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Sugar and health: a complicated relationship

Sugar enhances the taste, balances the flavors and reveals the aromas. It allows the consumption of a variety of foods, for example by rebalancing the acidity of a fruit or yogurt. Appreciated from birth, it contributes to eating pleasure. It is an integral part of our diet and therefore should not be demonized. However, we know that an excess of sugar intake greatly contributes to obesity and type 2 diabetes. There is also more and more talk of mental disorders linked to excess sugar and even of an addictive tendency. This is why the World Health Organization (WHO) revised downwards in 2015 its recommendations on sugar which should constitute, according to its advice, 5% of daily energy intake, that is to say the equivalent of 25 grams per day.

In Switzerland, however, we consume between five and seven times more and, which is striking, twice as much as in 1970. This corresponds to the increase since then in the consumption of pre-prepared meals: we are spending moreover in average three times less time to prepare our meals than fifty years ago! But it also corresponds to the explosion in the consumption of industrialized sweetened drinks (sodas, cold teas and fruit juices). The WHO also emphasizes that a large part of the sugars consumed today is “hidden” in foods that are not considered sweets. One tablespoon of ketchup contains 4 grams of hidden sugar. And a single can of soda can contain up to 40 grams of sugar – nearly twice the total recommended daily intake.

This made say to the Vice Minister of Prevention and Health Promotion of the Government of Mexico, Hugo López-Gatell Ramírez, visiting the State of Chiapas (in the south of the country), that Coca-Cola is ” a poison in a bottle ”. It must be said that if Mexico is the largest consumer per capita in the world ahead of the United States, Chiapas holds a sad national record: each inhabitant drinks an average of 2.2 liters of soft drinks per day – the market for which is largely dominated by Coca-Cola – equivalent to 200 grams of sugar (or 800 calories)! This frankly incredible observation is nevertheless established by a study by the Center for Multidisciplinary Investigations on the Southern Border and Chiapas (CIMSUR) published in 2019, and taken up by the Mexican Ministry of Health. The consequences are obvious: southern Mexico has the palm of the country’s type 2 diabetes. According to official data, 30% of minors there are overweight – a third of which is morbidly obese – and this concerns 70% of adults. This is all the more paradoxical given that a Mexican child under 5 out of eight years is chronically undernourished and this proportion is higher in the southern states including Chiapas, mainly in rural indigenous communities.

How did we get here? The CIMSUR study invokes the scarcity of drinking water – sold as expensive as sugary drinks while it is without caloric intake! Thus, some districts of San Cristóbal de las Casas, although well known to tourists, only have running water a few times a week, while this city is home to the largest Coca-Cola factory in Central America which mobilizes 1.3 million liters of water per day that the inhabitants do not have!

This shows that while excessive sugar consumption is a public health problem, it is not enough to do people-centered health promotion and prevention, but that it takes the political courage to legislate. to better control the entire industrial agro-food sector. In Switzerland, rather than re-authorizing the use of neocotinoids, which are very toxic to bees, to fight against “viral jaundice” which has reduced beet yields for many producers, it would probably be more consistent to compensate farmers on an ad hoc basis. , to consider alternative production techniques and to limit the use of sugar in the food industry: that would be good both for nature and for health.
This underlies a paradigm shift. Isn’t this what the Covid-19 pandemic is teaching us?

Our columnist is an FMH pediatrician and member of the E-Changer committee, a Swiss French-speaking cooperation NGO.

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