by Marion Nestle

Search results: soft drink tax

Nov 28 2012

The Danish fat tax: reflections on its demise.

My latest publication is a commentary on the reversal of the Danish fat tax in New Scientist, November 26:

Fighting the flab means fighting makers of fatty foods

A YEAR ago in these pages, I congratulated the Danish government on its revolutionary experiment. It had just implemented a world-first fiscal and public health measure – a tax on food products containing more than 2.3 per cent saturated fat.

This experiment has now been dropped. Under intense pressure from the food industry in an already weak economy, the Danish government has repealed the fat tax and abandoned an impending tax on sugars.

Nobody likes taxes, and the fat tax was especially unpopular among Danish consumers, who resented having to pay more for butter, dairy products and meats – foods naturally high in fat.

But the real reason for the repeal was to appease business interests. The ministry of taxation’s rationale was that the levy on fatty foods raised the costs of doing business, put Danish jobs at risk and drove customers to buy food in Sweden and Germany.

In June this year, a coalition of Danish food businesses organised a national repeal-the-tax campaign. The coalition said that fat and sugar taxes would cause the loss of 1300 jobs, generate high administrative costs and increase cross-border shopping – precisely the arguments cited by the government for its U-turn.

We can now ask the obvious questions. Did the tax achieve its aims? Was it good public policy? What should governments be doing to reduce dietary risk factors for obesity?

The purpose of food taxes is to reduce sales of the products concerned. In bringing in its fat tax, the Danish government also wanted to raise revenue, reduce costs associated with obesity-related diseases, and increase health and longevity. A year is hardly time to assess the impact on health, but the tax did bring in $216 million. Danes will now face higher income taxes to make up for the loss of the fat tax.

Business groups insist that the tax had no effect on the amount of fat that Danes ate, although they chose cheaper foods. In contrast, economists at the University of Copenhagen say Danish fat consumption fell by 10 to 20 per cent in the first three months after the tax went into effect. But it is not possible to know whether it fell, and cross-border shopping rose, because of the tax or because of the slump that hit the Danish economy.

A recent analysis in the BMJ suggests that 20 per cent is the minimum tax rate on food to produce a measurable improvement in public health. The price of Danish foods hit by the tax increased by up to 9 per cent, enough to cause a political firestorm but not to make much of a difference to health.

Is a saturated-fat tax good public policy? A tax on sugary drinks would be a better idea. To see why, recall that obesity is the result of an excess intake of calories over what we burn. Surplus calories, whether from carbohydrate, protein or fat, are stored as body fat. All food fats are a mix of unsaturated and saturated fatty acids; all provide the same number of calories per unit weight.

Saturated fats raise the risk of coronary heart disease, although not by much. Trans fats, banned in Denmark since 2003, are a greater risk factor. Because the different saturated fatty acids vary in their risk, imposing a single tax on them as if they are indistinguishable is difficult to support scientifically.

For these reasons, anti-obesity tax measures in other countries have tended to avoid targeting broad nutrient groups. Instead, they focus on processed foods, fast food or sugary drinks – all major sources of calories. Taxing them seems like a more promising strategy.

What else should governments be doing? That they have a role in addressing the health problems caused by obesity is beyond debate, not least because they bear much of the cost of dealing with such problems. In the US, economists estimate the cost of obesity-related healthcare and lost productivity at between $147 billion and $190 billion a year. The need to act is urgent. But how?

One lesson from Denmark is that small countries with open borders cannot raise the prices of food or anything else unless neighbouring countries also do so. But the greater lesson is that any attempt to encourage people to eat less will encounter fierce food-industry opposition. Eating less is bad for business.

In the US, state and city efforts to tax sugary drinks have met with overwhelming opposition from soft-drink companies. They have successfully spent tens of millions of dollars lobbying legislators and convincing the public that such measures deprive voters of their “right to choose” or, as in Denmark, can damage the economy.

What’s more, the poor cannot be expected to support measures that increase food costs, even though obesity-related problems are much more common among low-income groups.

If governments really want to reduce the costs of obesity-related chronic diseases, they will have to address the problem at its source: the production and marketing of unhealthy food products.

A review by the American Heart Association cites increasing evidence for the benefits of anti-obesity interventions: food taxes, subsidising healthy foods, media campaigns to promote exercise and good diet, restrictions on portion sizes, and restrictions on the marketing of unhealthy foods and their sale in schools.

Governments must decide whether they want to bear the political consequences of putting health before business interests. The Danish government cast a clear vote for business.

At some point, governments will need to find ways to make food firms responsible for the health problems their products cause. When they do, we are likely to see immediate improvements in food quality and health. Let’s hope this happens soon.

Marion Nestle is the author of Food Politics and What to Eat and is the Paulette Goddard professor of nutrition, food studies, and public health at New York University

Jul 2 2012

Soda taxes and other measures designed to fight obesity

My once-a-month (first Sunday) Q and A column in the San Francisco Chronicle deals with recent city initiatives.

Q:Why do municipalities continue to try to tell us what to eat or drink through taxes (the 1-cent soda tax on the Richmond ballot in November) or outright bans (eliminating super-size soft drinks, proposed by Mayor Michael Bloomberg in New York)?  Richmond residents could just buy their sodas in neighboring towns, and 1 cent seems hardly enough to influence anyone. New Yorkers could just buy two drinks if they want more. Isn’t this all rather silly?

A: Silly? On the contrary. These are dead-serious attempts to address the health problems caused by obesity through “environmental” change – changing the context in which we make food choices.

By now, health officials are well aware that asking individuals to take responsibility for making their own healthy food choices hasn’t got a prayer of success in the face of a marketing environment that encourages people to eat everywhere, all day long, in very large portions and at relatively low cost.

