Experts call for cigarette-style health warnings on sugary drinks

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Health experts think cigarette packet-style health warnings on sugary drinks could be a solution to Australia’s obesity crisis.

Research from Deakin University has shown that if packaging featured graphical health warnings – such as rows of rotten teeth – on cans of cola and other sugary soft drinks, it could deter some young adults from buying them.

Professor Anna Peeters and colleagues looked at the feasibility of introducing health warnings about the links between sugary drinks and obesity, type 2 diabetes and tooth decay.

The study involved 994 young adults, aged between 18 and 35, who were asked to imagine they were entering a shop, a cafe, or approaching a vending machine to choose one of 15 different drinks to buy, some sugary and some unsweetened. Some of the sugary drinks had no label. Others carried a warning or a health star rating.

Four different kinds of warnings were tested, including plain text about the disease risk, the number of teaspoons of sugar in the drink, and a picture of rotten teeth.

The results found that all warnings reduced the inclination of the subjects to buy the drinks, but there was a 20% drop in imagined purchases of those drinks bearing a picture of rotten teeth.

Participants were also 20% less likely to purchase sugary drinks that included the health star rating and 18% less likely when displaying teaspoons of added sugar.

Furthermore, the study outlined that it was more likely for subjects to choose healthier alternatives when health star ratings were displayed compared to no label.

“The study showed much larger changes than I had expected,” said Prof Peeters at the European Congress on Obesity, where she presented the findings.

“If there was political palatability for graphic warnings, that [one] had the strongest effect, so that’s the one I would go for.

“You are going to get pushback from the industry and possibly the community,” she said. “If you had good social acceptance of graphic warnings, you’d go for that. But if government found that too difficult the other three are pretty good too.”

A written warning about the increased risk of type 2 diabetes as a result of obesity would not have quite the same impact as the picture, she said, “unless you go for amputations”, which can be a consequence of the disease.

She said the study showed the potential of changing people’s behaviour with front-of-pack warnings.

“While no single measure will reverse the obesity crisis, given that the largest source of added sugars in our diet comes from sugar-sweetened drinks, there is a compelling case for the introduction of front-of-pack labels on sugary drinks worldwide,” she added.

Are sugary drinks to blame for the obesity crisis?

Sugary drinks are blamed for worsening the obesity crisis. However, despite the large quantities of sugar these drinks often contain – some almost 10 spoons in just one can – they do not carry a red traffic-light warning, which is voluntary in the UK.

While the sugar tax that has also recently been introduced in the UK may reduce sales, obesity experts believe more action is needed.

Prof Jason Halford from Liverpool University, treasurer of the European Association for the Study of Obesity, said there was a need for manufacturers and retailers – including supermarkets – to bring in traffic-light warnings on sugary drinks. If they do not, “We’d have to adopt something regulatory and the regulatory might be this. And it might be the most effective,” he said.

Barbara Crowthers, a Children’s Food Campaign coordinator, said “There is definitely a role for honest and clear health labelling in discouraging people from consuming too many sugary drinks, alongside other measures such as product reformulation, marketing and advertising restrictions, tackling portion sizes and introducing price disincentives such as the UK’s new sugary drinks tax.

“Whilst, as we’ve seen on cigarettes, not everyone will be put off by graphic labels, making it clearer that consuming sugary drinks may also lead to the dentist’s drill could provide an additional powerful deterrent for many young people.”

Gavin Partington, Director General at the British Soft Drinks Association, said sugar intake from soft drinks was already dropping.

“Experience in the UK suggests that the action industry is taking – around reformulation, portion size and switching advertising spend to low/no calorie products – is having ample effect in changing consumer behaviour,” he said.

“In fact, sugar intake from soft drinks in the UK has fallen by almost 19% since 2013 – five times as much as other categories according to latest PHE data – and no and low-calorie beverages now account for the largest category in the UK soft drinks sector.”

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