The Possible Impact of Different Pack Sizes of Carbonated Soft Drinks on Sugar Intake in Nigeria

Background : According to WHO, in 2022, 16% of adults and 8% of children and adolescents globally were living with obesity. In Nigeria, the adult obesity prevalence was around 15%. Excessive intake of added sugars – particularly in the form of sugar-sweetened beverages – increases overall energy intake, obesity and the risk of non-communicable diseases (NCDs). WHO recommends reducing the intake of added sugars to ≤ 10% of total energy intake, and further to < 5% for additional health benefits. The current trend of 600-ml bottles of carbonated soft drinks - being popularized in the Nigeria market - contributes to the “supersizing” phenomenon, which might be an important contributor to the rise in obesity rates in Nigeria. Although the National Policy on Food Safety and Quality - and its Implementation Plan 2023 seeks to address this concern through its development and implementation of a national strategic plan/guideline for the reduction/reformulation of sugar in packaged and processed foods, there is a gap in implementation due to lack of policies that regulate pack sizes of sugar-sweetened beverages. Controlling pack sizes and sugar content of carbonated soft drinks may be a public health regulatory measure that could contribute to placing Nigeria ‘on track’ towards achieving its target of reducing obesity. Objective : This study estimates the possible impact of different pack sizes and the establishment of a maximum sugar level of carbonated soft drinks on sugar intake in Nigeria, based on the assumption that consumers entirely consume a single pack per day. Methodology : The pack sizes and level of sugar in the carbonated soft drinks were estimated by this study from on-pack nutrition food labels of the 16 randomly selected brands in the open markets and supermarkets in Nigeria. An online questionnaire, which asked 42 correspondents in several States of the Federation about their consumption of carbonated soft drinks daily or weekly, was used to estimate intake daily. The assessment of sugar intake and its associated risk to health from different pack sizes was done according the Codex Nutritional Risk Assessment. Comparison of the estimated intakes were made based on the recommended maximum level of sugar intake from the WHO Sugar Guidelines. Result and Discussion: The average sugar content of the carbonated soft drinks was 8.3-g per 100-ml. The estimated intake of sugar increased with pack size, from 16.6-g per day (200 ml pack) to 49.8-g per day (600-ml pack). The risk of excessive sugar intake from 200-ml to 250-ml pack was low, from 300-ml to 330-ml pack medium, and from 350-ml to 600-ml pack high. A high-risk score indicated the possibility to exceed the WHO-recommended maximum daily sugar intake and the need for risk management strategies. If the proposed maximum sugar level of 5-g per 100-ml of carbonated soft drinks was implemented, the estimated risk of excessive sugar intake from 200-ml to 450-ml pack became low, from 500-ml to 550-ml pack medium, and from 600-ml pack high. The estimated relative risk reduction was 40%. This suggests that the likelihood of exceeding the WHO-recommended maximum daily sugar intake is 40% less if maximum sugar level for carbonated soft drinks is set at 5-g per 100-ml. From the questionnaire, the estimated average intake of carbonated soft drinks daily was 335-ml. Using this value and the average sugar content estimated in this study, the estimated sugar intake from carbonated soft drinks was 27.8-g per day (which is more than 50% of the WHO-recommended maximum daily sugar intake). Conclusion and Recommendation: The consumption of carbonated soft drinks increases the risk of excessive sugar intake and is likely to be a major reason behind the rise in obesity in Nigeria. The establishment of a pack-size cap of 450-ml with a maximum sugar concentration of 5-g per 100-ml of the product, would be expected to significantly reduce this risk.