Sana Ullah Ghumman
Obesity has emerged as a global health problem. According to WHO estimates, 1.6 billion adults worldwide were overweight and at least 400 million were obese. Epidemic studies indicate that overweight and obesity are important risk factors for Non communicable Diseases like cardiovascular diseases, hypertension, type 2 diabetes and some types of cancer. Consumption of Sugar Sweetened Beverages is a major cause of obesity. Sugar Sweetened Beverages include any liquid with added sugar or other sweetener like high fructose, corn syrup, sucrose, fruit juice concentrates and more. This includes soda, cola, energy drinks, packed fruit juices and flavored milks. Situation in Pakistan is even worse.
According to report of National Step Survey for Non communicable diseases (2014 – 15) carried out by WHO and by Pakistan Health Research Council 41.3 % adults in Pakistan were obese or overweight and 37% have hypertension. International Diabetic Federation report for 2021 shows alarming figures that Pakistan has the 3 rd highest burden of type 2 diabetes worldwide with over 33 million cases. National Nutrition Survey (2018) indicates that overweight and obesity in the women of reproductive age (WRA) has increased from 28 % to 38 % from 2011 to 2018. The prevalence of overweight under 5 years has almost doubled in this period. According to WHO, NCDs have caused over 800,000 deaths in Pakistan in 2016.
International Diabetic Federation (2021) report shows that nearly 400,000 deaths are attributed to diabetes and its complications. 1100 lives per day lost due to diabetes. In 2015 cost of obesity was estimated to be 428 billion Pak rupees. According to IDF (2021) report, expenditures to manage diabetes were 2640 million US$. We need to understand why these SSBs are dangerous to health. The amount of sugar in one serving is very high. There are 4.2 grams of sugar in a single teaspoon and there are 7 – 9 teaspoons in one serving. These drinks provide so many calories and no other nutrients. People who drink sugary beverages do not feel full as if they had eaten the same amount of solid food.
The average can of sugar-sweetened soda of fruit punch provides about 150 calories, almost all them from added sugar. This increase the risk to gain weight and with that increase the risk of type 2 diabetes, heart disease, hypertension and other diseases. Furthermore, higher consumption of sugary beverages has been linked with an increased risk of premature death. In Pakistan domestic use of sugary drinks has increased a lot in last 15 years. These eye-opening and alarming facts and figures show that we are in a quite miserable and crisis like situation and need to work on war footings to tackle the situation otherwise our public health system will collapse. Sugary drinks are major contributors of obesity and consumption of Sugary Drinks has increased manifold in recent years.
We need to look how other countries have managed this situation. Are there any success stories in combating the consumption of SSBs and can we replicate them in Pakistan? Global Practices to Combat Sugar Sweetened Beverages: One of very effective and tested strategy to combat the consumption of SSBs is to increase the taxes on these drinks to reduce their consumption. More than 50 countries in the world have gained remarkable results by increasing the taxes on sugary drinks. Saudi Arabia has imposed 100 % tax on Energy Drinks and 50 % on Sodas. This resulted in annual volume of energy drinks reduced to 58% and sodas to 41%. We have similar examples from India, Maldives, Qatar, Bahrain and many other countries. In Pakistan tax on SSBs is less as compared to neighboring countries.
Qatar and Bahrain have also imposed 100 % tax on energy drinks and 50 % on sweetened aerated drinks. Maldives has imposed a levy of 2.18&/ liter that is equal to Rs. 235/L. Due to current alarming situation people are in favor of increasing taxes on SSBs. According to result of an opinion poll conducted by Pakistan National Heart Association (PANAH), 78% adult Pakistanis support increasing taxes on SSBs. 85.3 % discourage the consumption of junk food and 84.4 % were in favor to use this additional amount in public health sector.
This is the need of hour that departments, legislators and FBR shall take it as a top priority to make policies to increase tax on SSBs and ensure its implementation to save public health. If in countries like Saudi Arabia, Qatar and Bahrain where people have more purchasing power, consumption has reduced after increasing taxes, in Pakistan results would be even better. This would not only reduce the consumption of SSBs and improve public health but also will increase the revenue of the government which is a win – win situation for the country.
The writer is Accredited & Certified Best Volunteer Secretary General of PANAH