Sugar, a modern day pandemic?

If you knew sugar was slowly killing you, would you eliminate it from your diet? Could you see past the intensive marketing of your favourite candy bar, sugary beverage, or dessert and not feel that internal desire? Should we rely on individuals to make these choices themselves? Or if we know that a healthy lifestyle reduces the incidence of Type 2 Diabetes, saves significant healthcare dollars, and improves the lives of millions of Canadians, should we make policy and regulation changes to control sugar intake much like smoking cessation measures have over the last 30 years?

This week I spoke on a panel at the “Reversing the Course of Type 2 Diabetes Dialogue” event, sponsored by the Institute for Health System Transformation and Sustainability, which aims to discuss and identify opportunities to promote dialogue around prevention, management and reversal of Type 2 Diabetes in BC. There was representation from the BCCDC, Canadian Diabetes Association, Ministry of Health, Health Authorities, UBC, SFU, Internal Medicine experts, Divisions of Family Practice, Therapeutic Nutrition experts and allied health – all of whom brought an incredible variety of knowledge and experience, and gathered to tackle this complex issue in the light of the rising incidence of this chronic condition.

In BC, approximately 10% of our population has been diagnosed with Diabetes which fairs pretty well in comparison to the rest of Canada. But this number doesn’t take into consideration those who are undiagnosed, which is a suspected 1 in 3 and could in part be due to individuals choosing not to be tested or not having access to basic primary care services. This number also doesn’t take into consideration those who have “prediabetes”. Add these figures in, and roughly 30% of our population has – or is on their way to having – Diabetes. It is time to begin addressing this epidemic at all levels of society.

Of course sugar is not the whole story. Inconsistent access to healthy foods, either voluntarily or geographically, and an inactive lifestyle are also major contributors. And not all sugars are evil – I am not recommending a carbohydrate-free diet – but I believe our tolerance to and acceptance of high sugars in our diet would suggest our society has truly become “addicted” to sugar. This disease is not unique to our developed world. Across the world rising adult body mass indexes and rising numbers of children who are obese point to a major health care crisis on par with a pandemic.

The recently revamped Canada Food Guide is definitely a step in the right direction, particularly if they are promoted and supported in our children’s early developing years and schools. Easy access to water in public places could go a long way to reducing the temptation of sugared beverages, and new warning packages could highlight foods considered unsafe for diabetic patients. Improved labelling that reflects the total amount of sugars in processed foods, particularly the amount of added sugar, has helped with population education – but only for those who are taught what the labels actually mean. I believe now is the time to modernize all of our healthy living standards, and leverage social marketing to apply these standards to prevention and access to treatment.

I applaud all the tremendous work done to date, but recognize that the multiple organizations present at this week’s event will need the backing of our Provincial and Federal government to meet this challenge head on. We must foster a societal ground swell of education and supportive resources to turn this disease around. Many issues are simply too big for individual organizations to effect change. Can we change the way people eat? How do we reach the most people in the shortest amount of time? and which population or sub-population do we target first? We could probably start with my house – Christmas and Easter baking and Valentine’s chocolates were certainly part of my upbringing and I am guilty of passing this onto my own children.

Whatever plan we make needs to be both culturally sensitive, inclusive and respectful of long held traditions. We need to urgently change the conversation: what we eat is important, an active lifestyle is important. We have the evidence – Type 2 Diabetes is not a chronic progressive life sentence as previously thought. With the right diet and treatment, remission and reversal is not only possible, it should be our shared vision for the future.

- Dr Kathleen Ross