Kwesi Marshall | Don’t buy Professor Morrison’s sweet talk
The presentation of Interim Guidelines seeking to reduce the sugar content of sugar-sweetened beverages (SSBs) sold in schools, by Minister of Health Christopher Tufton, has garnered notable public attention. While much of the conversation concerning this initiative has been strongly supportive, some voices - as to be expected in a matter of such national importance - have been raised in opposition.
Perhaps the most surprising of these dissenting voices has been that of Professor Errol Morrison, the president and co-founder of the Diabetes Association of Jamaica (DAJ). As the recently appointed chairman of the National Food Industry Task Force (succeeding the able stewardship of Professor Fitzroy Henry), I have, of course, attended to the professor's comments with some interest. In this piece, I will deliver the response from the Task Force.
Professor Morrison's many contributions over several decades as a respected physician, scientist, and administrator mean that the explicitly stated reasons behind his decision warrant serious and fair-minded scrutiny. It is clear that the professor's remarks do not unsettle the considerable scientific rationale undergirding those Interim Guidelines and do not, in fact, provide sufficient support for his declared opposition to their implementation.
Here I focus on specific comments Professor Morrison made during an interview on Cliff Hughes Online on October 4, 2018. Professor Morrison centres the reasoning for his opposition on a scenario in which young children from "deep, rural settings" must walk long distances, without breakfast, to their schools. Hungry and in need of nutritional sustenance, these children are greeted by the proverbial bag juice man, from whom they buy rescuing servings of bag juice. In such situations, the professor argues, "sugary drinks may very well be helpful".
In fact, the professor goes further. "And I'm saying that sugary drink is of tremendous help to them. And that is not a matter of opinion. That's a fact. Because the brain requires that sugar and it's using 50 per cent of it. That's not giving you an opinion, Cliff." Furthermore, he forthrightly asserts: "When you're working hard in physical and mental activity, sugary drinks have no real adverse effects and I don't know who can take opposition to that. It's not an opinion. I'll say it again. It's a scientific fact."
So, is it a scientific fact that in certain contexts, sugary drinks "have no real adverse effects"? Not quite. In fact, it remains a matter of considerable debate whether sugary drinks, in any context, are as innocuous as the professor contends, especially when their potential long-term effects on health are considered.
However, is it a scientific fact that the brain requires sugar? Now, the answer is quite straightforward. Except for conditions of prolonged fasting or starvation, glucose - simple sugar - is indeed the preferred fuel for healthful brain activity. So, count that as a scientific fact.
But now we come to a crucial question: Does it then follow that SSBs, by themselves, are suitable single-source dietary choices in situations demanding elevated nutritional support? One could answer this question in the affirmative only if it were demonstrated that SSBs were sufficiently complete and acceptably balanced dietary sources of nutrients. So, what does the nutritional science say?
The answer from that science is extremely clear here. And the answer is an extremely clear and resounding no. Now and then, you might hear nutritionists or other health professionals speak of SSBs as dietary supplies of so-called 'empty' calories.
But why would they say such a thing? Well, in nutritional terms, a typical serving of such a beverage will provide its calories or energy in the form of simple sugars, some water for hydration and ... that's just about all. And, yes, that is a scientific fact. So, bag juices, in particular, and SSBs, more broadly, actually fall considerably short of being adequately complete or balanced nutritional sources.
One can imagine that this statement of the task force's position on SSBs might raise concerns in certain quarters, particularly among some food and beverage industry stakeholders, of a complete banning of SSBs from the Jamaican dietary landscape. Might that really be so?
No. Not at all. First, the proposed framework, which is scheduled to begin implementation in January 2019, is designed to produce a gradual, multi-year, stepwise reduction in the amount of sugar added to SSBs, limited to school settings only. Therefore, rather than talk of a ban or tax on sugary drinks, perhaps the term 'sugar cap' would be more apposite.
Second, the very idea of promoting sustainable lifestyle choices, grounded in sensible and nutritionally balanced diets, is based on allowing consumers to select freely, without any semblance of coercion, their own food and beverage choices, from as broad a dietary spectrum as they can afford.
So, on occasion, SSBs might well be enjoyably and perhaps even healthily consumed but consumed prudently as extremely minor players from among a much larger and more diverse dietary cast of characters.
So, we have seen the nutritional science clearly recommends the implementation of the Interim Guidelines. The Guidelines, then, by promising to promote the current and future public health, deserve the active support of all well-meaning Jamaicans.
Accordingly, on behalf of the members of the National Food Industry Task Force, I urge Professor Morrison to reconsider his opposition to the proposal. I also urge our partners in the Jamaican food and beverage industry to lend, in good faith, their crucial assistance throughout the implementation process.
And, above all, I urge the people of Jamaica, in schools and out of them, to provide their whole-hearted backing to this important policy initiative.
- Kwesi Marshall, PhD, is chairman of National Food Industry Task Force. Email feedback to firstname.lastname@example.org.