Diabetes can be characterized as a new type of pandemic. It is probably the first pandemic to be mostly caused by our modern lifestyle: what and how much we eat and how much we exercise. Historically, people over 65 years of age used to develop diabetes. Today, however, younger people tend to develop diabetes, especially in developing countries. Besides lifestyle choices, the packaged food and beverage industry are facing more and more criticism, as it seems to have become clear that replacing fats with sugar has become one important causal factor for the epidemic.
For several decades, the prevailing diet paradigm has been that high intake of saturated fat and cholesterol increases the risk of atherosclerosis and ischemic heart disease. As a response, lowering the risk of heart disease has been the main driving force behind national and international dietary recommendations. This model, which promotes diets that are typically low in fat (particularly saturated fat) and high in complex carbohydrates, has led to substantial declines in the percentage of energy intake from total and saturated fats. At the same time, it has spurred a compensatory increase in consumption of refined carbohydrates and added sugars — a dietary shift that may be contributing to the current twin epidemics of obesity and diabetes. In other words, as fat has been replaced by sugars, what appears like a healthier diet might in fact have been counterproductive to our health.
A recent example from the dessert aisle: Frozen yoghurt is one of the recent success stories in the food industry. Sales of frozen yoghurt in Britain have grown from 6 million GBP in 2011 to 13 million GBP in 2013, an increase of 117%. Part of the reason is because frozen yoghurt is perceived as a healthier product than traditional ice cream. What differentiates ice cream from frozen yoghurt, however, is that the latter is made with yoghurt instead of cream, which also gives it a sour taste and overall feels lighter than ice cream. But here is the catch: if you are opting for frozen flavoured yoghurt because you consider ice cream is fattening, it might not always be such a wise choice because flavoured frozen yoghurt contains a significant dose of sugar. And whilst cream saturates, sugar doesn’t as much, leaving you feeling hungry as a result. Hence, you may eat more frozen yoghurt than you would have eaten conventional ice cream. This effects correlates with research showing that “sugar bingeing” produces addictive-like behavior, while data with regard to the relationship between fat intake and addictive behavior is not conclusive.
Another issue compounds the unintended consequence of replacing fat with sugar to lower fat content in food but preserve taste: namely the type of sugar used. Conventional sugar, produced from sugar cane or beets, is gradually being replaced by fructose, a processed sweeter derived mostly from corn. Fructose, especially the type produced from corn in the form of High Fructose Corn Syrup (HFCS) is relatively inexpensive, has some advantages in terms of processing, and has therefore become very popular in the food industry. In the United States, fructose, in the form of HFCS, represents more than half of the sweet products that US consumers eat and drink. Most of that HFCS is currently used in the production of soft drinks. Yet there is academic research providing evidence that fructose induces an increase in uric acid which may be a major mechanism causing cardiorenal disease. This disease is characterized by increasing rates of obesity, the metabolic syndrome, Type 2 diabetes and kidney disease.
Increased sugar and especially increased HFCS-consumption in soft drinks and processed foods may represent important causal factors in the global diabetes pandemic. And as the discussion has finally entered the public space, the first politicians and regulators have started to take action.
Mexico, for instance, plans to raise levies on the fatty foods and sugary sodas in order to reduce consumption and spur consumers to replace some food and beverage item with healthier alternatives. New York City has just lost its bid to impose a ban on oversize sodas in a ruling by the state’s highest court. The ban, which when introduced by former Mayor Mike Bloomberg drew voluble responses on both sides of the issue, had been an attempt to promote a healthier diet.
Food and beverage companies are increasingly aware of this issue, and the most sustainable companies – some of which also have some rather unhealthy products in their portfolio – have started to change product recipes, or to more strongly promote some new and healthier product innovations. Companies, however, try to go step by step, in order to preserve consumers’ favorite tastes and reduce the risk of losing their customers in the process of offering healthier product alternatives.
As the unintended consequences of replacing fat with sugar become more widely acknowledged by the food and beverage industry, regulators and consumers, innovation budgets should be redirected to providing alternatives that are healthier all around. And as this tipping point comes, sustainability leaders will have a competitive edge over those who choose to stand still.Jürgen Siemer, PhD is a Senior Analyst on the Sustainability Investing Research team at RobecoSAM, specializing on the link between sustainability and financial performance in the Consumer Staples sector. Prior to joining RobecoSAM in 2011, he worked for more than 13 years at DEG-Deutsche Investitions und Entwicklungsgesellschaft GmbH in Cologne, Germany, where he appraised project financing for agribusiness firms in developing countries.
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 “Epidemic obesity and type 2-diabetes in Asia”; The Lancet, 2006
 “Are refined carbohydrates worse than saturated fat?”; The American Journal of Clinical Nutrition; 2010
 “Sugar and fat bingeing have notable differences in addictive-like behavior”; Avena et al.; The Journal of Nutrition; 2009
 U.S. Sweetener Consumption Trends and Dietary Guidelines. Jensen and Beghin; Iowa Ag Review; 2005
 Potential role of sugar (fructose) in the epidemic of hypertension, obesity and the metabolic syndrome, diabetes, kidney disease, and cardiovascular disease. Johnson et al.; The American Journal of Clinical Nutrition; 2008