Not so sweet, please

The growing incidence of diabetes is a concern for all of us: non-communicable diseases, including diabetes, will consume a huge proportion of the public and private purse in the near future. The South African Medical Journal said last year: “The accumulated losses to South Africa’s gross domestic product between 2006 and 2015 from diabetes, stroke and coronary heart disease alone are estimated to cost the country US$1.88-billion.” 

The worldwide incidence of diabetes is currently about 9%, according to the World Health Organisation and is predicted to rise by 54% in 2030 — great news for the drug industry (the diabetes drug market is predicted to top $550-billion by 2017, up by $20-billion from 2012) but not so great for the rest of us, particularly in South Africa, which is seeing diabetes growth rates as high as anywhere in the world. A 2010 article in the The Lancet stated: “The projected growth for sub-Saharan Africa is 98%, from 12.1 million in 2010 to 23.9 million in 2030.” 

But some practical steps are emerging from research, which is painting an increasingly clearer picture of one simple thing individuals can do to avoid the onset of type 2 diabetes: reduce the levels of sugar in our diet — either in sugar added to foods or sugar-sweetened beverages (SSBs).

A recent paper concluded that: “Habitual consumption of sugar-sweetened beverages was associated with a greater incidence of type 2 diabetes, independently of adiposity [obesity or overweight]” and that “… both artificially sweetened beverages and fruit juice were unlikely to be healthy alternatives to sugar-sweetened beverages for the prevention of type 2 diabetes.”

Sugar-sweetened beverages have become the primary source of added sugars in the diet of US citizens, which is rapidly being adopted in South Africa (consumption there has more than doubled since the 1970s). 

SSBs contain sweeteners such as sucrose, high-fructose corn syrup or fruit juice concentrates, all of which have essentially similar metabolic effects. SSBs include not only sodas but also iced teas, energy drinks and vitamin waters.

A publication from April 2015 added sweetened milk beverages to the list, concluding that: “The consumption of soft drinks, sweetened-milk beverages and energy from total sweet beverages was associated with higher type 2 diabetes risk independently of adiposity.” The authors of this study found that water or unsweetened tea and coffee were good alternatives. 

Another review published in the Journal of the American College of Cardiology in September showed that consuming one or two servings of sweetened beverage a day pumps up your risk of developing type 2 diabetes by 26%. Lead investigator Professor Frank Hu of the Harvard TH Chan School of Public Health said there is now strong evidence to support more aggressive public policies to reduce the consumption of sugar-sweetened beverages.



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