Fruit juice is not ‘more equal’ when it comes to sugar and public health

Decades after its publication, Animal Farm by George Orwell remains strikingly relevant for its reflection on how systems evolve. One of its central insights is that even well-intentioned systems benefit from ongoing reflection to ensure they continue to serve their original purpose. 

This lesson offers a valuable lens for modern policymaking. At its best, policy is a collective effort, balancing interests while staying grounded in evidence and public good. South Africa is on the brink of a major public health milestone through the finalisation of regulations introducing front-of-package warning labelling (FOPL) on unhealthy foods and beverages. FOPL is a major step forward in helping consumers make informed choices and in addressing the growing burden of diet-related diseases.

Within this process, there is an important opportunity to ensure that the principle underlying the regulations is applied consistently across all products, including 100% fruit juice. Doing so will help ensure that foods and beverages with comparable sugar content are treated in the same way, enabling consumers to make truly informed choices. It would also strengthen alignment across South Africa’s broader nutrition policies.

The Health Promotion Levy has made meaningful progress in reducing sugar consumption. Extending this levy to beverages exceeding 4g of sugar per 100ml (such as fruit juices) and requiring a FOPL label on all high-sugar items – including 100% fruit juice – would strongly reinforce this progress.

FOPL has emerged as one of the most effective public health tools to help consumers make informed dietary choices by providing clear, visible warnings about high levels of sugar, salt, and fat. 

Yet, despite its promise, there appears to be an important area for reflection in the draft FOPL regulations. As it stands, the regulations do not extend to 100% fruit juice. This exclusion is noteworthy given that 100% fruit juice also contains high amounts of sugar, which is recognised by the World Health Organization as contributing to adverse health outcomes. 

One hundred percent fruit juice is marketed and consequently perceived as “healthy”. It is advertised as natural, vitamin-rich and wholesome, thus benefiting from a powerful “healthy” narrative that shapes consumer beliefs. 

A growing body of evidence indicates that despite some benefits, fruit juice still contains a lot of sugar that affects the body in the same way as sugary sweetened beverages such as cool drinks.  When fruit is turned into juice and stored, most of the fibre is removed, and what is left is a concentrated sugary drink that the body absorbs very quickly. For example, drinking one glass of 100% orange juice is equivalent to eating three to four oranges, but without the fibre that helps protect against diseases like cancer. Consequently, drinking fruit juice regularly can increase the risk of obesity and conditions like diabetes.

The exclusion of 100% fruit juice in the regulations appears to stem from a focus on added sugar rather than free sugar. Consequently, 100% fruit juice falls outside the scope of the regulation despite its high sugar content and the amount of sugar in 100ml being roughly the same as that of Coca-Cola.  

FOPL regulations are designed to address precisely these risks by clearly indicating when products are high in sugar, salt, or fat based on scientific thresholds. From this perspective, FOPL serves as an important public health tool. Ensuring that FOPL consistently reflects the full range of sugar-sweetened beverages would strengthen its scientific foundation and improve the clarity of information provided to consumers. 

The need for policy coherence

The exclusion of 100% fruit juices in FOPL regulations has broader implications that are worth reflecting on. In Animal Farm, the gradual shift from the ideal that “all animals are equal” to the evolving notion that “some are more equal than others” serves as a reminder of how systems can unintentionally drift from their original intent over time. In many ways, fruit juice risks becoming the “more equal” product in this story, not because it doesn’t pose any health risks but rather because of how it is currently treated within the regulatory framework. This raises considerations for regulatory consistency. 

When similar products are not assessed in the same way, it can lead to a fragmented approach posing the risk of inconsistency and legal uncertainty over time. This is particularly so where similar products are subject to different standards without a clear scientific basis. From a regulatory perspective, consistency in the application of criteria is an important element of rational decision-making and supports the defensibility of the regulations if challenged. 

In addition, this inconsistency also has an impact on consumers. When labels highlight the risks of some sugar-sweetened beverages but remain silent on others with similar sugar content, it can further perpetuate the “healthy” narrative associated with 100% fruit juice. Consumers may interpret the exclusion of fruit juice as meaning that it is a low-risk choice, which will limit consumers’ ability to make fully informed choices – an important component of the right to access information relevant to health. 

Importantly, as the regulations have not yet been finalised, there remains a timely opportunity to strengthen their coherence and impact. A targeted adjustment, aligning the criteria with free sugar as defined by the World Health Organization to include both added sugars and those naturally present in fruit juices rather than just added sugar, would ensure that warning labels accurately reflect health risks and provide consumers with the information they need. Thus, extending FOPL to include 100% fruit juice ensures consistency, transparency, and fairness across the food system. From a consumer protection perspective, ensuring that all products are assessed against consistent standards supports transparency and informed choice.

In Animal Farm, Old Major inspires the idea of a system built on equality and shared benefit. He does not call the animals to abandon their farm in search of something new. Instead, he invites them to reimagine the very system they are already part of but grounded in fairness and collective wellbeing. His vision is not about starting over, but about ensuring that what exists serves everyone equally and remains true to its original purpose. In many ways, South Africa’s approach to FOPL reflects the same spirit.

The National Department of Health (NDoH) is already demonstrating strong leadership in advancing an evidence-based FOPL framework. The current draft regulations reflect an important step forward in strengthening public health policy and aligning the environment with scientific evidence. Within this progress, the discussion around certain exclusions should be seen not as a failure of the system, but an opportunity for refinement. Through this lens, including 100% fruit juice becomes part of strengthening the system. Similar to Old Major’s vision, the goal is to ensure that the framework remains coherent and aligned with its core purpose of protecting public health and serving the collective good.

By continuing to anchor decisions in evidence and ensuring consistent application across product categories, the NDoH can further strengthen an already important public health intervention. The ongoing development of the regulations is part of a collaborative policy process, ensuring that its purpose remains clear, its messaging remains trusted, and its impact on public health remains meaningful over time. DM