In 2015 and 2016, over a third of adults in the United States were obese . That figure significantly increased since 1999 . Obesity is commonly defined as a health condition, but it is also a major risk factor for developing more serious chronic diseases like cardiovascular disease and diabetes. To better illustrate the seriousness of the issue, cardiovascular disease was the number one leading cause of all deaths in the United States during 2016 and diabetes was the seventh [2, 3]. On a global magnitude during the same year, cardiovascular disease was also the first leading cause of death . These statistics are very useful in understanding health trends over time, and demonstrate the pressing need to address the growing obesity epidemic, its causes, and its adverse effects.
Research has revealed that certain behavioral factors, such as consuming unhealthy diets and living a sedentary or inactive lifestyle, contributes to weight gain and modifying these lifestyle choices can lead to long-term weight control . Specifically, the consumption of sugar has gained attention for its possible association to weight gain, diabetes, and cardiovascular disease . The evidence for causality between sugar, diabetes and obesity can be evident when examining the strength, consistency, specificity, and dose:response associations .
We all know that food is a necessity to survive, however, understanding the nutritional composition of our food is often disregarded. Seeing that obesity trends are increasing over time, it may help to understand the history of the demand chain in the food and beverage industry.
Since the introduction of fast food restaurants in the mid-1900’s, consumers have gotten accustomed to “dining out” rather than cooking and “eating in”. The convenience of on-demand food and the avoidance of messy cleanups has contributed to the need for food and beverage products with a long-lasting shelf life. To deliver those needs, food and beverage companies have utilized trans-fats in products to increase shelf life and reduce costs of production . Fortunately, years of health research have revealed that trans-fat in foods are correlated with adverse health issues, and thus consumers started demanding low-fat or reduced-fat products. Food and beverage companies adapted to the demands of their customers, but this resulted in adding extra sugar and salt to their products in order to improve their taste and better appeal to their customers . It’s no coincidence that since then, chronic conditions like obesity, cardiovascular disease and diabetes rates have only increased and continue to do so.
While sugar comes in a variety forms, such as carbohydrates, fructose, or sucrose, the popular choice of sugar-additive in food and beverages is high-fructose corn syrup. The food and beverage industry has an economic interest in utilizing high-fructose corn syrup in their products because of how much sweeter it is than table sugar, how cheap it is, and how readily available it is . High-fructose corn syrup was granted “generally recognized as safe” by the United States Food and Drug Administration in 1983. Since its introduction in 1970, high-fructose corn syrup consumption has surpassed table sugar consumption, further showcasing the pressing need to reduce consumption of this ingredient.
A study was conducted to determine what food and beverage groups had the highest added sugar content and which were consumed the most . They found that soft drinks and sodas accounted for the highest intake of added sugars (33% of total intake of added sugars), followed by candy, sugars and sugary foods (19.5%) and cakes, cookies, quick bread, pastries and pies (14.4%). Likewise, the United States Department of Health and Human Services and the United States Department of Agriculture have stated that almost half of the added sugars in our current diets are attributed to beverages . The large consumption of sugar is especially problematic considering they contribute to a tremendous amount of calorie intake but have essentially no nutritional value . What is even more astonishing is that some studies propose that sugar may be addictive by stimulating dopamine levels in the brain, which activate the reward center and develop into more sugar cravings, similar to a substance addiction . This may explain why people over-consume sugary foods and drinks.
Many challenges are introduced to our society as a result from all of this. Considering that sugar consumption contributes to obesity, and obesity is the biggest health threat our society faces; the economic costs are insurmountable . An estimated two trillion dollars were spent in 2014 on preventative, diagnostic, and treatment services, and therefore, may be correlated with a rise in healthcare costs [12, 13]. Indirect costs, which are the resources used as a result of the health condition, are commonly related to the workplace and may include additional society consequences like decreased work productivity, high workers’ compensation, lower earnings, and premature mortality and disability . Interestingly, a systematic literature review on the economic burden of obesity shows that few studies have mentioned costs for mental disorders . Even though one study found a bidirectional relationship between depression and obesity, the exclusion of mental health burden on obesity can cause an underestimation of overall costs . Other surprising research findings have mentioned obesity impacts on automobile and airline fuel consumption [16, 17]. Greater weight in transport vehicles translate into more fuel consumption. While it is possible that weight increases may be attributed to other factors such as cargo, a key study found that nearly one billion gallons of additional fuel are used for passenger automobiles per year and are associated with weight gain of United States citizens between 1960 and 2002 . Similarly, a ten pound average weight increase in Americans in the 1990’s resulted in airlines spending an additional 275 million dollars on fuel to account for weight growth . Not only is additional fuel consumption costly, but it poses an enormous threat to our environment. The same study goes on to explain that the additional jet fuel consumption produced an extra 3.8 million tons of carbon dioxide emissions and other pollutants into the atmosphere . The causality links proceed further – air pollution and respiratory diseases are correlated which can also impact health economic costs .
To conclude, this information has been widely researched, is available to the public, and gives valuable and worthwhile information; obesity has detrimental effects on our health, society and our planet. Yet, why does our society still struggle with rising obesity rates? What can we do about it? Addressing sugar consumption is an important and often overlooked necessity.
