The Sugar Tax does not go far enough

sugar-cubes

 

The tax on sugary drinks, arriving no later than April 2018 is not enough. As little as 20% of the added sugar in people’s diet comes from sugary drinks1. Clearly, the culprit responsible for bulging waistlines lies not in what we drink.

Tackling the empty, nutrient-void calories found in easily slurpable sugary drinks is a start, but it is only a start. If nothing else, it will encourage manufacturers of sugary drinks to reduce the sugar content at no added cost to the public, benefiting their health with minimal impact on profits. The reduction of sugar content in goods, rather than consumption of total the goods is as good an aim as any. Edibles must be targeted as well as drinks.

Spending the estimated £520 million raised by the new levy on sports in primary schools is also a start, but again it is still only a start. A tax on all foods with their sugar content labelled red on their packaging should be used to subsidise the cost of healthier, green labelled and coloured foods. This makes the healthier options cheaper and more accessible. It may also cut down on wasted fresh produce. Simply making unhealthy food more expensive is not enough and has the reeks of elitism – the healthy alternatives must be made proportionally cheaper and accessible. Britain should follow France2 and Italy’s3 lead in forcing supermarkets to give away unsold food, with a particular emphasis on remaining green-banded food that has not been sold by their expiry date distributed to food banks and those on disability benefits.

As it stands, the Government’s proposed sugar tax on drinks merely follows a precedent rather than blazes a trail as a tax on all foods with their sugar content in the red would; Mexico has had a tax on sugary drinks in place since January 1st 2014. By December of the same year, sales of sugary drinks were down 17%4. In Denmark, when a similar tax was revoked in 2013 consumption rose5. That tax was revoked mostly due to mismanagement and an ill-judged fat tax, which missed the point in an already relatively lithe nation where the population could pop across the border to Germany or Sweden to get their sugary or fatty fix. The UK does not have this issue.

There have been cries too that the sugar tax is classist6. This is not only erroneous but classist in itself; such a view supposes that ‘the poor’ are unable or unwilling to choose a healthier option to drink. A subsidy for healthy food paid for by taxes on sugary foods would help, as would dropping the patronising attitude towards the disadvantaged’s problem-solving skills; ASDA have started selling a £3.50 ‘wonky veg’ box, initially on a small scale, but as word spreads, so too will supply. Bulk buying meats and basic necessities such as oats has never been easier online. It is not beyond the wit of anyone to find a good deal when pressed. If all else fails, water comes cheaply from the tap.

This aside, according to figures published by Diabetes UK, type 2 of the illness is more common among the poor; the lowest quintile of earners in England are 2.37 times more likely to have the disease than the wealthiest. Deprivation has no impact on the occurrence of type 1 diabetes. Type 2, on the other hand, is caused by diet. It would be classist to ignore that issue. Diabetes is not alone: 19% of children aged 10-11 in the UK are obese and another 12.8% were overweight according to the National Child Measurement Programme8, with areas of deprivation seeing the highest levels of childhood and adult obesity9 at a direct and indirect cost of an estimated £27 billion to the NHS in 201510.

As mentioned, the proposal to spend the levy on sports in primary schools is a noble one, but it does not go far enough and must be specific. For the past three years, students at St. Ninians primary in Stirling have run or walked a mile a day11. None of the school’s children are overweight, as opposed to the national average of one third12. That must be rolled out as policy across all primary and secondary schools in the UK – be they curriculum-exempt academies or not. Just 20 minutes of exercise dramatically increases brain activity13 and improves memory, focus and mood, all of which make learning and educating easier. In an age where teachers are overworked and there is concern for the length of the school day this can only be a good thing.

Regular physical activity reduces the risk of type 2 diabetes14, obesity15, and can alleviate mental health issues16 – all issues aided by reducing a high-sugar diet, and all of which cannot be tackled by one single policy or a set of uncoordinated policies alone.

An accompanying public education campaign, similar to the drink driving and stop smoking ads must be instigated, particularly targeting new parents. So too should dietary education, focusing on cooking from fresh and associating nice flavours with healthy foods, begin at a young age; good habits formed young tend to stick more often than new lessons that fly in the face of established behaviours. Things like sugar taxes are less necessary if people do not gain their addiction to the substance in the first place. The tone of these messages is important too; a positive and less preaching tone regarding eating your greens and a focus on the simplicity, practicality and potential cheapness of healthy eating and exercise should also be implemented.

