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Sir, the Scientific Advisory Committee on Nutrition (SACN) has concluded that the recommended average population maximum intake of sugar should be reduced by 50% and not exceed 5% of the total dietary energy intake. The SACN also recommended that consumption of sugar-sweetened drinks should be minimised by adults and children.1 In 2016 the Soft Drinks Industry Levy aimed to reduce the consumption of sugar-added soft drinks. From 2018, beverage manufacturers will be taxed according to the volume of sugar-sweetened beverages produced or imported. This soda tax encompasses carbonated drinks, non-carbonated drinks, sports drinks and energy drinks. It has been proposed that pure fruit juices and milk-based drinks are excluded from taxation.2 The levy directly encourages the producers and importers of sugary soft drinks to refrain from addition of sugar, to promote diet drinks, and to reduce portion sizes for high sugar drinks.
However, with regard to diet drinks while they are not cariogenic and might help to reduce weight, frequent consumption can be a potential risk factor in developing erosive tooth wear as their pH values are very low. Development of new beverages with less erosive potential is still recommended but the high profits on beverages will probably not encourage companies to invest in this. Confronted with the sugar tax, companies mainly seem to invest in the marketing of their currently available sugar-free alternatives with erosive potential.
However, there is a healthy, simple and cheap solution. Just encourage your patients to drink tap water! In New Zealand, caries decreased spectacular when children in primary school only drank water and their parents gave them a healthy lunch.3 The schools were no obstacle for the introduction of ‘water only’. Lack of cooperation of parents was the main obstacle.4 If their involvement can be increased, the introduction of water-only policies seems an easy way to improve children’s health without risk of dental erosion. Promotion of drinking (tap) water could start at very young age. Offering fancy reusable bottles might help the acceptance by children.
Tedstone A, Targett V, Allen R and staff at PHE. Sugar Reduction: The evidence for action. Public Health England, 2015.
Soft Drinks Industry Levy: 12 things you should know. Available at: https://www.gov.uk/government/news/soft-drinks-industry-levy-12-things-you-should-know (assessed 28 August 2017).
Thornley S, Marshall R, Reynolds G, Koopu P, Sundborn G, Schofield G . Low sugar nutrition policies and dental caries: A study of primary schools in South Auckland. J Paediatr Child Health 2017; 53: 494–499.
Mansoor O, Ali R, Richards R . Regional survey supports national initiative for ‘water-only’ schools in New Zealand. Aust N Z J Public Health 2017 10.1111/1753-6405.12705.
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Gambon, D., Brand, H. Let them drink water.
Br Dent J 223, 746 (2017). https://doi.org/10.1038/sj.bdj.2017.1008