Correspondence Address:
Ullal Anand Nayak
Department of Preventive Dental Sciences, Ibn Sina National College for Medical Studies, Jeddah
Saudi Arabia

Full Text



Diet rich in sugar has been associated linearly with common diseases and disorders affecting adults and children, such as dental caries, obesity, and also inferior diet quality. These disorders have an enormous monetary impact because of the money spent on their treatment and the indirect expenses caused due to loss in work productivity. The most recent published data estimates that dental diseases cost the world economy $544 billion, with dental caries directly contributing 15% of the entire burden of dental disease.[1] According to estimates, obesity accounts for 2%–4% of Europe's overall health spending, and by 2050, that percentage is expected to double.[2]

In keeping with a new World Health Organization (WHO) recommendation released in March 2015, both adults and children should consume less sugar over the course of their lives as sugar consumption frequency and volume are significant risk factors.[3] Furthermore, both developed and developing nations consider cost-effective prevention programs to stop these disorders essential for containing this public health problem. Apart from the economic burden, they also have a psychological impact in reducing self-esteem, work productivity, and concentration.

Every nation must take into account the WHO standards for sugar consumption so that appropriate nutrition intake regulations and dietary recommendations can be developed following the unique requirements of each nation or culture. Several policies might be put in place to limit the use of free sugars, including restrictions on the promotion of goods with high sugar content, accurate sugar content labeling of foods and beverages, and most importantly, education of both consumers and healthcare professionals.

A tax on the soft drink industry called “The Sugar Tax” was implemented in Britain in 2018.[4] Companies would pay taxes under this program on the sales of drinks with moderate to high sugar levels (excluding fruit juice and milk-based drinks). It featured a charge on sugary soft drinks based on the quantity produced or imported. The British Society of Dental Hygiene and Therapy (BSDHT) deemed this a positive development. The BSDHT promoted the idea that the tax would not only draw attention to products with a lot of sugar but also would aid in the introduction of low-sugar substitutes. Additionally, it was hoped that the higher price would serve as a financial deterrent, preventing kids from consuming cold beverages or snacks. The BSDHT specifically wanted to foster a relationship between local schools and professionals through its First Smiles program to create a channel for information delivery that may aid in instilling and fostering the development of positive habits in children from an early age.

Sugar-sweetened beverages (SSBs) are linked to obesity and increased body weight in France, which can lead to a variety of health problems like diabetes or cardiovascular diseases. Excise taxes were implemented to reduce the usage of SSB. Using a synthetic control strategy, it was assessed how sugar taxes affected sales of SSB in France and Hungary. After the tax was implemented, there was a minor decline in SSB sales in France, but an increase in soft drink sales overall. However, in Hungary, there was only a brief decline in SSB sales, which vanished after 2 years and resulted in a rise in SSB sales overall. However, there is a lot of doubt about both impacts.[5]

To effectively combat obesity in South Africa, the former finance minister Pravin Gordhan suggested the sugar tax legislation in the 2016 country Budget Speech. The WHO also supported the implementation of a sugar tax and promoted the adoption of healthier behaviors, the South African legislature had not yet formalized such a tax into legislation, so lessons can be learned from foreign approaches. The implementation of the sugar tax laws in Finland, Hungary, and the United Kingdom was the subject of an exploratory research project.

These nations employ the same tax base as South Africa's proposed sugar tax base, namely the threshold approach. The proposed sugar tax in South Africa was evaluated using the four pillars of sound taxation (equity, certainty, economy, and convenience). The proposed sugar tax legislation needs urgent amendatory action from the legislature since the four maxims were not followed. The second-highest sugar tax rate of 2.1 cents per gram of sugar content over 4 g per 100 ml may not be sufficient to stop excessive SSB use because consumers may choose less expensive alternative SSB options.[6]

India is one of the largest sugarcane producers and has witnessed a rising prevalence of type-2 diabetes and obesity.[7] Hence, a Sin category tax was levied on “sugar-sweetened aerated and flavored water,” which was set at 40%, which aimed to substantially affect public health. These high-sugar, low-nutrient beverages, which include all colas and similar junk drinks, were subjected to additional cases of 12% on top of the existing luxury tax rate of 28%.

The sugar levy looks arbitrary as an anti-obesity measure. While obesity has been on the rise for years, consumption of sugar and SSBs has been declining. Soft drinks contribute very little to daily calorie consumption on average. Comparisons amongst European nations reveal no link between the intake of sugary drinks and obesity. According to the Office for Budget Responsibility, the fee will push up inflation by 0.25% in 2018–19, increasing accumulated interest payments on index-linked gilts by ≤1 billion. The cost of index-linked salaries, pensions, and benefits will increase by several millions of pounds as a result of inflation. The levy will also require additional funding for enforcement and administration. The sugar levy will be loss-making and will give companies the perverse incentive to raise sugar levels to the threshold of each tax bracket.[8]

The majority of sugar levies cover SSBs, although several also cover pure fruit juices and other high-sugar items. Some taxes are volumetric, whereas others are caloric. Along with other initiatives to improve diets or raise awareness of the risks associated with excessive sugar consumption, some fees have been put into place. In certain jurisdictions, sugar taxes are also established to increase tax revenue; there is no specific assumption that any decrease in intake will positively impact health, but sometimes the money raised is set aside for health programs. The main key element in preventing dental decay apart from reducing sugar intake is inculcating the good habits of oral hygiene maintenance, too early in life. It's important to inform parents and those who look after young children about the negative effects of consuming more sugar. Together, healthcare groups, dental professionals, and governmental organizations could develop and implement preventive measures and efforts to address the escalating general and oral health crisis.

References