame are inconclusive.
One hundred percent fruit juice also poses a challenge, as some studies have suggested it has negative health effects including links to obesity, but others have not found evidence to support that claim. And to date, no randomized controlled trials -- the gold standard for scientific research -- have been done in either children or adults, representing a major gap in research.
Further studies are needed to determine whether these are good substitutes for sugar-sweetened beverages, the researchers say.
The paper also looked at a few things countries can do to help reduce the health burden of sugar consumption.
The authors found that people seem to be consuming less sugar in countries with higher taxes on sugar-sweetened beverages or foods with added sugar, including Mexico, Finland, Hungary, and France, though research is at the early stages of evaluating their effect.
Tighter regulations on marketing, more prominent labeling of sugar content on food packages, and school restrictions should also be studied to see what's most effective.
"WHO [World Health Organization], major scientific bodies, and most countries recognize the importance of reducing consumption of sugar-sweetened beverages to improve public health," the authors write. "The evaluation of not only sugar taxes, but also new marketing controls and front-of-pack labeling, is important and represents one of the next frontiers -- namely, can these policies effectively reduce consumption of sugar-sweetened beverages and intake of total added sugars?"