Australia's “not-so-sweet” stance on sugar policy

Australians consume an average of a ½ kilo of sugar per week, much of it ‘hidden’ in high-sugar foods. For Sugar Awareness Week (13 – 19 November), VicHealth Postdoctoral Researcher Adyya Gupta (@AdyyaGupta) of Deakin University (@IHT_Deakin @GLOBE_Deakin) explains the current policy climate in Australia for regulating free sugars and what policy options are under consideration to create a healthier food environment.  

The State of Sugar Consumption in Australia

Sugars are a type of carbohydrate that provide energy to the body. Sugars are of two types: natural and free (or added) sugars. Natural sugars are sugars that are found in fruits and vegetables and are healthy – but it is the free sugars that are of concern.

The World Health Organisation defines free sugars as “all monosaccharides and disaccharides added to foods by the manufacturer, cook, or consumer, plus sugars naturally present in honey, syrups, and fruit juices”. The common sources of these free sugars are a range of energy-dense and nutrient poor food groups (discretionary foods), and include sugar-sweetened beverages, table sugar and sweet spreads; cakes, biscuits, pastries and batter-based products; sweetened dairy products; chocolate and confectionery.

Australians consume on average far more free sugars than the recommended amounts. Part of the reason is that sugar is ‘hidden’ in many everyday foods. Photo credit: Congerdesign on Pixabay.

The World Health Organisation ‘strongly’ recommends limiting the intake of free sugars to <10% of total energy intake for better overall health. This is equivalent to 12 teaspoons of sugar a day for an average adult. The World Health Organisation further ‘conditionally’ recommends limiting the intake of free sugars to <5% of total energy intake, for additional health benefits of reduced dental caries. The is equivalent to 6 teaspoons of sugar a day for an average adult. For reference, the average can of soft drink contains 10 teaspoons of sugar.

Approximately one in two Australians exceed the <10% recommendation and nine of ten exceed the <5% recommendation for free sugar intake. Consuming free sugars above the recommended levels is a leading cause for several preventable health problems such as overweight or obesity; type-2 diabetes; tooth decay, heart diseases and cancers. More than one-third of adults across all demographics, socioeconomic and health behaviour groups in Australia consume >10% of free sugars. Over half of young Australians consume >10% of free sugars from sugar-sweetened beverages.

Sugars, which historically was regarded as a luxury due to its rarity, is now both readily available and affordable. It is now found in every household and has become an unquestioned part of our typical diet. Food choice decisions are complex. Food environments play a significant role in determining population food choice and health outcomes. In the Australian food environment, individuals are persistently bombarded with conflicting information about free sugars in food and unhealthy advertising in general, leading to moral conflicts when making food choice decisions. For example, supermarkets are laid with rows of high free sugar-containing food and beverages, often at cheap prices (compared to healthier food options), nudging both children and adults’ food choices.

In the new digital age, the digital food environment mirrors this reality. In a quick scroll through social media or a website for online grocery shopping or online food delivery services, consumers are exposed to a plethora of unhealthy marketing tactics that influences their food choice decisions. My research found that this creates a discrepancy in understanding different types of sugars and how much of those are free sugars , leading to moral conflicts within individuals when make food purchase decisions. Every individual navigates through these persistent moral conflicts between one’s inner dispositions and self-presentation in their own ways to justify their food choices. Food industries take advantage of these individual-level moral conflicts to put the onus back on the consumers for their food choice decisions.

While every individual has the right to make their own food choices, high intake of free sugars is a population-level problem that requires population-level solutions. It is evident that our current food environment is not conducive for making healthy food choice decisions. New forms of selling and purchasing foods high in free sugars via built food environments such as supermarkets or digital food environments such as online food or grocery delivery platforms, makes contemporary food environment complex and underscores the pervasive nature of this public health challenge. Industries are exploiting the user-generated data to develop content to influence consumers to purchase and consume unhealthy food. This requires the government to shake up its status quo, and introduce deliberate policy reforms to create a healthier and supportive food environment. This will enable consumers make more informed food choice decisions.

Government Initiatives: Tackling Sugar in the Australian Diet

There is worldwide acknowledgement that increased availability and affordability of foods and drinks high in free sugars are a public health problem. To tackle this, 85 countries and jurisdictions have already adopted a range of policies to reduce high intake of free sugars in population diets, which have demonstrated significant health and economic benefits. This includes introducing a health levy on foods and drinks with free sugars, limiting unhealthy marketing of foods and drinks with free sugars, product reformulation, mandatory labelling of free sugars, zoning, mass media campaigns, and creating a healthy food environment by replacing unhealthy with healthy alternatives in vending machines, at supermarket checkouts and food outlets.

But you may wonder, what is Australia’s position with its policy action on availability and affordability of foods and drinks high in free sugars? Australia is lagging behind other countries in tackling the public health challenge of high free sugars consumption. There is currently no mandatory policy in Australia despite evidence from economic modelling demonstrating the health and economic benefits for Australia.

Australian Dietary Guidelines advise Australians to ‘limit intake’ of foods and drinks containing added sugars, with no defined thresholds for free sugars consumption. Furthermore, Australia has a government-endorsed front-of-pack nutrition labelling system, the Health Star Rating (HSR) system, but it is voluntary and has limitations. Also, the current standards and codes that govern food advertising in Australia are largely industry regulated and no policy regulation exists for the challenging online food environments, which are evolving and expanding rapidly.

At the moment, the HSR system is currently under review to improve its labelling for free sugars, as well as added sugars across all categories. A recent nationally representative survey in Australia suggests 75% of the general public support restricting sugary drinks in school vending machines and junk food advertising bans to children under 16 years of age. The study also found that two-thirds of respondents were supportive for zoning to restrict the sale of junk food near schools, while over half backed a sugar tax on unhealthy food and drinks. As Australians demonstrate a strong public support for policy initiatives to address unhealthy diet in Australia, it is time policymakers take strong action in the interest of its population’s health and well-being.

Future Directions: Sugar Policy Down Under

So, while the public health problem of sugar is undeniably challenging, there is hope on the horizon. Australia’s commitment to WHO’s global target to halt the rise in overweight and obesity is an important opportunity for government, industry, the community, and individuals to work together to make healthier choices easy choices. The National Obesity Strategy 2022–2032 is a key resource to guide the country’s actions to transform the overall food environment (physical and online) to support health and well-being. As we continue to explore the ways to tackle the multifaceted public health problem of free sugars, collective and synergistic efforts are needed to create a social movement to drive political change to shape a future where our relationship with sugar is healthier, more balanced, and aligned with our well-being – making Australia a healthy yet delicious place for generations to come.

Dr Adyya Gupta currently holds a VicHealth Postdoctoral Research Fellowship. Her research explores how online food delivery systems target children and young people with advertisements. Her views may not reflect the position of VicHealth.

Posted by @SusanMaury