Mobilizing for a war on the home front against sugar-related morbidity and mortality

Dean Schillinger, James G. Kahn

In Israel today, there are 420,200 Israelis diagnosed with diabetes, and every year, Israelis sustain thousands of diabetes-related deaths and tens of thousands of diabetes-related amputations. As such, in Israel, as in much of the world, there is a silent and deadly public health war against obesity and diabetes taking place on the home front -- one in which clinicians, patients, and families fight thousands of life- and limb-threatening battles daily, involving preventable heart disease, diabetes, strokes and amputations. Yet the global clinical and scientific communities, indeed society at large, have barely begun to mobilize. Fighting this war requires confronting and altering "obesogenic" and "diabetogenic" economic and social factors, including food and beverage marketing and pricing that push diets engorged with processed sugars. Ginsberg, in a study recently published in IJHPR, contributes to our understanding of the combined sugar-related health burdens in Israel, producing an epidemiology and health economics study that estimates the health burdens of obesity, overweight, and dental caries in Israel today. He projects the reductions resulting from that portion of disease burden and associated costs if sugar consumption declined to 10 or 5% of daily caloric consumption as a result of multifaceted public health interventions. Projected over 70 years, these reductions in sugar consumption would prevent 16,590 and 34,580 deaths, respectively. These numbers of Israeli deaths averted are similar to, or exceed, the total resulting from armed conflict or terrorism over the past 70 years. While overconsumption of sugar is only one of many factors that drive cardio-metabolic disease, the study by Ginsberg suggests a path through which we can overcome the numerous internal and external obstacles that societies face in making a public policy commitment to fight the warm on the home front: promoting health by reducing added sugar exposure.