Moynihan P, Miller C. Beyond the chair: public health and governmental measures to tackle sugar. J Dent Res 2020; DOI: 10.1177/0022034520919333.

Only through coalition among authorities responsible for planning and health will 'obesogenic and cariogenic' environments be replaced with those that make healthy choices the easiest choice.

Limiting free sugars to <5% of energy intake is a World Health Organisation evidence-based recommendation to protect oral health throughout the life course. Achieving this requires a concerted approach with upstream interventions, including legislation underpinning community interventions and health promotion. Global production and trade are the main drivers of sugars consumption, which can be addressed only through prioritisation of health impacts in agricultural and trade agreements, including pricing and subsidies. Increasing evidence demonstrates the benefit, including dental benefits, of taxes on sugar-sweetened beverages, a major source of sugars - with taxes based on sugars content being favoured due to the dual impact in incentivising consumers to buy less and encouraging producers to use less through product reformulation. A benefit of product reformulation is that the potential impact on sugars intake occurs independent of consumer behaviour change, making the benefits more equitable across social groups. Evidence from meta-analysis indicates that sugars reformulation and portion size reduction could lower energy intake by more than 10% and 16%, respectively. Sophisticated and targeted digital marketing of products high in sugars is another key driver of sugars intake. With the exception of children's television broadcasting, marketing of products high in sugars is largely unregulated, and increased awareness of modern marketing strategies and more stringent regulation are needed. Midstream actions include creating healthier food environments in neighbourhoods, community settings, and workplaces. Only through coalition among authorities responsible for planning and health will 'obesogenic and cariogenic' environments be replaced with those that make healthy choices the easiest choice. It is recognised that providing nutrition health education alone is insufficient; however, education has a key role to play in changing social norms and creating drive for change.