Citing diabetes as a serious health concern in Singapore, for having the highest prevalence of diabetes among developed nations, Ministry of Health is seeking feedback from the public on what measures Singapore can take to reduce the intake of sugar from pre-packaged sugar-sweetened beverages (SSBs) so as to combat the rising trend of diabetes.
The public consultation will be held from 4 December 2018 to 25 January 2019.
MOH had earlier declared a War on Diabetes in 2016 to mobilise a whole-of-society effort to tackle the disease. It adopted a multipronged strategy through ;prevention through healthy living; regular screening and follow up for early detection and intervention; and better disease management, anchored on public education, community outreach and industry partnership.
It noted that while the War on Diabetes has seen encouraging signs of progress, but more needs to be done to create a supportive environment for Singaporeans to lead healthier lifestyles, and to live free from diabetes.
MOH points out that Singaporeans are consuming on average twelve teaspoons (or 60g) of sugar daily. More than half of Singaporeans’ daily sugar intake comes from SSBs, of which pre-packaged SSBs contribute 64 per cent of this intake. More pre-packaged SSBs are consumed per person per day in Singapore than in many other Asian jurisdictions.
It further noted that although the average sugar level of all pre-packaged SSBs has fallen from five to three teaspoons over the past 10 years, the average sugar level for those with medium- and higher-sugar level has remained high at five teaspoons. These medium- and higher-sugar products make up over half of the total sales of pre-packaged SSBs in Singapore.
Possible Measures for Consultation
MOH claims to have carefully reviewed the measures and practices adopted by other countries, and studied their impact in these countries. Therefore, it is seeking views on four possible measures, which are not mutually exclusive, towards pre-packaged SSBs. MOH says that these measures aim to accelerate industry reformulation to reduce sugar levels in pre-packaged SSBs, and empower Singaporeans to make informed and healthier choices.
(I) Mandatory Front-of-Pack Nutrition Label
To help consumers make healthier choices, one possible measure is to introduce a mandatory front-of-pack (FOP) nutrition label on pre-packaged SSBs. This will empower consumers to readily identify the range of less healthy SSBs ‒ those high in sugar and other nutrients such as saturated fats ‒ and complement the existing Healthier Choice Symbol programme, which is voluntary and marks out only the healthier drinks.
Evidence has shown that FOP nutrition-summary labels, as compared to a full listing of nutrition information, are more effective in helping consumers easily identify products with higher sugar content and/or poorer nutrition quality, as these do not require sophisticated nutrient knowledge. Overseas experience has also shown that adoption of such labels is slow and biased towards healthier products when implemented on a voluntary basis.
(II) Advertising Regulations
Studies have found that exposure to advertisements of less healthy food and drinks influences choice and induces consumption, especially among children. The WHO also concluded that there is “unequivocal evidence that the marketing of unhealthy foods and SSBs promotes childhood obesity”. Studies also show that restricting advertisements can reduce consumption of the product of concern. Many jurisdictions have enacted laws restricting advertisements of less healthy food and drinks.
Currently Singapore has voluntary guidelines to limit the advertising of less healthy food and drinks to children which cover only limited TV time-belts and media channels. There are no guidelines to address the needs of the general population. A possible measure is to regulate advertisements of less healthy SSBs in the mass media, including on online channels, to reduce their influence on consumer preferences. The possible options are:
- Make the current restrictions mandatory and expand them to include more TV time-belts and media channels that children are exposed to; or
- Ban advertising across all time-belts and mass media channels.
(III) Excise Duty on Manufacturers and Importers
Globally, there has been increased momentum to combat obesity and diabetes through fiscal measures. Currently, about 45 jurisdictions have imposed excise duties on SSBs including Brunei, Thailand, Mexico, the United Kingdom, and cities in the United States of America such as Berkeley, California. Experiences in these jurisdictions show that excise duties are effective in spurring industry reformulation to reduce sugar content in drinks.
A possible measure is to introduce an excise duty on manufacturers and importers of pre-packaged SSBs, to encourage the industry to reformulate and reduce the sugar content in their products. The objective of imposing duties on SSBs, if introduced, is not for revenue generation, but to shape the behaviour of manufacturers and consumers. Duties on SSBs aim to encourage manufacturers to reformulate their products and to encourage consumers to choose healthier drinks that are lower in sugar content or drink plain water. Switching to these healthier options can help consumers reduce their sugar intake, and in turn, lower their risk of obesity and diabetes further.
(IV) Ban on Higher-Sugar Pre-Packaged SSBs
In Singapore, SSBs with more than three teaspoons of sugar per 250ml serving are not allowed to be sold in schools and on government premises. While this restricts access to higher-sugar SSBs in schools, the students and general population can still obtain such SSBs from other avenues. In 2017, seven major SSB manufacturers have also pledged to limit the sugar content in their pre-packaged SSBs sold in Singapore to no more than six teaspoons per 250ml serving. Another possible measure is to introduce a nationwide ban on the sale of higher-sugar pre-packaged SSBs to further discourage consumption of such SSBs.
The public consultation paper with details of the four possible measures can be found on REACH at http://www.reach.gov.sg/sugarydrinks.
Views and feedback can be submitted via the REACH website from 6:00pm, 4 December 2018 to 6:00pm, 25 January 2019. All responses received by the closing date will be carefully considered. As part of the public consultation exercise, MOH and HPB will organise dialogues with the public and industry in the coming months. Details of the public dialogues will be provided closer to date.
Prime Minster Lee Hsien Loong had earlier raised the issue of diabetes during his National Day Rally in 2017 and sugar-intake was one of the key topics discussed during the Committee of Supply debate this year.