The economic burden of excessive sugar consumption in Canada: should the scope of preventive action be broadened?

Abstract

Objective Excessive sugar consumption is an established risk factor for various chronic diseases (CDs). No earlier study has quantified its economic burden in terms of health care costs for treatment and management of CDs, and costs associated with lost productivity and premature mortality. This information, however, is essential to public health decision-makers when planning and prioritizing interventions. The present study aimed to estimate the economic burden of excessive free sugar consumption in Canada. Methods Free sugars refer to all monosaccharides and disaccharides added to foods plus sugars naturally present in honey, syrups, and fruit juice. Based on free sugar consumption reported in the 2015 Canadian Community Health Survey–Nutrition and established risk estimates for 16 main CDs, we calculated the avoidable direct health care costs and indirect costs. Results If Canadians were to comply with the free sugar recommendation (consumption below 10% of total energy intake (TEI)), an estimated $2.5 billion (95% CI: 1.5, 3.6) in direct health care and indirect costs could have been avoided in 2019. For the stricter recommendation (consumption below 5% of TEI), this was $5.0 billion (95% CI: 3.1, 6.9). Conclusion Excessive free sugar in our diet has an enormous economic burden that is larger than that of any food group and 3 to 6 times that of sugar-sweetened beverages (SSBs). Public health interventions to reduce sugar consumption should therefore consider going beyond taxation of SSBs to target a broader set of products, in order to more effectively reduce the public health and economic burden of CDs.

Canadian Free Sugar Intake and Modelling of a Reformulation Scenario

“…There have been some recent efforts made to estimate Canadian free sugar intake. For instance, analyses of the most up to date national nutrition survey data have estimated that free sugar accounts for between 12% and 13.3% of Canadians' energy intake, and that most Canadians were exceeding the guidelines of a 10% caloric contribution of free sugar [7,8]. These findings align with earlier work, indicating that efforts to improve free sugar intake among Canadians are still needed [9][10][11].…”

The equitable impact of sugary drink taxation structures on sugary drink consumption among Canadians: a modelling study using the 2015 Canadian Community Health Survey-Nutrition

“…However, no single policy will reduce sugary drink consumption to healthy levels and additional interventions should be considered ( 43 , 44 ) . A recent Canadian study estimated that targeting SSB with taxation would be insufficient on its own to effectively reduce the health and economic burden of chronic diseases associated with excess sugar consumption from additional products ( 13 ) . Moreover, it is imperative to consider taxation in the context of an embodied policy approach, with additional considerations for improving access (i.e.…”

“…In Canada, a national sugary drink tax has not been adopted, despite these beverages contributing 21 % (aged 9–18) and 17 % (aged 19+) of Canadians’ total sugar consumption ( 10 , 11 ) and a higher prevalence of consumption and mean energy intake from sugary drinks among individuals with low compared with high socio-economic position (SEP) ( 12 ) . A recent Canadian study estimated that total free sugar consumption above 10 % of total energy intake, WHO’s benchmark for total free sugar intake, cost Canada’s healthcare system 2·5 billion CAD in 2019 from direct (1·1 billion CAD) and indirect (1·4 billion CAD) costs ( 13 ) . Subnational SSB taxes exist in the Canadian provinces of Newfoundland and Labrador (a 20 cent/l sugary drink tax levied on manufacturers since September 2022 ( 14 ) ) and in British Columbia (where soda beverages are no longer exempt from the 7 % provincial sales tax applied to food products for human consumption as of April 2021 ( 15 ) ).…”

Historical lessons for Canada’s emerging national school food policy: an opportunity to improve child health

“…2 They also consume five times more sugar than recommended by the national guidelines and get more than half of their calories from ultra-processed foods. 3,4 Overall, Canadians are the second largest consumers of ultra-processed foods and beverages in the world. 5 Poor diet has been linked with nutritional deficiencies and the development of chronic diseases such as obesity, type 2 diabetes and heart disease.…”