Sugar shovellers are making us sick, fat and poor (and check out what they pay in tax!)

by James Muecke and Grant Ennis | Nov 15, 2022 | Business, Latest Posts

We need to beat the lobbyists at their own game. Rather than blaming victims, we need to demand political action and stand in solidarity with those who battle to remain healthy within our transparently rigged and unhealthy food environment, writes James Muecke, with Grant Ennis.

I can see more clearly now. For three years I’ve been calling for a public campaign to raise awareness of the dangers of type 2 diabetes. I’ve even produced two commercials that played nationally on free-to-air television – both featuring a working class Aussie bloke, Neil, who suddenly went blind in both eyes due to neglect of his type 2 diabetes.

I’d hoped the hard-hitting story would scare the 1.7 million Australians with this disease into having their eyes checked, to prevent them from going blind.

I now realise these interventions don’t work. Although personal stories can be emotive and powerful, they obscure the government food and beverage policies shaping the behaviour of victims such as Neil. And worse, they erode any desire to change those harmful policies.

The underlying issue is that government policies have created an unhealthy food and beverage environment (hereafter referred to as “food environment’) – one that is flooded with highly processed “foods” that are loaded with sugar and seed oils.

And what’s the impact? One hundred thousand Australians develop type 2 diabetes every year, with over 537 million suffering from the disease around the world (1).

Fifteen thousand Australians die from type 2 diabetes every year, with over 6.7 million dying worldwide (2). One hundred thousand Australians have sight-threatening eye disease due to type 2 diabetes, and over 93 million globally (3) And most of this misery, disability, and death is preventable.

There has been a four-fold increase in type 2 diabetes globally over the past four decades, in one generation, and an eighty-fold increase among Australia’s First Nations’ people. This is not due to genetics. Genetics may load the gun, but diet pulls the trigger.

As it stands, government policies favour the ultra-processed “food” and sugary drink industries (hereafter referred to as “industries”) and incentivise them to produce and sell sugary consumables. It’s this policy environment that is driving a multitude of avoidable chronic diseases and deaths each year. And yet these industries deploy sophisticated framing techniques to cover their tracks, muddy the waters and divert our attention — deceitful framing techniques that protect their profits.

In my advocacy, I’ve also been calling for better education of our children regarding the dangers of ultra-processed “foods” and sugary drinks, and I’ve been calling for a food-labelling system that’s clear and transparent and not hijacked by industry. I now realise initiatives such as these may simply be different forms of victim blaming.

As such initiatives hinge on providing more information so individuals can make better “choices”, they divert attention away from the pro-industry policy environment, shifting accountability from laws favouring industry to the willpower of everyday people, the victims of these harmful policies.

You’re being conned – and it’s not your fault

Sadly, these efforts don’t change population health; they undermine support for policy change, and they reduce political will for meaningful action. We do, however, need to find better language to inform people they’re being conned, and that it’s not their fault. What I should have been doing, in solidarity with Neil and others like him, was going after the root cause – the government policies shaping a food environment which is making us sick.

Many jurisdictions around the world are admirably putting an end to long-standing policies harming the health of their people. By working with other champions advocating for a healthy food environment, we can demand our governments and councils do the same. We can end subsidies for ultra-processed substances and sugary drinks, outlaw their sale in and around schools, hospitals, and government buildings, and implement other measures that demonstrably improve our food environment, and our health.

To do that, we first must come to terms with the nefarious industry public relations we’ve been force-fed, that distract us from organising and taking action. The problem is, we‘ve been so surrounded by false narratives – aka “industry public relations” – and for so long, that we must question our most basic assumptions about the root causes of ill health. Not an easy task, as industry PR, by design, makes learning the truth all too challenging.

The Big Sugar juggernaut: how corporate players keep Australia addicted to a sweet killer

To see through the smoke and mirrors, I reached out to Grant Ennis, a disinformation researcher, who shared with me his typology of nine devious PR strategies. Now I see them everywhere, especially when it comes to the ultra-processed “food” and sugary drink industries.

Of the framing techniques corporations employ to deceive the public, first and perhaps foremost are blatant lies. Lies enable corporations (and the associations that often front them) to undermine support for policy change by denying the fact that sugar causes diseases such as tooth decay, obesity, and type 2 diabetes.

