Will taxing foods with high sugar content make a difference for the obesity epidemic?

Issue: April 2017

Click here to read the Cover Story, "Managing childhood obesity requires commitments from family, community, public policy."

Managing childhood obesity requires commitments from family, community, public policy.

Taxing sugary beverages and foods at high enough rates to solicit reduced consumption of these unhealthy options will contribute toward slowing down the obesity epidemic initially. When sustained over a longer period — about 5 to 10 years — it can stop growth and eventually — in 10 to 20 years — reverse the epidemic. There are no easy and quick fixes to an epidemic that grew over decades of poor dietary choices driven by heavy and ubiquitous marketing of unhealthy, including high-sugar, foods and beverages. That said, I think the difference will be greater and faster among the young, particularly children, who are able to change their habits and preferences earlier in life. Simulation studies projecting the impacts of taxing sugary beverages across a number of countries support this.

Taxing sugary products is a start and should be part of a comprehensive set of effective measures, including restricting marketing of unhealthy products and informing consumers of the health risks of these foods and beverages through education and labeling. International health organizations support taxation, which has been found to be the most cost-effective approach. Many countries (eg, Mexico, United Kingdom, Ireland, South Africa) and localities (eg, San Francisco, Philadelphia) have started using, or are considering using, taxation of these unhealthy products to address both the obesity and diabetes epidemics.

The implementation of taxes also increases public awareness of the harms of sugary products and incentivizes industry to reformulate and market healthier alternatives. In jurisdictions that have enacted taxes on sugary beverages, consumption of sugary beverages has declined while consumption of healthier alternatives has risen. In the short run, taxes also generate new revenue that can be directed toward obesity prevention efforts and other important healthy programs, thus enhancing its health impact.

References:
Andreyeva T, et al. Prev Med. 2011;doi:10.1016/j.ypmed.2011.03.013.
Briggs AD, et al. BMJ. 2013;doi:10.1136/bmj.f6189.
Colchero MA, et al. BMJ. 2016;doi:10.1136/bmj.h6704.
Sánchez-Romero LM, et al. PLoS Med. 2016;doi:10.1371/journal.pmed.1002158.
World Cancer Research Fund International. Curbing global sugar consumption: Effective food policy actions to help promote healthy diets and tackle obesity. 2015. Available at: www.wcrf.org/int/policy/our-policy-work/curbing-global-sugar-consumption. Accessed March 24, 2017.
Shu Wen Ng, PhD, is associate professor in the department of nutrition at the Gillings School of Global Public Health and a researcher at Duke-UNC Center for Behavioral Economics and Healthy Food Choice Research at the University of North Carolina at Chapel Hill. She reports no relevant financial disclosures.

Opponents of a tax on sugary drinks often argue that it is a personal responsibility to eat healthily — not an area for a “nanny state” intervention.

The main driver of the obesity epidemic globally is the increased supply of tasty, energy-dense food that is heavily marketed, widely available and often relatively cheap. While there is no easy solution for improving population diets and addressing obesity, there is an important role for governments in creating environments that encourage people to make healthy choices.

We know that price is one of the most important factors that influence what foods people buy. So, increasing the price of unhealthy food will discourage consumption. Accordingly, several governments around the world have recently implemented food taxes in an effort to shift consumption patterns to healthier products. A prime target for these taxes are sugar-sweetened drinks that have little nutritional value and strong associations with obesity as well as poor dental health. They are also readily substituted for water and low-calorie drinks. Evidence from countries that have implemented sugary drinks taxes show that consumption of sugary drinks has gone down in response to the taxes, and this is almost certain to reduce rates of obesity over time. For food taxes to be most effective in reducing obesity in the longer term, they should target unhealthy foods in general, taking into account not just sugar content, but salt and saturated fat, too.

While it’s true that we all have a responsibility for what we put in our mouths, unhealthy diets and obesity are major public health problems that mean that, as a community, we need to consider a range of options for addressing the problem. The evidence clearly points to taxes on sugary drinks as a highly potent and cost-effective intervention option, as part of a comprehensive approach that also includes restrictions on marketing of unhealthy foods, improved food labeling and a range of other measures.

References:
Swinburn BA, et al. Lancet. 2011;doi:10.1016/S0140-6736(11)60813-1.
WHO. Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013-2020. Available at: http://apps.who.int/iris/bitstream/10665/94384/1/9789241506236_eng.pdf?ua=1. Accessed March 24, 2017.
Gary Sacks, PhD, is a senior research fellow at WHO Collaborating Centre for Obesity Prevention at Deakin University in Australia. He reports no relevant financial disclosures.