A variety of solutions and strategies are available and strongly advocated, such as campaigns to increase awareness, education on reading nutrition labels correctly and calorie counting, knowing the important food groups, portion and frequency control methods, consumption of healthier options, excise taxes, setting-specific bans, and choice architecture . Many organizations are taking the necessary steps to raise awareness on sugar consumption. For instance, the United States Department of Health and Human Services and the United States Department of Agriculture created dietary guidelines for Americans. Within this document, guidelines for sugar consumption specify that adults should consume less than ten percent of calories per day from added sugars. For an average 2,000 calorie diet, that is 200 calories, or about 12 teaspoons . Similarly, the American Heart Association recommends that women consume no more than six teaspoons of added sugar per day and nine teaspoons for men . However, recent health data show that the average American consumes 17 teaspoons of sugar each day ! Obviously creating and providing awareness and guidelines on sugar consumption is not enough. There is still a disparity that needs to be addressed – the demand chain in businesses. Focusing on the mechanisms of which businesses utilize sugar in their products, how products are used by customers, its disposal methods, and its impact on others including the planet, may help leadership to realize their negative impact on the health of their customers, society, and the planet.
While current health trends seem daunting to some, other individuals like myself remain optimistic that change can be achieved to benefit all entities – businesses, governments, people, and the planet! Returning to the business demand chain – it is our civic duty to stand up for what is right. Innovators and role-models in the world have an immense advantage of being leaders that can bring people together to advocate for reducing sugar and other unhealthy additives to our food and beverage products. Moreover, requiring food and beverage companies to reformulate products, disclose bioengineered products, provide descriptive and honest nutrition labels, modify their marketing tactics, and taxing unhealthy foods and beverages are strategies that are starting to be implemented and show promising results. Yet, more work needs to be done to convince the leaders in the food and beverage industry to make significant changes. That can be accomplished if they realize the negative impacts their products have on the population and planet. The hope I have is that the power of the masses will drive such awareness and necessary change to our society as a whole, and the sustainability of our planet.
- Hales, C.M., Carroll, M.D., Fryar, C.D., & Ogden, C.L. (2017). Prevalence of obesity among adults and youth: United States, 2015-2016. NCHS Data Brief, No. 288.
- Centers for Disease Control and Prevention. (2017). National Diabetes Statistics Report, 2017. Atlanta, GA: Centers for Disease Control and Prevention, U.S. Dept of Health and Human Services.
- Leading causes of death and numbers of deaths, by sex, race, and Hispanic origin: United States, 1980 and 2016. NCHS, National Vital Statistics System. Vital statistics of the United States, 1980. Volume II —Mortality, part A. Available from: https://www.cdc.gov/nchs/data/hus/2017/019.pdf.
- The top 10 causes of death. (May 24, 2018). In World Health Organization. Retrieved February 3, 2019 from https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death.
- Wadden, T.A., Butryn, M.L., Byrne, K.J. (Dec 2004). Efficacy of lifestyle modification for long-term weight control. Obesity Research, 12:151S-162S.
- Kastrinakis, M. (June 2015). Metabolic Syndrome [Powerpoint Slides]. Retrieved from The George Washington University School of Public Health Biology Concepts.
- Dietz, W.H. (September 2016). How can we reduce sugar drink consumption to control obesity and diabetes? [Powerpoint slides]. Retrieved from The George Washington University School of Public Health Community Organization, Development, and Advocacy.
- Dani, S. (January, 2016). The sugar dynamic: innovation is key for the food supply chain. Retrieved February 3, 2019 from https://www.koganpage.com/article/the-sugar-dynamic-innovation-is-key-for-the-food-supply-chain.
- Huth, P.J., Fulgoni III, V.L., Keast, D.R., Park, K., Auestad, N. (2013). Major food sources of calories, added sugars, and saturated fat and their contribution to essential nutrient intakes in the U.S. diet: data from the national health and nutrition examination survey (2003-2006). Nutrition Journal, 12:116.
- U.S. Department of Health and Human Services and U.S. Department of Agriculture. (March, 2016). 2015-2020 dietary guidelines for Americans: Cut down on added sugars.
- U.S. Department of Health and Human Services. (2001). The surgeon general’s call to action to prevent and decrease overweight and obesity. U.S. Department of Health and Human Services, Public Health Service, Office of the Surgeon General.
- Nath, T. (April 17, 2015). The economic cost of an obese society. Retrieved February 3, 2019 from https://www.investopedia.com/articles/personal-finance/041715/economic-cost-obese-society.asp.
- Tremmel, M., Gerdtham, U.G., Nilsson, P.M., Saha, S. (April 19, 2017). Economic burden of obesity: a systematic literature review. Int. Journal of Environmental Research and Public Heatlh,14:435.
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- La Milia, D.I., Sciaraffa, R., Borghini, A., Montuschi, P., et al. Impact of air pollution on respiratory diseases in urban areas: a systematic review. 10th European Public Health Conference: Poster Walks.
- U.S. Department of Health and Human Services and U.S. Department of Agriculture. (December, 2015). 2015-2020 Dietary Guidelines for Americans. 8th Edition.
- Johnson, R.K., Appel, L.J., Brands, M., Howard, B.V., et al. (September, 2009). Dietary sugars intake and cardiovascular health: A scientific statement from the American Heart Association. Circulation, 120:1011-1020).