They back up their lies by funding studies that manipulate the data in their favour. One eye-opening review paper revealed that of the 34 studies not sponsored by industry, 33 showed that sugar-loaded beverages are associated with obesity and type 2 diabetes. In contrast, of the 26 studies sponsored by industry, none showed a link between sugar-loaded beverages and chronic disease (4).

Industry pollutes the scientific literature on purpose so they can argue the data is inconclusive. This ultimately undermines support for any change at all. Coca-Cola has been one of the biggest culprits in the dissemination of disinformation, denying their drinks can be dangerous to our health. For years, Coca-Cola’s annual reports to the US Securities and Exchange Commission listed obesity and its health consequences as the biggest threat to their profits.

The industries counter such threats with intensive marketing and lobbying. They also fight public health campaigns with deviously misleading campaigns of their own. One such initiative is Nestlé’s “Be Body Positive with Nestlé.” The concerning trend of normalising obesity, amplified by industry, is an injustice to those who suffer from this condition and its many life-changing and life-threatening consequences. Only 0.5% of people with obesity are metabolically healthy (5).

Devious and misleading messages on obesity

The normalisation of obesity instils a belief in the population that obesity is not a problem and hence no solution is required. With two-thirds of Australians either overweight or obese – in other words metabolically unhealthy – it looks as though most of us have fallen for this devious frame. This in turn has led us into murky waters, as attempting to even discuss the global obesity pandemic can swiftly be deemed fat shaming.

Beyond the lies, corporations employ solutions that generate the appearance of action. Coca-Cola is a founding corporate partner of Exercise is Medicine, a global initiative that perpetuates the message that exercise is the solution to our chronic health problems. The argument that physical activity is the key to weight loss, is unsurprisingly backed up by research funded by Coca-Cola.

This is reinforced by copious links between the food and drink industries and sporting clubs, teams, and associations – think Cadbury’s sponsorship of the Wallabies rugby team or Kellogg’s Nutrigrain – “iron man food.”

There’s no doubt exercise is important for health, however the reality is, according to a recent study published in The Lancet, our unhealthy food environment is responsible for more disease and death than tobacco, alcohol, and physical inactivity combined (6).

The pervasive message to “move more and eat less”, popularised by industry and their various fronts, is not the answer to obesity and type 2 diabetes. Even more concerning is Nestle’s sponsorship of suicide prevention charity RU OK through sales of their unhealthy confectionary bar KitKat.

With 50% of patients with type 2 diabetes suffering from mental health issues, this is a thinly veiled attempt to divert attention away from the fact that unhealthy consumables are the likely culprits driving our chronic disease and mental health crisis (7).

I met executives from both Coles and Woolworths in Australia during 2020. I expressed my concern regarding their relentless promotion of junk food and drinks at checkouts and at the end of aisles within their supermarkets. They attempted to throw me off the scent by communicating their support of a variety of charitable organisations. All well and good, however this virtue signalling is blatant devious framing that by no means excuses the predatory marketing and sales behaviour of these giants of the food world, ruthless behaviour that’s driving profits at the expense of our health.

Deadly impulse: temptation at the checkout

It’s not just the supermarkets preying on our addictions, but service stations, post offices, chemists, and office supply stores. Chemists, please no! Office supply stores, really? I wrote to Officeworks in Australia, questioning the junk food at their checkout counters. Apparently, as they wrote to me in their response, they have “identified the need … to include more health products” in their “impulse range” at checkouts. Presently, nearly three-quarters of Officeworks’ “impulse” products are unhealthy, and parents must run the gauntlet of junk food stands as they progress in the queue with their kids. Watch out Mum and Dad!

Or better still, Mum, Dad and everyone else, you can make a difference to stop this. Call your policy-makers to demand this egregious practice be banned, as it is in the United Kingdom (8) and other places that prioritise health (9).

Another example of devious framing can be found on Nestle’s Know More About Diabetes webpage, where its states,

The main reason behind acquiring diabetes is genetic… (10).

There has been a four-fold increase in type 2 diabetes globally over the past four decades, in one generation, and an eighty-fold increase among Australia’s First Nations’ people. This is not due to genetics. Genetics may load the gun, but diet pulls the trigger.

The illusion that innovative genetic therapies will be the solution to obesity and type 2 diabetes once again clouds the policies promoting our unhealthy food environment. More disturbing is that industry is now offering up dietary treatments for obesity and type 2 diabetes at the same time as continuing the subsidised marketing of the very products that are responsible for these chronic diseases.

