With diabetes on the rise, we can’t afford to ignore the evidence any longer

There are renewed calls this week for the Australian government to implement a range of measures aimed at improving our diets. These include restrictions on junk food advertising, improvements to food labelling, and a levy on sugary drinks.

This time the recommendations come from a parliamentary inquiry^[1] into diabetes in Australia. Its final report, tabled in parliament on Wednesday, was prepared by a parliamentary committee^[2] comprising members from across the political spectrum.

The release of this report^[3] could be an indication that Australia is finally going to implement the evidence-based healthy eating policies public health experts have been recommending^[4] for years.

But we know Australian governments have historically been unwilling^[5] to introduce policies the powerful food industry opposes. The question is whether the current government will put the health of Australians above the profits of companies selling unhealthy food.

Diabetes in Australia

Diabetes is one of the fastest growing chronic health conditions in the nation, with more than 1.3 million people affected^[6]. Projections^[7] show the number of Australians diagnosed with the condition is set to rise rapidly in coming decades.

Type 2 diabetes accounts for the vast majority of cases of diabetes. It’s largely preventable, with obesity^[8] among the strongest risk factors.

This latest report makes it clear we need an urgent focus on obesity prevention to reduce the burden of diabetes. Type 2 diabetes and obesity cost the Australian economy billions of dollars^[9] each year and preventive solutions are highly cost-effective^[10].

This means the money spent on preventing obesity and diabetes would save the government^[11] huge amounts in health care costs. Prevention is also essential to avoid our health systems being overwhelmed in the future.

What does the report recommend?

The report^[12] puts forward 23 recommendations for addressing diabetes and obesity. These include:

• restrictions on the marketing of unhealthy foods to children, including on TV and online

• improvements to food labelling that would make it easier for people to understand products’ added sugar content

• a levy on sugary drinks, where products with higher sugar content would be taxed at a higher rate (commonly called a sugar tax).

These key recommendations echo those prioritised in a range of reports on obesity prevention^[13] over the past decade. There’s compelling evidence^[14] they’re likely to work.

Restrictions on unhealthy food marketing

There was universal support from the committee for the government to consider regulating marketing of unhealthy food to children.

Public health groups have consistently called^[15] for comprehensive mandatory legislation to protect children from exposure to marketing of unhealthy foods and related brands.

An increasing number of countries, including Chile^[16] and the United Kingdom^[17], have legislated unhealthy food marketing restrictions across a range of settings including on TV, online and in supermarkets. There’s evidence^[18] comprehensive policies like these are having positive results.

In Australia, the food industry has made voluntary commitments^[20] to reduce some unhealthy food ads directly targeting children. But these promises are widely viewed as ineffective^[21].

The government is currently conducting a feasibility study^[22] on additional options to limit unhealthy food marketing to children.

But the effectiveness of any new policies will depend on how comprehensive they are. Food companies are likely to rapidly shift their marketing techniques^[23] to maximise their impact. If any new government restrictions do not include all marketing channels (such as TV, online and on packaging) and techniques (including both product and brand marketing), they’re likely to fail to adequately protect children.

Food labelling

Food regulatory authorities are currently considering a range^[24] of improvements to food labelling in Australia.

For example, food ministers in Australia and New Zealand are soon set to consider^[25] mandating the health star rating front-of-pack labelling scheme.

Public health groups have consistently recommended^[26] mandatory implementation of health star ratings as a priority for improving Australian diets. Such changes are likely to result in meaningful improvements^[27] to the healthiness of what we eat.

Regulators are also reviewing^[28] potential changes to how added sugar is labelled on product packages. The recommendation from the committee to include added sugar labelling on the front of product packaging is likely to support this ongoing work.

But changes to food labelling laws are notoriously slow in Australia. And food companies are known^[29] to oppose and delay any policy changes that might hurt their profits.

A sugary drinks tax

Of the report’s 23 recommendations, the sugary drinks levy was the only one that wasn’t universally supported by the committee. The four Liberal and National party members of the committee opposed implementation of this policy.

As part of their rationale, the dissenting members cited^[31] submissions from food industry groups that argued against the measure. This follows a long history of the Liberal party siding^[32] with the sugary drinks industry to oppose a levy on their products.

The dissenting members didn’t acknowledge the strong evidence^[33] that a sugary drinks levy has worked as intended in a wide range of countries.

In the UK, for example, a levy on sugary drinks implemented in 2018 has successfully lowered the sugar content^[34] in UK soft drinks and reduced sugar consumption^[35].

The dissenting committee members argued a sugary drinks levy would hurt families on lower incomes. But previous Australian modelling^[36] has shown the two most disadvantaged quintiles would reap the greatest health benefits from such a levy, and accrue the highest savings in health-care costs.

What happens now?

Improvements to population diets and prevention of obesity will require a comprehensive and coordinated package^[37] of policy reforms.

Globally, a range of countries facing rising epidemics of obesity and diabetes are starting to take such strong preventive action.

In Australia, after years of inaction, this week’s report is the latest sign that long-awaited policy change may be near.

But meaningful and effective policy change will require politicians to listen to the public health evidence rather than the protestations of food companies concerned about their bottom line.

References

1. ^{^} parliamentary inquiry (www.aph.gov.au)
2. ^{^} parliamentary committee (www.aph.gov.au)
3. ^{^} report (parlinfo.aph.gov.au)
4. ^{^} recommending (www.foodpolicyindex.org.au)
5. ^{^} unwilling (pubmed.ncbi.nlm.nih.gov)
6. ^{^} 1.3 million people affected (www.aihw.gov.au)
7. ^{^} Projections (www.diabetesaustralia.com.au)
8. ^{^} obesity (www.aihw.gov.au)
9. ^{^} billions of dollars (www.pwc.com.au)
10. ^{^} cost-effective (y97516.p3cdn1.secureserver.net)
11. ^{^} save the government (journals.plos.org)
12. ^{^} report (parlinfo.aph.gov.au)
13. ^{^} reports on obesity prevention (www.foodpolicyindex.org.au)
14. ^{^} compelling evidence (apps.who.int)
15. ^{^} called (phaa.net.au)
16. ^{^} Chile (www.ourkidsourcall.com.au)
17. ^{^} the United Kingdom (www.gov.uk)
18. ^{^} evidence (www.thelancet.com)
19. ^{^} August de Richelieu/Pexels (www.pexels.com)
20. ^{^} voluntary commitments (aana.com.au)
21. ^{^} ineffective (apo.org.au)
22. ^{^} feasibility study (consultations.health.gov.au)
23. ^{^} marketing techniques (www.obesityevidencehub.org.au)
24. ^{^} range (www.foodregulation.gov.au)
25. ^{^} consider (www.foodregulation.gov.au)
26. ^{^} consistently recommended (www.foodpolicyindex.org.au)
27. ^{^} meaningful improvements (pubmed.ncbi.nlm.nih.gov)
28. ^{^} reviewing (www.foodstandards.gov.au)
29. ^{^} known (assets.advocacyincubator.org)
30. ^{^} BLACKDAY/Shutterstock (www.shutterstock.com)
31. ^{^} cited (parlinfo.aph.gov.au)
32. ^{^} siding (www1.racgp.org.au)
33. ^{^} strong evidence (www.obesityevidencehub.org.au)
34. ^{^} sugar content (pubmed.ncbi.nlm.nih.gov)
35. ^{^} sugar consumption (www.gov.uk)
36. ^{^} previous Australian modelling (journals.plos.org)
37. ^{^} comprehensive and coordinated package (www.thelancet.com)