In March last year, I wrote about the Government’s two measures to reduce the sugar content in our food and drinks in order to stem the increase in conditions such as type 2 diabetes. The first is the sugar reduction programme, which is being run by Public Health England. Its aim is to reduce the amount of sugar in foods by 20% by 2020. This focuses on the food products most commonly eaten by children: things like sweets, chocolate, yoghurts and biscuits, to name just a few. Work on this is underway (Public Health England, 2017). The second measure is the Soft Drinks Industry Levy, sometimes called the “Sugar Tax”. This will charge soft drink manufacturers for producing drinks that are high in added sugar. The aim is to encourage the industry to change their recipes to reduce the sugar content in their drinks, in order to avoid the added charge. It will come into force in April 2018.
The levy is squarely aimed at high-sugar drinks, particularly fizzy drinks, which are popular among teenagers. Pure fruit juices and milk-based drinks will be excluded, and the smallest producers will have an exemption from the scheme. The levy will be imposed on companies according to the volume of the sugar-sweetened drinks they produce or import. There will be two bands: one for total sugar content above 5 g per 100 mL and a second, higher band for drinks with more than 8 g per 100 mL. Analysis by the Office for Budgetary Responsibility suggests the drinks will be levied at 18 p and 24 p per litre, respectively. Examples of drinks that would currently fall under the higher rate of the sugar tax include full-strength Coca-Cola and Pepsi, Lucozade Energy and Irn-Bru. The lower rate would catch drinks such as Dr Pepper, Fanta, Sprite, Schweppes Indian tonic water and alcohol-free shandy.
When it comes to a sugar tax, all the emphasis in the UK has been on drinks. There are a number of reasons for this. Firstly, unlike a chocolate bar or slice of cake, soft drinks are not automatically seen as a treat. People who drink them tend to have them every day. Secondly, some of the drinks are incredibly high in sugar. A typical 330 mL can contains enough sugar – about nine teaspoons – to take an adult over their recommended daily sugar intake in one hit. Soft drinks are the number one source of sugar for teenagers, while, overall, children get a third of their daily sugar intake from them. Sugary drinks have also been dubbed “empty calories”, as they have no nutritional benefit.
Even a year before the levy comes into force, it is already having an effect, with major companies rushing to cut their sugar content before April 2018. Of particular note, Lucozade Ribena Suntory, the company that produces Lucozade and a number of other carbohydrate-containing drinks (including Lucozade Sport, Ribena and Orangina), has begun the process of reformulating its products. The sugar and carbohydrate levels of its drinks are being reduced by approximately 50%.
The first product to be reformulated is Lucozade Energy, both the original and orange flavours. The reformulated product will be available from April 2017, and other products will follow suit later in the year. Many people use Lucozade to treat hypos, and we need to inform our patients that they should check the labels of the energy drink, as the amount of sugar it contains is being halved. Per 100 mL, the total carbohydrate content is falling from 17.0 g to 8.9 g. This means that people with diabetes will need to drink 200 mL of the new formulation to achieve the 15–20 g of glucose recommended for the treatment of hypoglycaemia.
Please note that other flavours may contain different amounts of carbohydrate, so check the label.
According to the manufacturers, both old and new stock of Lucozade will be on sale for some time, so we need to advise our patients to check the label before they buy, or to consider using an alternative option for fast-acting glucose, such as jelly babies.
TREND-UK and MSD are changing the advice for treating hypoglycaemia within the Why do I sometimes feel shaky, dizzy and sweaty? leaflet, which will be available on our website very soon (www.trend-uk.org).
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