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16-05-2012 | Cardiology | Article

‘Fat tax’ needs to be at least 20% to improve health

Abstract

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MedWire News: Taxing unhealthy food and drinks could improve the public's health, but the tax rate would need to be at least 20% to have a significant effect on obesity and cardiovascular disease, say researchers.

Ideally, such a tax should be combined with subsidies on healthy foods such as fruit and vegetables, write Oliver Mytton and colleagues from the University of Oxford, UK, in the BMJ.

The researchers explain that several countries are beginning to introduce "fat taxes" that involve taxing fatty foods, foods that include saturated fats, or, more generally, foods that are considered unhealthy.

The UK is one country that is considering the implementation of "health related food taxes," but Mytton et al note that despite recent interest among policy-makers, there has been relatively little critical analysis.

The team therefore examined the evidence on the health effects of food taxes.

They found that taxing a wide range of unhealthy foods or nutrients is likely to result in greater health benefits than narrow taxes, although the strongest evidence base is for tax on sugary drinks.

For example, a US study found a 35% tax on sugar sweetened drinks (US$ 0.45 or € 0.34 per drink) in a canteen led to a 26% decline in sales. However, it was unknown whether this decline led to increased consumption of sweetened drinks away from the cafeteria.

Only two studies, conducted in the USA, have examined the health effects of food taxes. Neither study found a significant association between taxes and the prevalence of obesity at a state level, but the taxation level, at 1‑8%, may have been too low to observe an effect on population health, says the team.

Most published work on the dietary or health effects of health-related food taxes has used modeling. Results from these studies predict that a 20% tax on sugary drinks in the USA would reduce obesity levels by 3.5%.

In addition, modeling studies suggest that extending value added tax (at 17.5%) to unhealthy foods in the UK would result in a 1‑3% reduction in incidence of ischemic heart disease, or 900‑2700 fewer deaths per year.

The researchers also observe that views on the acceptability of health-related food taxes vary widely, with support being greater when the health benefits of the tax are emphasized.

By contrast, the food industry argues that the taxes would be ineffective, unfair, and would damage the industry, leading to job losses. Mytton and team point out that similar arguments were used by the tobacco industry against tobacco taxes.

The researchers conclude that many questions remain about how these taxes should be introduced and enforced. For example, they write: "Should the tax be levied on the raw ingredients or on the final product? Should all sweetened drinks be taxed, as in France, or just sugar sweetened? How much sugar needs to be added before the drink is taxed?"

By Laura Cowen

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