Promoting healthy eating must be a priority. Making calorie dense, nutritionally void sugars unattractive is merely a part of this. One can be fat and malnourished, although undernourishment – defined as the disruption of one or more bodily functions arising from a deficiency in one or more nutrients – corresponds with a low BMI. In either case it corresponds with ill health; in 2003, 40% of hospital patients were considered undernourished – a British Nutrition Foundation report published the same year noted that high levels of wasted hospital food resulted in patients receiving only 70% of their energy and protein requirements.17 Another key correlation is with poverty: the mean fruit and vegetable consumption was significantly lower at all ages for both genders of those belonging to the lowest income group in society.18

The National Diet and Nutrition Survey of young people carried out in 2000 found that those who received free school meals (and were therefore from households in receipt of benefits) had lower vitamin and mineral intakes. But things are moving in the right direction. The 2014 NDNS notes, however that mean intakes of iron, calcium, vitamin C and folate for children aged 1.5 to 3 years, and adults 65 and over were higher than previous surveys.19 Despite this, it was still estimated that three million people in the UK either live with or at risk of malnutrition; worryingly, GPs regarded the condition more as a red flag of other illnesses than a problem in of itself.20

Given undernutrition leads to impaired immune function, making the undernourished more susceptible to illness and less capable of fighting it in the process, the cost of the issue to the NHS is likely high – The British Association For Parenteral And Enteral Nutrition estimated that public expenditure on malnutrition in the UK in 2007 was £13 billion.21 Given the cost of missed work due to resulting illness, the true cost to the UK’s economy is likely to be higher. It is in everyone’s interest to make sure the British population is fit and healthy.

The government must put together a unified portfolio of health policies, taxing and making sugar undesirable, improving access to healthier foods and legislating for daily exercise for students in order to tackle the increasingly costly, joint issues of our overweight, under-fit and over-sugary country. So by all means, tax sugary drinks, but don’t expect much to change unless a broader, coordinated plan to tackle poverty, obesity, undernourishment and public health is put in place.

 

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1: Economist, The (2016); Pricier Pop. The Economist, available at: http://www.economist.com/news/britain/21694993-levy-drinks-may-change-recipes-not-waistlines-britain-gets-new-tax-sugary-drinks

2: Chrisafais, A (22 May 2015); France to force big supermarkets to give unsold food to charities. The Guardian, available at: http://www.theguardian.com/world/2015/may/22/france-to-force-big-supermarkets-to-give-away-unsold-food-to-charity

3: Payton, M (15 March 2016); Italy to change law to make all supermarkets give unsold food to needy. The Independent, available at: http://www.independent.co.uk/news/world/europe/italy-food-waste-law-supermarkets-a6931681.html

4, 5: Rosenberg, T (3 November 2015); How one of the most obese countries on earth took on the soda giants. The Guardian, available at: http://www.theguardian.com/news/2015/nov/03/obese-soda-sugar-tax-mexico

6: Lott-Lavigna, R (23 October 2015); I love you, Jamie Oliver, but your sugar tax idea is classist. New Statesman, available at: http://www.newstatesman.com/politics/health/2015/10/i-love-you-jamie-oliver-your-sugar-tax-idea-classist

7: Diabetes UK (November 2015); p. 6 Facts and Stats. Diabetes UK, available at:

https://www.diabetes.org.uk/Documents/Position%20statements/Diabetes%20UK%20Facts%20and%20Stats_Dec%202015.pdf

8; 12: Public Health England (unknown); Child Obesity. Public Health England, available at: http://www.noo.org.uk/NOO_about_obesity/child_obesity

9: Health & Social Care Information Centre (3 March 2015); Statistics on Obesity, Physical Activity and Diet. HSCIC, available at: http://www.hscic.gov.uk/catalogue/PUB16988/obes-phys-acti-diet-eng-2015.pdf

10: Public Health England (unknown); Economics of obesity. Public Health England, available at:  https://www.noo.org.uk/NOO_about_obesity/economics

11: Slawson, N (28 September 2015); Miles ahead: school that fired starting gun on running revolution. The Guardian, available at: http://www.theguardian.com/education/2015/sep/28/daily-mile-school-st-ninians-stirling-scotland

13: Hopkins, M.E et al (26 July 2012); Differential effects of acute and regular physical exercise on cognition and affect. Neuroscience, available at: http://www.ncbi.nlm.nih.gov/pubmed?term=22554780

14: Colberg, S et al (December 2010); Exercise and Type 2 Diabetes. National Center for Biotechnology Information, available at:  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2992225/

15: Garrow S.J (1986) Effect of exercise on obesity. National Center for Biotechnology Information, available at:  http://www.ncbi.nlm.nih.gov/pubmed/3535415

16: Taylor, Sallis, Needle (March-April 1985); The Relation of Physical Activity and Exercise to Mental Health. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1424736/pdf/pubhealthrep00100-0085.pdf?origin

17: Schenker, S. (2003); Undernutrition in the UK. British Nutrition Foundation, available at:  https://www.nutrition.org.uk/attachments/153_Undernutrition%20in%20the%20UK.pdf

18, 19: Bates, B et al. (2014); National Diet and Nutrition Survey. Public Health England, available at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/310997/NDNS_Y1_to_4_UK_report_Executive_summary.pdf

20: Andalo, D (17 March 2014); Malnutrition: it’s time the UK public recognised it as a problem we face. The Guardian, available at: https://www.theguardian.com/healthcare-network/2014/mar/17/malnutrition-uk-problem

21: Brotherton, A et al. (2010); Malnutrition Matters. BAPEN, available at:  http://www.bapen.org.uk/pdfs/toolkit-for-commissioners.pdf

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