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

Siyuan Liu,Lalani L Munasinghe,Paul J Veugelers,Katerina Maximova,Jennifer P Taylor,Arto Ohinmaa

doi:10.17269/s41997-022-00615-x

Abstract

ObjectiveExcessive 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.MethodsFree 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.ResultsIf 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).ConclusionExcessive 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.

Highlights

Chronic diseases (CDs) are a leading cause of death in the world (WHO, 2015a)
The economic burden resulting from free sugar consumption above 10% of total energy intake (TEI) was estimated to be $2.5 billion per year (Table 3)
Public health interventions to reduce sugar consumption must go beyond taxation of sugar-sweetened beverages (SSBs) to target a broader set of food products

Summary

Introduction

Chronic diseases (CDs) are a leading cause of death in the world (WHO, 2015a). In Canada, CDs, including diabetes, cardiovascular diseases (CVD), and cancer, accounted for 62% of all deaths in 2019 (Statistic Canada, 2021). The treatment and management of CDs were estimated to consume 67% of all direct health care costs, adding up to CA $190 billion annually (Elmslie, 2012). Adopting healthy lifestyles, such as healthy eating, active living, tobacco abstinence, and responsible alcohol consumption, can prevent up to 80% of type 2 diabetes and CVD and 40% of cancers (Lieffers et al, 2018). Despite a series of healthy eating recommendations issued in Canada to improve health and reduce CDs (Health Canada, 2019; Health Canada, 2007), the majority of Canadian residents do not meet these recommendations (Liu et al, 2020; Black & Billette, 2013). More than three out of four Canadians do not consume enough vegetables and fruit (Black & Billette, 2013; Ekwaru et al, 2016), and nearly two out of three consume more free sugar than what is recommended (Liu et al, 2020)

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