The obesity epidemic and sugar-sweetened beverages: a taxing time

We fully support Colagiuri’s appeal to implement comprehensive, regulatory action to reduce sugar-sweetened beverage consumption.1 Excessive sugar-sweetened soft drink consumption is associated with weight gain, diabetes and dental caries.2 Strikingly, sugary drinks are the single largest contributor of added sugars in the diet of Australians aged 14–50 years.3

In recognition that environmental changes can support healthier consumer choices, the New South Wales government has pledged to remove sugary drinks for sale from all its health facilities by December 2017.4 This follows the lead of 13 health services in Victoria that have also adopted this health-promoting policy. Media coverage of these measures has been positive,4 as communities look to health centres to be leaders in supporting and protecting public health.

In contrast, Australian university campuses, including those with medical schools responsible for developing future health leaders, remain saturated in soft drink promotions and sales.

Detractors of policy-based approaches suggest that education efforts and offering healthy choices are preferable to “nanny state” restrictions. Health education campaigns that advise people to restrict their consumption of sugary drinks must battle against the ubiquitous advertising and availability of these products. In the United States, it is well documented that the university food environment is shaped by purveyors of unhealthy food and drink.5 “Free choice” arguments ignore the realities of sales contracts that include exclusively selling certain brands and products. Similarly, in Australia, exclusive sales contracts offered to suppliers may restrict the choices of staff and students on campus.

The real issue appears to be the unfounded fear that banning the sale of soft drinks on campuses may have negative revenue implications. This fails to acknowledge that replacement beverages that are not sugar-sweetened could still be sold. Australian university campuses have readily banned smoking and the sale of tobacco without experiencing financial hardship as a consequence.

Universities, especially those training future health professionals, need to flex their collective muscle and be part of the momentum towards creating healthy environments. Initiating healthy beverage policies is a significant step forward.