Experts sound alarm about South Africans' excessive sugar intake

South Africa has the highest obesity rate in sub-Saharan Africa, with 70% of women and 40% of men over 35 classified as overweight

Experts are calling for heightened awareness of the negative health effects of sugar as South Africans consume between 12 and 24 teaspoons per day, well above the WHO's recommended six teaspoons.

As World Sugar Awareness Week (November 18-24) kicks off, experts have sounded the alarm about excessive sugar intake in South Africa, where the average daily consumption far exceeds World Health Organisation (WHO) guidelines. 

World Sugar Awareness Week is a global campaign aimed at reducing sugar consumption by educating the public on the health risks associated with added sugars and the importance of reducing their intake. 

CEO of the Heart and Stroke Foundation SA Prof Pamela Naidoo said the country is facing an epidemic of non-communicable diseases such as cardiovascular, type 2 diabetes and obesity, with raised sugar consumption playing a key role in driving these conditions.

“During World Sugar Awareness Week, we are encouraging everyone to consider how small behavioural changes to their diet can make a big difference to their health,” said Naidoo. 

Naidoo said most sugar intake in South Africa comes from added sugars in processed foods and sugar-sweetened beverages (SSBs).

She said common items like soft drinks, fruit juices and processed snacks often contain hidden sugars, contributing to higher blood sugar levels and, over time, increased risks of heart disease, hypertension, diabetes, liver disease and other serious health issues.

“Excessive sugar intake has a significant effect on our overall weight, as well as on our organs, skin, teeth and energy levels. The high rate of added sugars in diets, especially in beverages, is a major contributing factor to the obesity crisis. Reducing sugar intake, particularly from SSBs, could help reverse these troubling health trends.” South Africa has introduced a sugar-sweetened beverage tax, she said.

A spokesperson for Pharma Dynamics and advocate for healthy living, Nicole Jennings, emphasises the unique risks posed by sugar in liquid form. 

“When we consume sugar-sweetened beverages, the body absorbs it rapidly, often within 30 minutes, which can lead to a sharp spike in blood sugar levels. This rapid increase doesn't provide the feeling of fullness that we get from solid foods, so people often consume more than they realise,” she said.

Jennings said cutting down on SSBs is one of the simplest yet most effective changes people can make to reduce their sugar intake. She said the effect of sugar consumption on obesity is another pressing concern.

South Africa has the highest obesity rate in sub-Saharan Africa, with 70% of women and 40% of men over the age of 35 classified as overweight.

Jennings points out that obesity significantly increases the risk of developing type 2 diabetes (T2D), heart disease and certain cancers, noting that it’s a public health crisis that requires urgent action.

“Unfortunately, unregulated food outlets often do not comply with the South African legislation. One barrier to cutting down on sugar is the prevalence of 'hidden sugars' in processed foods,” she said.

Learning how to read nutrition labels can empower consumers to make healthier choices. 

“Labels often list sugars under different names, like high fructose corn syrup, dextrose or maltose, which can make it difficult to understand just how much sugar you are consuming,” she said.

Naidoo points out that in South Africa an average 330ml soft drink contains about eight teaspoons of sugar, while a similar serving of fruit juice contains roughly nine teaspoons.

“These amounts far exceed the daily limit suggested by the WHO and quickly add up, especially if you’re drinking more than one a day. It’s essential for consumers to know that ‘total sugars’ on labels includes both natural and added sugars. It’s best to aim for products with little or no added sugar,” said Naidoo.

Jennings has stressed the role of education in reducing sugar consumption by learning about where sugars are hidden and how to recognise them on labels so people can make more informed choices. She said it’s not about depriving oneself, but about making small, sustainable changes that benefit healthy living.

Naidoo acknowledges that while cutting down on sugar may seem challenging, the health benefits are profound. 

“Reducing sugar intake can help prevent a host of health issues, from heart disease to diabetes and even some cancers. Our goal is not just to reduce sugar intake, but to support a future where we are free from preventable diseases tied to our diets. Increased sugar intake is addictive,” Naidoo said.

Therefore behavioural control and self-management are important. 

“World Sugar Awareness Week is an opportunity for us all to rethink our sugar habits and commit to healthier choices.”

The International Diabetes Federation (IDF) estimates that globally 537-million people aged 20 to 79 have diabetes, or about one in ten. Nearly half of these individuals are not aware that they have the disease. By 2030, this figure is expected to increase to 643-million, and by 2045 it will reach 783-million. According to studies from Wits University, it is also the second leading cause of death in South Africa. About 4.2-million people in South Africa have diabetes, representing about one in nine adults. However, due to inadequate surveillance, the precise number of people with diabetes is unknown.

Lizeth Kruger, clinic executive at Dis-Chem said diabetes, particularly type 2 diabetes, which is the most prevalent, is largely avoidable. 

“Maintaining a healthy lifestyle can help prevent or delay its onset and exercising regularly, sticking to a healthy weight, eating a balanced diet, avoiding smoking tobacco and limiting your alcohol consumption are key,” Kruger said 

Kruger said about 45% of South Africans with diabetes are unaware of their condition. 

“Regular check-ups with a clinic nurse and blood sugar tests can help identify those at risk. Symptoms to watch for include frequent urination (especially at night), unexplained weight loss, blurred vision, fatigue, numbness or tingling in the hands or feet, slow-healing sores or cuts, irritability and mood swings,” said Kruger.

“Some individuals, particularly those with type 2 diabetes, may experience only vague symptoms, which makes it even more important and relevant to be screened for diabetes. The earlier it is identified, the better it can be managed, leading to a better quality of life.”

To help the public curb their sugar intake, Jennings and Naidoo suggest the following practical strategies:

• Reduce added sugars: Cut back on sugar added to coffee, tea and cereals. Even small reductions can make a big difference over time.
• Switch to healthier beverages: Choose water, unsweetened herbal tea or sparkling water instead of sugary drinks.
• Limit sugary breakfast foods: Opt for high-fibre, high-protein options like oatmeal with fruit or wholegrain toast with avocado instead of sugar-laden pancakes or muffins.
• Avoid processed snacks: Choose whole foods like fruits, vegetables, nuts and seeds rather than sugary snacks and highly processed foods.
• Choose healthier desserts: Instead of sugar-heavy desserts, try fresh fruit or Greek yoghurt with a sprinkle of cinnamon.