SECOND OPINION:Obesity is likely to grow unless drastic action is taken
IN 1776, ADAM SMITH wrote The Wealth of Nationsand recommended that governments tax tobacco, alcohol and sugar. We now have the first two taxes and Minister for Health James Reilly is considering taxing sugary drinks in the next budget as a strategy for tackling Ireland's growing obesity problem.
A compelling case can be made for taxing all drinks containing sugar, fructose and fruit juice concentrates. Most people are well aware of obesity and it is estimated that one-quarter of Irish children and a third of Irish adults are now overweight or obese. These figures are likely to increase over the next number of years unless drastic action is taken by government.
Programmes such as RTÉ's Operation Transformationhave entertainment value only and will not bring about the kind of behaviour change required. What is needed are fiscal policies such as a sugar tax and a complete ban on advertising energy-dense nutrient-poor foods.
New research published in Obesity Reviewsshows that our modern sedentary lifestyles not only create weight problems, they actually promote the overconsumption of food. Watching television, listening to music, playing video games and working at our desks makes us eat more, even when we are not hungry. Our biology has not caught up with our new lives.
Watching TV is associated with more frequent meals and turning on the TV often signals feeding time. People who eat two meals a week while watching TV gain eight pounds of weight annually. Video games and personal music players have a similar effect on appetite and act as a distraction, so that people eat more and drink more sugary drinks while playing the games and listening to music as well as afterwards.
Sitting in a chair resting uses the same number of calories as working at a desk, but people eat more when they finish their desk work than those who were just resting.
Fiscal policies and banning adverts for energy-dense nutrient-poor food directed at children are effective strategies for changing health habits. The most important thing is to levy a big enough tax to affect customer behaviour. In countries where sugar taxes have been introduced, they have not influenced obesity levels because the taxes are too small to have an affect on consumption. For example, many states in America have introduced a 5 per cent tax, but it needs to be about three times greater.
The Rudd Center for Food Policy at Yale University recommends a tax of one cent per 30ml on all drinks containing sugar or taxing drinks that exceed a threshold of grams of added sugar. They suggest that this threshold be set at one gram of sugar per 30ml or 66 calories per 500ml container.
Virtually all sugary drinks sold in Ireland greatly exceed these levels and popular brands contain between 53g and 130g of sugar and 210-290 calories in a standard drink. This translates into an appropriate tax of about 20 cents. The Rudd Center believes that a tax per gram of added sugar over a certain threshold is more effective than taxing all drinks, as manufacturers might then be encouraged to reduce the amount of added sugar. If all sugary drinks are taxed, customers might just change to cheaper products or larger containers, resulting in no calorie reduction thus defeating the whole purpose.
In addition to a sugar tax, Ireland must fully implement the International Obesity Task Force (IOTF) code on the marketing of food to children. TV advertising is strongly associated with increased consumption of snacks, high-sugar drinks and nutrient-poor high-calorie foods. The IOTF code specifies that there should be no marketing of these foods to children between the hours of 6am to 9pm. The Irish Heart Foundation has recently campaigned for the Broadcasting Authority of Ireland to implement the code. Given Ireland’s obesity problem it is truly amazing that this type of advertising is not already forbidden.
Food manufacturers will complain about any tax on sugary drinks just as publicans complained about the smoking ban and drink-driving laws. They will argue that more health education is needed and that people are just not responsible enough about their eating habits. They will claim that it is unfair to tax everyone because of the behaviour of a few greedy people. They must be told that education will not work and that the environment where people choose their foods has to change. It is time to stand up to the food industry.
Dr Jacky Jones is a former regional manager of health promotion with the HSE