A classic example is Optifast, an ultra-processed food-like substance designed for weight loss by Nestlé, a company in which over 60% of its portfolio does not meet the “recognised definition of health.” Nestlé is currently providing Optifast for a study in Sydney to determine whether the substance can put type 2 diabetes into remission. Disturbingly, this study is being supported by local obesity and diabetes associations.

We are being conned – “treatments” are being promoted by companies rather than preventive measures that would impact on their profits. And pharmacists, health practitioners and patients alike are falling for it.

We also see combinations of these devious strategies, framing the public health crisis as multifactorial or complicated. The Australian Non-alcoholic Beverage Industry’s recent Sugar Reduction Pledge is one such tool from the devious framing toolbox of the sugary drink industry. The pledge utilises a “multifactorial” strategy that harnesses several activities with dubious efficacy. These include nutritional literacy programs and funding for companies that frame obesity as an individual issue instead of the public health issue it is. Both these activities have been proven ineffective.

The Sugar Reduction Pledge makes the Non-alcoholic Beverage Industry appear to be working for the public good, when it is unlikely to be having any impact at all. Such a tool distracts us from more tightly regulating an industry that’s harming our health. The reality is the reduction in sugar of less than 1g/100ml still leaves the average drink with 5g of sugar per 100ml of liquid (more than 1.25 teaspoons), a dangerously high level.

Sadly, this initiative is destined to fail in solving our public health crisis. What’s worse, it will dilute political will for real change. Further, only four out of over 70 members of the Australian Beverages Council have committed to the voluntary pledge. Industry lobbyists persuade our governments to provide tax breaks, also called tax subsidies, which lower operating costs and the cost of their products, thereby increasing consumption.

Tighten tax laws and abolish subsidies

Rather than taxing these products, a strategy that’s evidence-based but has been successfully demonised by industry, a more powerful tool may be to put an end to these tax subsidies and incentives altogether. According to public health group Live Lighter,

In Australia, food companies receive subsidies that are contrary to public health outcomes from both state and federal governments.

While recent discussions around Australia’s taxation system have canvassed several unsatisfactory proposals, such as removal of the GST (goods and services tax) exemption on basic foods, costs incurred by the junk food associated with advertising, marketing and sponsorship are tax deductible. In this respect, Australian taxpayers are effectively subsidising the advertisements for junk food and sugar sweetened beverages (11).

Walter Heller, former adviser to US President John F. Kennedy, once commented on this type of tax subsidy, that “The back door to government subsidies marked ‘tax relief’ is easier to push open than the front door marked ‘expenditures’ or the side door marked ‘loans, guarantees, and insurance’ … The very groups that use this back door are often among the most insistent advocates of responsible and informed Government budgeting. Yet here is a whole catacomb of Government benefits which are largely hidden from public view, let alone, periodic review.” (12)

Like Americans, Australians and others around the world also suffer from these largely hidden and perverse tax subsidies. Grant Ennis’s book, Dark PR, lays out the shocking scale of industry subsidies at the global level, but I wanted to understand better how these kinds of subsidies look in Australia.

Using 2019-2020 tax data, Grant and I compared what ultra-processed “food” and sugary drink companies should have paid in taxes, the 30% corporate tax rate, to what they actually paid after tax breaks. (13)

The results were disturbing. Through a plethora of tax breaks, many of the largest companies paid essentially 0% in taxes. This means we’re incentivising these companies to make us sick, through our tax code.

Diabetes tax implications

Tax subsidies of the sugar industry

Coca-Cola alone costs Australian taxpayers over one billion dollars each year in lost tax revenue. In total, these industries receive nearly $5 billion a year in subsidies. This lost tax revenue means the cost of production of their products is cheaper, effectively lowering prices – the opposite of a sugar tax.

This is plainly outrageous. We need to beat the lobbyists at their own game. Rather than focus on individuals through a myriad of victim-blaming approaches, we need to demand political action as we stand in solidarity with those who battle to remain healthy within our transparently rigged and unhealthy food environment.

 We must organise and demand policymakers change these deadly laws. It’s well past time for our governments to act to end the harmful policies causing such needless devastation and deaths.

