Public Health News South Africa

New salt regulation could pave way for sugar intervention

The new legislation on regulating salt content in food in effect since the beginning of July - although appearing without much fanfare - is a welcomed move by government. As a member of the Public Health Community of South Africa, we are motivated by these developments and are confident that the fight against obesity and high consumption of sugar-sweetened beverages (SSBs) will be equally prioritised and receive the same commitment by all stakeholders.

Driven by big food industries

Excessive salt consumption is linked to the epidemic of hypertension and its cardiovascular fallout. The magnitude of these and other lifestyle diseases is putting a strain on our healthcare system and we cannot afford to look the other way anymore.

These damaging health concerns are driven by “big food industries” to improve “taste” in an effort to create demand and thus increase sales and profit. Of great concern is the excessive and widespread marketing and advertising of salty and sugary food to children. It is a biological fact that children, especially, have a fondness for sweet and salty flavours, which puts them at high risk of addiction to these products.

New salt regulation could pave way for sugar intervention
© Nicoleta Ifrim-Ionescu 123RF.com

Proposed law on sugary drinks

On the back of the salt legislation now in effect, which will enforce the gradual reduction of salt content on certain foods, the policy paper released by Treasury outlining the proposed tax to be levied on SSBs is a milestone towards efforts to beat obesity. According to research by Priceless SA, adult diabetes could cost South Africa’s healthcare system between $1bn and $2bn by 2030.

Cause and effect

When it comes to non-communicable diseases (NCDs), unfortunately there is a lack of perception of “cause and effect”. Unlike communicable diseases such as HIV, tuberculosis and even Ebola, the public perception of these ailments is that there is a cause (virus) and an effect which is the actual illness (that can lead to death). There is a visual imprint in the minds of people of a negative association between the virus and the outcome/illness.

The problem that contributes to the rise in NCDs is that this negative causal relationship imprint does not exist in the minds of the population.

For example, we know that excessive consumption of sugar, such as SSBs, is a major contributor to the development of obesity and type 2 diabetes. However, the public doesn’t see it this way as they have an incorrectly perceived “positive” imprint of SSBs in their mind. Through mass marketing and advertising and today’s access to social media and the internet, these products have become part of normal consumption. At the end of the day we are faced with a situation where “abnormal has become the perceived norm” and people continue to blindly consume products that eventually lead to dreaded diseases such as diabetes.

The proposed tax, while it will only be a first step, will bring much needed attention to blind consumption of SSBs. Research shows that there could be 250,000 fewer obese South Africans in three to five years if the SSB tax is introduced. An intervention is needed as SSBs have no nutritional benefit whatsoever, but contribute directly to the increasing incidences of obesity, diabetes and other lifestyle-related illnesses. We need parents to contemplate that giving SSBs to their children is as harmful as giving cigarettes and alcohol to them.

SSB awareness campaigns

In our current economic climate, I hope that there will be an overwhelming sense of necessity among our leaders to take care of the nation and take control of non-communicable diseases and obesity which could be avoided through healthier food choices.

The proposed SSB tax requires support from education campaigns and reinforcement through accurate food labelling. As awareness increases, I hope that there will be a shift in perceptions and finally people will question what they’re putting into their bodies and how it will affect them. Without urgent preventive measures we will face a dire situation of growing deaths and disabilities in the next few years. This will disproportionately impact women, children and the poor and overwhelm our health syst

About Dr Sundeep Ruder

Dr Sundeep Ruder is an endocrinologist at Life Fourways Hospital, honorary consultant at Charlotte Maxeke Academic Hospital, associate lecturer at University of Witwatersrand and one of the representatives of the Public Health Community of South Africa that strongly endorse the decision to implement a sugar-sweetened beverage tax in 2017.
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