Impact case study database

Impact on World Health Organization (WHO) Guideline on Sugars

Newcastle research provided the basis for the WHO 2015 Guideline “Sugars intake for adults and children” (EV1), which assesses the effect of free sugars on unhealthy weight gain and dental caries. The latter aspect is informed entirely by R5; in addition, the data from R5 were robust enough to provide a numerical cap that applies to both aspects, as stated on page 16 of the Guideline. On pages 4 and 16, the Guideline strongly recommends reducing free sugars intake to below 10% of total energy intake, and recommends a further reduction to below 5%.

The Guideline was subsequently endorsed by two bodies, both citing R5. The first was the US Dietary Guidelines Advisory Committee, whose 2015 Scientific ReportFootnote:

https://health.gov/sites/default/files/2019-09/Scientific-Report-of-the-2015-Dietary-Guidelines-Advisory-Committee.pdf Page 342. strongly recommends keeping sugars intake to below 10%, citing the WHO Guideline and R5 specifically on page 344. Secondly, the FDI World Dental Federation’s 2015 responseFootnote:

Available on request to the WHO recommendations requests that “the 5% reduction is not a conditional but a strong recommendation.” In addition, the report states that “the systematic review by Moynihan and Kelly [R5] is the most extensive and rigorous on the subject.”

Impact of WHO Guideline on global implementation of a Sugar Tax

In direct response to the WHO Guideline, three countries implemented a Sugar Tax on soft drinks as a vehicle to limit free sugars intake. The first country was South Africa, who in April 2018 introduced a tax as a result of a July 2016 Policy Paper (EV2), directly citing the Guideline (page 5). Secondly, in May 2018 Ireland announced a tax of 20c/litre on drinks with 5-8g of sugar per 100ml, and 30c per litre on drinks with ≥8g/100ml (EV3). This resulted from an October 2016 Working Paper citing both R5 and the Guideline. The third country was Bermuda, who in October 2018 introduced a 50% tax on sugary products, which increased to 75% in April 2019. This resulted from a Ministerial brief delivered in June 2018 (EV4) which cites the Guideline.

The 2015 Guideline also informed a 2017 WHO Technical Document (EV5). On page 2, the document proposes a tax on sugary drinks as a major action to help prevent obesity, promote population health and reduce healthcare costs. Consequently, 13 further countries and cities have introduced or updated a sugar tax since the publication of the Technical Document, increasing the population now benefitting from a cap on sugar intake to over 536 million. These are (EV6): Brazil (2018), Estonia (2018), France (2018), French Polynesia (2018), Malaysia (2019), Norway (2018), Oman (2019), Peru (2018), the Philippines (2018), Qatar (2019), the Seychelles (2019) and Thailand (2019); and San Francisco and Seattle, (both 2018, EV7).

Campaign to introduce a Sugar Tax in the UK

In 2015, a “Sugar Rush” campaign took place in the UK to reduce sugar intake. The accompanying Channel 4 Documentary mentions the WHO report and repeatedly calls for a “Sugar Tax”. The campaign led to a petition for a tax on sugary drinks, which closed with over 155,000 signatures and was debated in both Parliament and in the House of Lords. A July 2016 Public Health England document (EV8) cites the WHO figures in a recommendation to reduce free sugars to 5% of energy intake to combat both dental caries and obesity, especially in children. In April 2017 this was cited, along with the WHO recommendations directly, in a House of Commons Library Briefing Paper that calls for a tax on sugary drinks (EV9). Consequently, the Soft Drinks Industry Levy (SDIL) came into effect across the UK in April 2018. Under the SDIL, drinks containing 5-8g of sugar/100ml are taxed at 18 pence per litre; and drinks containing >8g/100ml at 24 pence per litre.

Response by manufacturers and retailers to the Sugar Drinks Industry Levy (SDIL)

In response to the SDIL, most soft drink manufacturers and retailers reformulated their products, including Suntory (Lucozade and Ribena), Britvic (Robinson’s, J20 and Fruit Shoot); AG Barr (Irn Bru and Rubicon), Coca-Cola Fanta; and retailers’ own brands including Tesco, Morrisons, Asda and Co-op. Internationally, in September 2017 Unilever announced a reduction in the sugar content of certain drinks in line with WHO recommendations (EV10).

A September 2019 report by Public Health England (EV11) found that the average sugar content per 100ml of drinks subject to the SDIL decreased by 28.8% between 2015 and 2018, saving 30,000 tons of sugar from entering the food chain. In addition, sales shifted towards products with a lower sugar content, indicating that the higher price of drinks subject to the SDIL has changed consumer buying habits.

Summary

Research by Newcastle University allowed a numerical cap to be placed on free sugars intake. This evidence underpinned 2015 WHO guidance, which contributed towards several countries introducing a sugar tax on soft drinks. This high-level change in policy has already led to reformulations of sugary drinks, which are a step towards reducing obesity and dental caries at a population level.