Would taxing sugar and other unhealthy products improve public health?
In 1900 in the United States, the top-three killers were infectious diseases: pneumonia, tuberculosis, and diarrheal disease. Now, the killers seem to be largely lifestyle diseases: heart disease, cancer, and chronic lung disease. Is this because antibiotics allow us to live long enough to suffer from degenerative diseases? Probably not. The emergence of these chronic disease epidemics seem to have been accompanied by dramatic shifts in dietary patterns, best exemplified by what’s been happening to disease rates among people in the developing world as they’ve westernized their diets.
The World Health Organization recommends we reduce our added sugars, along with consumption of salt, trans fats, and saturated fats, because consumption of such foods may be the cause of at least 14 million deaths every year from chronic diseases.
In 1990 around the world, most years of healthy life were lost to under-nutrition, such as diarrheal diseases in malnourished children. Now, the greatest disease burden is attributed to high blood pressure, a disease of over-nutrition. The chronic disease pandemic has been ascribed in part to the near-universal shift toward a diet dominated by animal-sourced and processed foods — in other words, more meat, dairy, eggs, oils, refined grains, soda, salt, and sugar.
Let’s focus on sugar in this blog post. Under the American Heart Association’s sugar guidelines, most American women should consume no more than 100 calories per day from added sugars, with the maximum for most American men being 150 daily calories. That means one can of soda could take us over the top for the entire day.
In 1820, each American consumed about 20 pounds of sugar annually. That had risen to 80 pounds by 1920 and 120 pounds by 1994. Today, we may be closer to ingesting 160 pounds of sugar every year, half of which may be fructose, taking up about 10 percent of our diet.
Even researchers paid by the likes of The Coca-Cola Company acknowledge sugar is empty calories without essential micronutrients. Concern has been raised, though, that sugar calories may be worst than just empty. Mounting evidence suggests that, in large enough amounts, added fructose in the form of table sugar and high fructose corn syrup may trigger processes that can lead to liver toxicity and other chronic diseases.
What can we do to deter people from this addictive food source? Increasing the cost of cigarettes through tobacco taxes is one of the most effective ways to decrease the harms of smoking. Increasing the cost of cigarettes by just 10% could prevent millions of tobacco-related deaths. So, what about taxing unhealthy food? In general, public health decision makers have had three main options: inform consumers with labeling, “nudge” people with incentives, or more heavy-handed approaches, such as instituting regulations or taxes. These “policy approaches have proven crucial reducing tobacco use, alcohol abuse, and deaths from car crashes.
So, maybe a national system of subsidies for good foods and taxes for bad could facilitate more sensible dietary choices. Decreasing the consumption of unhealthy foods — the more you tax, the lower consumption drops — and, increasing the consumption of healthy foods — the more you subsidize foods like fruits and vegetables, the cheaper you make them, the more may be eaten.
Do subsidies work out in the real world?
According to National Institute of Health (NIH) research, South Africa’s largest health insurance company started offering 10 or 25% cash back on healthy food purchases to hundreds of thousands of households — up to 500 bucks a month. Why would they do that? Why would they give money away? Because it works — apparently increasing the consumption of fruits and vegetables and whole grains, while decreasing the consumption of foods high in added sugar, salt, and fat, including processed meats and fast food.
It will be interesting to see a national program in the U.S that either taxes the unhealthy food or subsidize the healthy ones. Better yet a government that institutes both. Maybe it needs to start at local and state level to put enough pressure on big food lobby. What are your thoughts?