 Note: Many of the concepts from this article, particularly those regarding “framing techniques”, have been sourced, with permission of the author, from Grant Ennis’s book Dark PR: How Corporate Disinformation Undermines Our Health and the Environment – available here.

1 IDF. “IDF Diabetes Atlas: 2021 – 10th Edition.” International Diabetes Federation, December 13, 2021.

2 IDF. “IDF Diabetes Atlas: 2021 – 10th Edition.” International Diabetes Federation, December 13, 2021.

3 Tilahun, Melkamu, Teshome Gobena, Diriba Dereje, Mengistu Welde, and Getachew Yideg. “Prevalence of Diabetic Retinopathy and Its Associated Factors among Diabetic Patients at Debre Markos Referral Hospital, Northwest Ethiopia, 2019: Hospital-Based Cross-Sectional Study.” Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy 13 (June 24, 2020) Retail Food Group Limited $323,924,266 $0 $0 0.00% $97,177,280 MPD Dairy Products Pty Ltd $324,866,517 $10,054,810 $3,016,434 0.93% $94,443,521 General Mills Holding (Australia) Pty Ltd $321,771,075 $10,910,171 $2,979,702 0.93% $93,551,621 Mackay Sugar Ltd $269,763,795 $0 $0 0.00% $80,929,139 Tully Sugar Limited $150,611,543 $667,286 $0 0.00% $45,183,463 Coca-Cola South Pacific Pty Ltd $163,470,670 $16,676,242 $5,002,873 3.06% $44,038,328 Total $4,862,681,516

4 Schillinger, Dean, Jessica Tran, Christina Mangurian, and Cristin Kearns. “Do Sugar-Sweetened Beverages Cause Obesity and Diabetes? Industry and the Manufacture of Scientific Controversy.” Annals of Internal Medicine 165, no. 12 (December 20, 2016)

5 Araújo, Joana, Jianwen Cai, and June Stevens. “Prevalence of Optimal Metabolic Health in American Adults: National Health and Nutrition Examination Survey 2009–2016.” Metabolic Syndrome and Related Disorders 17, no. 1 (February 2019)

6 Afshin, Ashkan, Patrick John Sur, Kairsten A. Fay, Leslie Cornaby, Giannina Ferrara, Joseph S. Salama, Erin C. Mullany, et al. “Health Effects of Dietary Risks in 195 Countries, 1990–2017: A Systematic Analysis for the Global Burden of Disease Study 2017.” The Lancet 393, no. 10184 (May 11, 2019)

7 Malmir, Hanieh, Fatemeh Sadat Mahdavi, Hanieh-Sadat Ejtahed, Elham Kazemian, Abolfazl Chaharrahi, Nami Mohammadian Khonsari, Armita Mahdavi-Gorabi, and Mostafa Qorbani. “Junk Food Consumption and Psychological Distress in Children and Adolescents: A Systematic Review and Meta-Analysis.” Nutritional Neuroscience. (July 11, 2022)

8 Walker, Peter. “Unhealthy Snacks to Be Banned from Checkouts at Supermarkets in England.” The Guardian, December 28, 2020.

9 AFP. “California City Bans Junk Food from Checkout Aisles.” France 24, September 25, 2020.

10 Nestlé Family ME. “Know More about Diabetes! Your Family’s Nutrition.” Nestlé: Your Family’s Nutrition, February 7, 2021.

11 LiveLighter. “Australian Junk Food Industry,” 2016.

12 Heller, Walter Wolfgang. “Some Observations on the Role and Reform of the Federal Income Tax.” In Tax Revision Compendium: Compendium of Papers on Broadening the Tax Base, Vol. 1. Washington D.C.: United States Government Printing Office, 1959.

13 Khadem, Nassim. “A Third of Big Companies Paid No Tax in 2019-20, This Table Reveals Which Ones.” ABC News, December 9, 2021.

Vindication: dietitians cut ties with sugar lobby

Dr James Muecke AM is an ophthalmic surgeon and ophthalmologist. James has also been recognized for his work globally, particularly in South East Asia, and has been awarded the Australian of the Year for 2020.

Grant Ennis is the author of Dark PR: How Corporate Disinformation Undermines Our Health and the Environment. Grant has more than 20 years’ experience in international humanitarian affairs, environmental policy, and public health. He is a distinguished alumnus of both the University of the Pacific and the Middlebury Institute of International Studies.

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