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Response to BMJ Modelling Study on SSB Tax

November 2013

Sugar Nutrition UK Response to BMJ modelling study on the effect on obesity of applying a 20% additional tax to sugar-sweetened drinks.

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November 2013

Response to BMJ Modelling Study on the Effect of an Additional 20% Sugar-Sweetened Drinks Tax

This modelling study predicts that adding a 20% tax to the drinks in a shopping basket will reduce energy intakes by less than a mouthful, with an average reduction of just four calories a day (16.7kJ – Table 5).

While this paper adds to the debate, as acknowledged and highlighted by the authors themselves, it has a number of significant limitations. As with all modelling work, it cannot determine how people would respond to a tax in the real world, given that there is a lack of evidence showing how taxes actually affect individuals’ diets and health.

A review published by the World Health Organisation found no direct evidence of a reduction in consumption in response to food taxes, stating there was insufficient evidence to support a food tax. Therefore, subjecting individuals to increased costs, when budgets are already very tight, without solid evidence of improvements to health, is completely inappropriate.


Modelling study predicts that a 20% additional tax to sodas would reduce intakes by 4 calories

While this paper adds to the debate on food taxes, it shows that a theoretical additional tax of 20% on sugar sweetened drinks would reduce intakes by less than a slurp - 4kcal/day (16.7kJ/d – Table 5).

As with all modelling work it has a number of significant limitations, and a number of these are highlighted in the discussion section of the paper. Modelling studies cannot determine how a tax would actually affect health or how people will alter their diets and shopping habits in the real world. To date there is a lack of evidence on how food taxes affect what and how much people eat or if they have any impact on health.

A review published by the World Health Organisation found no direct evidence of food taxes reducing consumption, and stated there was therefore insufficient evidence or preparation to support a food tax. Additionally, analysis by British researchers also indicates that not only does a food tax penalise those on lower incomes more, as they have to spend a higher proportion of their income on groceries, but they could increase the wealth-health gap, resulting in detrimental unintended consequences.

Research also suggests that selective food taxes can also change purchasing towards higher calorie options and therefore increase calorie intake. Although this study attempted to model for substitution, it acknowledges that this is an estimate of what individuals may possibly do – which is often different from what people actually do. Therefore subjecting individuals to increased costs, when budgets are already very tight, without solid evidence of improvements to health and of an absence of any unintended consequences, is completely inappropriate.

Interestingly the Danish Government introduced a fat tax and proposed to extend it to sugar, but in November 2012 scrapped both of these and stated that ‘The suggestion to tax food for public health reasons are misguided at best, and counter-productive at worst’.

Sugar and Sugar-sweetened drinks

A review of all of the available scientific evidence shows that drinks containing sugars (whether fruit juices or soft drinks in general) do like all caloric foods and drinks contribute to an individual’s energy intake. However, there is conflicting evidence as to whether these types of drinks themselves lead to over-consumption, or contribute to obesity. Therefore the current evidence for singling out a single product line for taxation in respect to a potential contribution to obesity is weak.

On average in the UK, soft drinks (not including low-calorie) account for 4% of a child’s and 2% of an adult’s calorie intake, and alcohol accounts for 7% of adult’s calorie intake. Over the last decade consumption of sugars in the UK has declined by 6%. However, over the same time period the proportion of the population in England who are obese has increased by 5% and the percentage being diagnosed by a doctor with Diabetes has more than doubled. This supports the findings of numerous Expert Reviews by Scientific Committees across the globe, that have concluded that there is no evidence of any harm attributed to current sugar consumption levels, and that sugar can be enjoyed within a healthy balanced diet and lifestyle.

Lifestyle diseases such as obesity are caused by a number of complex factors, and therefore there is no simple solution.

In regards to trying to isolate a single food, drink or ingredient to blame for obesity and therefore provide a solution - a professor at the University of Lausanne sums it up eloquently in a research paper; rather than concentrating on demonising an individual ingredient, efforts should be focused on known health benefits. ‘Public health is almost certainly to benefit more from policies that are aimed at promoting what is known to be good than from policies that are prohibiting what is not (yet) known to be bad’.

References

  1. Wansink B, Hanks AS, Just D. et al. (2012) From Coke to Coors: A field study of a sugar-sweetened beverage tax and its unintended consequences. SSSN doi. 10.2139/ssrn.2079840
  2. Thow AM, Jan S, Leeder S, Swinburn B. (2010) The effect of fiscal policy on diet, obesity and chronic disease: a systematic review. Bull World Health Organ. 88: 609-14.
  3. Tiffin R, Salois M. (2012) Inequalities in diet and nutrition. Proc Nut Soc. 71: 105-111.
  4. Goodman C, Anise A (2006). What is known about the effectiveness of economic instruments to reduce consumption of foods high in saturated fats and other energy-dense foods for preventing and treating obesity? Copenhagen, WHO Regional Office for Europe
  5. Tappy L, Mittendorfer B. (2012) Fructose toxicity: is the science ready for public health actions? Curr Opin Clin Nutr Metab Care. 15(4):357-61.
  6. Henderson L, Gregory J, Irving K & Swan G (2003) The National Diet and Nutrition Survey: Adults Aged 19 to 64 Years. vol. 2: Energy, Protein, Carbohydrate, Fat and Alcohol Intake. HMSO, London.
  7. Department of Health (2012) National Diet and Nutrition Survey: Headline results from Years 1, 2 and 3 (combined) of the rolling programme 2008 – 2011
  8. NHS Information Centre for health and social care (2011) Health Survey for England 2010 – Trend Tables.
  9. European Food Safety Authority (2010) Scientific Opinion on dietary reference values for carbohydrates and dietary fibre. The EFSA Journal 8(3): 1462
  10. World Health Organization and Food and Agriculture Organization (2003) Diet, nutrition and the prevention of chronic diseases. Report of a Joint FAO/WHO Expert Consultation. WHO Technical Report Series 916. WHO Geneva.
  11. Institute of Medicine of the National Academies (2002) Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (Macronutrients) The National Academies Press, Washington
  12. Food and Agriculture Organization (1998) Report of a Joint FAO/WHO Expert Consultation. Carbohydrates in Human Nutrition. FAO Food and Nutrition Paper No 66
  13. Department of Health (1989) Dietary Sugars and Human Disease. Committee on Medical Aspects of Food Policy. Report on Health and Social Subjects No 37. HMSO, London.

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Sugar Nutrition UK is an association principally funded by UK sugar manufacturers and is involved in promoting nutrition research and raising awareness among academics, health professionals, the media and the public about sugars and their role in health.

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