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The daily drugs in our diet

- Leanne Rencken

“We need to create an environment for people where the healthy choice is the easier choice.”

Earlier this year, community WhatsApp groups and social media lit up with parents desperately looking for a fix. Under pressure from their social media savvy children who’d landed on YouTube viral content, it seemed consumers would do and pay anything to score some Prime, splurging upwards of R400 for 500ml of the American energy drink, and parents were left scrambling.

If you weren’t part of the Prime frenzy, think about the over-inflated prices people were prepared to pay for cigarettes and pouch tobacco during the most stringent Covid-19 lockdowns, and about the brewing of hazardous homemade concoctions to bootleg or top-up the booze cabinet.

It seems we are all prepared, in one way or another, to go the extra mile for ‘our daily drugs’ – those seemingly benign items we consume regularly without thinking too much about their impact on our health. And these daily drugs including caffeine, nicotine, alcohol and ultra-processed foods are readily available, aggressively marketed, promoted by influencers, and glamourised in the media.

Sugar, sugar tax, obesity | Curiosity 16: #Drugs ©

Dangerously transformed food

Professor Susan Goldstein is the Deputy Director and COO at the South African Medical Research Council (SAMRC)/Wits Centre for Health Economics and Decision Science (PRICELESS SA). She’s a public health medicine specialist in a multidisciplinary team focusing on non-communicable diseases (NCDs) in South Africa. She says that specific foods constitute a potential daily drug and are therefore “an important area to look at, as a lot of the food we eat every day is highly processed”.

She says that, although it hasn’t always been the case, these days we’re shopping for convenience foods; ready-to-eat that doesn’t require any preparation but which “can be very harmful”. The excess fat, sugar and salt contained in these foods has resulted in a sharp increase in NCDs like diabetes, hypertension, cardiovascular disease, and some cancers. 

Commercial determinants of health

One of the reasons we like to eat so much of these foods is because the additives with which they are filled make them taste good. Big industries have developed around these products to make them more competitive in the marketplace – think about the cartoon characters, games, and movies affiliated with children’s food. This is what’s known as a ‘commercial determinant of health’. “We don’t even know what we’re eating. A big part of the problem is that it’s all hidden,” says Goldstein.

Children’s cereals are a clear example. They are filled with sugar, so kids are tempted to eat them, which results in a sweet tooth, potentially leading to obesity. Historically, sugar was considered a condiment and used sparingly. Today, however (although some of it still exists in its most familiar form), ingredients like ‘corn sugar’ and ‘glucose’ on packaging are not recognisable to us as sugar. These are added to food in huge quantities and labelled using terminology with which we’re unfamiliar.

Legislating labelling

This is where food labelling becomes important. The South African Department of Health is on the threshold of introducing policy that will see a big change in food packaging requiring labels to be a certain size, and if the product contains more than the recommended amount of sugar, fat and salt, or non-nutrient sweeteners, the label needs to be placed on the front of the product.

“If you have these on the front of the pack, it means that at least people have an idea of what’s in there. It doesn’t necessarily mean that they are not going to buy it or eat it, but at least it will guide people’s understanding of what’s healthy and what isn’t”, Goldstein explains.

Furthermore, if products fall into the category requiring front labels, advertisers won’t be allowed to market them to children, and product owners will have to adapt the fonts, colours, illustrations, design and affiliations that make them so appealing to youngsters.

Smoke breaks and caffeine fixes

While food is clearly problematic, Goldstein says caffeine, in moderation, is probably okay. But when it comes to electronic cigarettes (e-cigarettes) or vaping, she believes these are just as dangerous and carcinogenic as any other tobacco product, including snuff and regular cigarettes.

“The tobacco industry wants us to think [e-cigarettes and vaping] help people stop smoking, but it seems like it’s the opposite. Studies are now showing that young people who use electronic cigarettes and get addicted, often then move on to smoking tobacco.” Her other concern is that e-cigarettes are available to youngsters and with their bright colours and over 50 flavours, including bubblegum, they’re specifically marketed to appeal to the youth.

Research by Guy Richards, a pulmonologist and Emeritus Professor of Critical Medicine at Wits, confirms the health hazards of e-cigarette vapours. His paper, published in the European Respiratory Journal (ERJ Open Research) in August 2023, compared the effects of e-cigarette vapours and tobacco smoke extracts on human neutrophils (a type of white blood cell that acts as your immune system’s first line of defence).


The study found that e-cigarette vapours, exactly in the same way as cigarette smoke, “adversely affect the innate immune system”. Richards says, “These findings indicate that while e-cigarettes may be less harmful than cigarettes in some respects, they are still harmful and have the potential to predispose to pulmonary infections”.

Step-up for a healthier environment

It’s clear that our daily drugs are far from benign, but how do we steer clear of them? Goldstein says, “The way we look at it from a public health perspective is that we need to create an environment for people where the healthy choice is the easier choice – where it’s easier to choose a healthy food than a processed food, easier to walk somewhere than go by car”.

She concedes that in some cases this is difficult to apply, given many people’s environment and financial constraints. Those who are living in poverty frequently have no means or space to cook, have no refrigeration, and limited access to shops offering fresh and healthier products.

People who do have choices should lobby government to ensure that products are labelled correctly, Goldstein says, and as consumers we should demand food that is healthier, cheaper, and more readily available to everyone.

Highly processed foods are feeding our addiction to salt, sugar and sugar derivatives and yet we remain oblivious to the harm they are doing.

  • Leanne Rencken is a freelance writer.
  • This article first appeared in Curiosity, a research magazine produced byWits Communications and the Research Office
  • Read more in the 16th issue, themed: #Drugs, where we highlight the diversity, scope, and multi-dimensional nature of drug-related research at Wits University.