- By Dr Sandra Davies, Director of Public Health, Liverpool City Council
Most of us think we know the basics about sugar. We know that there is likely to be a lot of sugar in a chocolate bar and less so in a yoghurt. It’s obvious, right? But are we as sugar savvy as we think?
A lot of the sugar we consume isn’t as obvious as we think. Many sugars consumed by families and children come from products that you wouldn’t necessarily expect to have much sugar in them; so called ‘hidden’ sources. Did you know that, on average, there are nine sugar cubes in a can of cola, over five sugar cubes in a sugary yoghurt and six sugar cubes in a chocolate bar? Yet the maximum added sugar intake for four to six year olds should not be more than five sugar cubes per day. There are also lots of hidden sugars in tomato sources, flavoured water, soups and lots of other unexpected items.
One of the problems is that many of us don’t study or understand food labelling. To help us get to grips with it all, Change4Life launched a campaign back in January to help parents and families to become more Sugar Smart and cut back on the amount of sugar in theirs and their children’s diets. The campaign revealed the surprising amounts of sugar in everyday food and drinks and encouraged families to take control and protect their children from the dangers of having too much sugar.
The campaign also advised on the maximum amount of sugar we should be having each day as recommended by the government and promoted the new Sugar Smart app. The app is a brilliant tool, completely free to use and download, designed to show quickly and easily how much total sugar is in the things you’re buying, eating and drinking and to help you spot it more easily so you can make healthier choices. You can just scan any barcode in your supermarket shop and it tells you how much sugar is in the item.
The campaign followed on from the successful Food Active GULP Campaign (Give Up Loving Pop) supported by North West Directors of Public Health which highlighted fizzy drinks as the biggest culprit in the fight against sugar in the diet of children and young people.
Liverpool Public Health and Liverpool City Council supported both of these campaigns locally which then further alerted us to the size of the health problems related to high levels of sugar in the diets of our children and young people. There are alarming levels of tooth decay in young children in the city, with dentists having to remove teeth from children as young as five under general anaesthetic on a daily basis, and around 2,000 children in the city will have had extractions by the age of five.
More than a third will have suffered from tooth decay. What’s most shocking, is that tooth decay in particular, in children, is largely preventable by reducing sugar intake and keeping teeth clean. Also, what many people don’t realise is that baby teeth help guide adult teeth into position and persistent infections. Loss of baby teeth can also lead to further problems with the development of the adult teeth in the future.
Rates of overweight and obesity reported through our National Child Weight Measurement Programme were also a real cause for concern, and with research suggesting that children are consuming three times the recommended daily allowances of sugar, largely through sugary drinks, we felt that we had to take some really strong action. As a parent myself, I know how important it is to get children into good habits early on. Whilst many of us might relate too much sugar to a sore tooth or putting on a bit of weight, it can also lead to tooth decay, obesity, diabetes and some cancers in the future.
The Change4Life campaign highlighted the fact that parents found that the labelling on drinks was confusing. Knowledge is half the battle and so we decided to develop a campaign that would clearly display the amount of sugars in drinks popular with children.
We are very fortunate in Liverpool to have an Insight and Behaviour Change team that works with every aspect of public health to come up with creative and outcome driven initiatives.
We decided to go one step further than with previous campaigns, launching our ground breaking ‘Sugar cube campaign’ which shows how much sugar is in popular branded children’s drinks. For the first time, branded drinks, including Lucozade, Capri Sun and Coca Cola, are explicitly named to show how many cubes of sugar each bottle contains.
The campaign launched on 9th May, and is aimed at families and parents of children aged 5-11. So we could influence this group, we placed campaign materials in areas where we expect parents to visit (e.g. children’s centres, hospitals, dental practices, GP practices, walk in centres etc).
Parents are being encouraged to swap their children’s sugary drinks for water, low fat milk and diet drinks and if they still choose sugary drinks they are advised to keep them to meal times only. As well as displays there will be a range of local family fun community events and regular items on radio. We’ve also used interviews in the local media with local dentists and councillors who are supporting the campaign.
The campaign will run over the summer, and will be fully evaluated for impact and awareness. We will measure the number of local hits and sign ups to the Change4Life website, the number of hits on the Liverpool Echo digital adverts, twitter engagement and engagement at the community events. The Campaign has already attracted a great deal of media interest, locally, regionally and nationally, and has led to many requests from other areas of the country who have asked to use the materials to bring this very important message to their own localities.
In developing the communications plan the Insight and Behaviour Change Team in Public Health worked with the Communications team at the Local Authority, and put together a team of spokespeople and health professionals available for media interviews. This included myself as DPH, the Elected Member for Health and Social Care and The Mayoral Lead for Health and Wellbeing and Consusltant Paediatric Dentists.
Whilst we did expect some media interest, given some of the startling facts that we were presenting, the level of interest up to and on the day of the launch was extensive. The fact that I as DPH was able to front a lot of the media is really testament to the relationship that we have with our Elected Member and mayoral lead for health and wellbeing, and how public health has been supported within the Council as a whole. Whilst it was great as DPH to be a voice for the campaign, it was important that we had Elected Member voices and other health professionals to add weight to the stance that the Council was taking.
For more information on the Sugar Cubes campaign please contact Katy.Simic@liverpool.gov.uk