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Why Cavities are on the rise around the world: Goats and Soda: NPR




The Candylicious store in Dubai Mall in the United Arab Emirates.

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The Candylicious store in Dubai Mall in the United Arab Emirates.

John Stanmeyer for NPR

Ninety-five percent of 12-year-olds in the Philippines have tooth decay or cavities. And cavities affect seven out of 10 children in India, one-third of Tanzania's teens and almost one of the three Brazilians.

These and other sensational oral health statistics are the focus of a two-part series released this week in The Lancet . In it, more than a dozen dentists and public health experts ask for radical measures to end neglected and widespread oral disease.

The culprit?

"Sugar is a causative agent for gums," says Robert Weyant, one of the study authors and a dental professional at the University of Pittsburgh. "Basically, without sugar, you won't develop maturity."

The Ram Ji Road Administration learned its trade from its father – and says he has trained 29 street dentists in Varanasi, India. He believes that sweets are the main cause of tooth decay he treats.

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The road network Ram Ji learned his trade from his father – and says he has educated 29 street dentists in Varanasi, India. He believes that sweets are the main cause of tooth decay he treats.

John Stanmeyer for NPR

Lancet The Lancet study authors also point out what they call a failed tooth system, where many dentists prioritize treatment over preventive work – such as fluorine toothbrush and limiting sugar intake. In combination with an overwhelming number of sweetened food and drink options, the cavities increase, especially in low- and middle-income countries.

This is because residents of these places undergo a global phenomenon known as a "business transition", says Habib Benzian, study consultant and assistant director of global health and politics at New York University's College of Dentistry.

"Low income countries usually have traditional diets, more plant and meat based foods, less sugar and processed foods," Benzian says. "But as a country's socio-economic relationship develops … it's a transition in terms of what people eat."

Benzian explains: "It is part of the convenience. If you work all day and come home, you will have fast food. Foods that are fried, high in fat, sweet and very cheap."

The sugar industry has been quick to jump on the trend. Weyant says, "I see efforts [by the sugar industry] to break into new areas and promote interest in high sugar foods in particularly vulnerable populations."

According to Marion Nestle, author of the book Soda Politics: Taking on Big Soda (and Winning) by 2020, Coca-Cola will spend $ 12 billion in marketing alone in Africa. PepsiCo, Inc. will spend $ 5.5 billion in India by 2020 to expand operations and develop Indian-flavored products.

Coca Cola is part of a spiritual offering that replaces sugar cane, on Sunday service at Sagurap Catholic Church in the village of Wabag, Enga Province, Papua New Guinea.

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Big Sugar marketing campaigns are not the only problem, the study says. According to the researchers t he currently has the industry influencing oral research organizations worldwide.

For example, the European Organization for Caries Research (ORCA) is supported by corporate members such as Mars Wrigley Confectionery, a chocolate, coin, chewing gum and other sugary beverage producer. Unilever, which includes ice cream and sweet drinks, is the company leader of the International Association for Dental Research (IADR).

These conflicts of interest could potentially weaken the direction and results of diet and nutrition research, says sugar politician Cristin Kearns, who wrote a comment on the new series Lancet and is based at the University of California, San Francisco.

Kearns has seen this happen before.

In a 2015 study PLOS Medicine Kearns revealed how the sugar industry affected the US Institute of Dental Research in the 1960s, diverting attention from the real problem at hand – that sugar is unhealthy. [19659008] "I uncovered documents showing how the industry cultivated partnerships with leaders and influenced NIDR's research priorities," said Kearns. or any method but that addresses the sugar consumption. "

In response to the Kearns & # 39; 2015 study, the Sugar Association said to Buzzfeed News," We recognize that Dr. Kearns has devoted significantly time for the task of reviewing thousands of documents from over 50 years ago, but question her motives and certainly the accuracy of her conclusions the Sugar Association … think [s] that sugar is best satisfied with moderation, a fact supported by decades of scientific research. "

A sweet shop in Varanasi, India.

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Towards Big Sugar, what can dentists around the world do?

"The real recommendation is to look at relationships in these [oral health research] organizations and how the sugar industry can affect these relationships," Kearns says. "These organizations must be certain that policies are in place to stop unlawful influence."

Weyant believes it is time for government and national authorities to enter.

He points to the tobacco industry and how it is now a global tobacco management agenda through the World Health Organization. The treaty was established in 2003 as a result of a global increase in tobacco use. The WHO Treaty requires reduction strategies, such as tobacco tax, to discourage people from using the addictive substance.

"However, there is no united global movement against sugar," Weyant says. "I think the model needs to be adapted for sugar."

Benzian points to the need for more focused oral hygiene efforts. For example, to combat cavities in the Philippines, the country established in the 2009 Fit for School program.

"They take education directly to schools," Benzian says. "It's a mandatory program where every day all the kids go out into the courtyards to brush their teeth and wash their hands."

Nadia Whitehead is a freelance journalist and author of science. Her work has appeared in Science, The Washington Post and NPR. Find her on Twitter @NadiaMacias



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