This is the default food environment, where it’s useless to tell people they need to eat less and expect them to do it. They can’t. Instead, it makes sense to try to change the food environment to make healthy choices the easy choices.

Healthy by design?

Suppose, for example, that all kids’ meals at fast-food restaurants were healthy by design and automatically provided milk or water.

You could still order a soda for your kid, but you would have to ask for it – and pay extra. If you are like most people, you won’t bother. That’s why the default matters.

Cities are trying to change the default. One change may or may not make a difference – we don’t know that yet. But changing the default might well make healthy choices easier in schools, fast-food restaurants and other institutions.

Bloomberg’s proposal in New York, to ban sodas larger than 16 ounces, is one such step. From my standpoint, 16 ounces is generous. It’s two full servings and provides about 50 grams of sugars, 200 calories and 10 percent of daily calories for someone who consumes 2,000 calories a day.

Portion sizes used to be a lot smaller. Decades ago, Coca-Cola advertised 16-ounce bottles as “big” and enough to serve three over ice.

If we could recognize that larger portions have more calories – and act on this knowledge – we might have an easier time maintaining weight. But we can’t, at least not easily.

The Richmond soda tax proposal recognizes that more than half of Richmond schoolchildren are overweight or obese. This percentage is higher than in other areas of Contra Costa County.

Even more striking, city officials estimate that two-thirds of Richmond adolescents consume more than 400 calories a day from soft drinks.

Kids who habitually drink sugary sodas tend to have worse diets, to be fatter and to display more risk factors for chronic diseases than kids who don’t.

This makes sugar-sweetened beverages an obvious target for environmental approaches to obesity prevention. Sugary sodas have calories but no nutrients. They are consumed in large amounts. They are highly correlated with obesity and health risks. They are “liquid candy.”

Sugary drinks should be once-in-a-while treats, not daily fare.

Richmond officials hope that the tax will encourage healthier choices. They deliberately set the proposed tax small so it would not unduly burden low-income residents.

One penny per ounce – 16 cents on a 16-ounce soda – may not be enough to change behavior, but it sends a clear message: It’s less expensive to drink water, and it’s healthier to reduce soda intake.

Funding programs

The Richmond proposal has one other critically important feature. It specifies that soda tax revenue will be used to fund city programs to address and reduce childhood obesity, especially in low-income areas where obesity rates are high.

These experiments are worth national attention. They may well do some good for individuals, and I can’t see how they would cause harm in any way except, perhaps, to the economic interests of soda companies.

Soda companies are taking these initiatives seriously. They are pouring millions of dollars into lobbying and community campaigns against both proposals.

Both have elicited plenty of public discussion, much of it focused on the rights of individuals versus the public health interests of government.

What I like about these initiatives is that they do not infringe on individual rights – people can buy as much soda as they want. The proposals simply try to make the default food environment slightly more conducive to healthy choices.

I’m hoping both proposals go forward. I can’t wait to see how they play out.

Oct 24 2011

On Denmark’s “fat tax”

I have a commentary in the October 23 issue of New Scientist (UK):

Cover of 22 October 2011 issue of New Scientist magazine

World’s first fat tax: what will it achieve?

Enviably healthy Denmark is leading the way in taxing unhealthy food. Why are they doing it, and will it work

THE Danish government’s now infamous “fat tax” has caused an international uproar, applauded by public health advocates on the one hand and dismissed on the other as nanny-state social engineering gone berserk.

I see it as one country’s attempt to stave off rising obesity rates, and its associated medical conditions, when other options seem less feasible. But the policies appear confusing. Why Denmark of all places? Why particular foods? Will such taxes really change eating behaviour? And aren’t there better ways to halt or reverse rising rates of diet-related chronic disease?

Before getting to these questions, let’s look at what Denmark has done. In 2009, its government announced a major tax overhaul aimed at cushioning the shock of the global economic crisis, promoting renewable energy, protecting the environment, discouraging climate change, and improving health – all while maintaining revenues, of course.

The tax reforms make it more expensive to produce products likely to harm the environment and to consume products potentially harmful to health, specifically tobacco, ice cream, chocolate, candy, sugar-sweetened soft drinks, and foods containing saturated fats.

Some of these taxes took effect last July. The current fuss is over the introduction this month of a tax on foods containing at least 2.3 per cent saturated fat, a category that includes margarine, salad and cooking oils, animal fats, and dairy products, but not – thanks to effective lobbying from the dairy industry – fluid milk.

Copenhagen is the home of René Redzepi’s Noma, voted the world’s best restaurant for the past two years. To Americans, “Danish” means highly calorific fruit – and cheese-filled breakfast pastries. Despite such culinary riches, the Nordic nation reports enviable health statistics and a social support system beyond the wildest imagination of inhabitants of many countries. Danish citizens are entitled to free or very low-cost childcare, education and healthcare. Cycle lanes and high taxes on cars make bicycles the preferred method for getting to school or work, even by 63 per cent of members of the Danish parliament, the Folketing.

Taxes pay for this through policies that maintain a relatively narrow gap between the incomes of rich and poor. The Danish population is literate and educated. Its adult smoking rate is 19 per cent. Its obesity rate is 13.4 per cent, below the European average of 15 per cent and a level not seen in the US since the 1970s. Denmark has long used the tax system to achieve health goals. It has taxed candy for nearly 90 years, and was the first country to ban trans-fats in 2003.

Because its level of income disparity is relatively low, the effects of health taxes are less hard on the poor than in many other countries. But the Danes want their health to be better. Obesity rates may be low by US standards, but they used to be lower – 9.5 per cent in 2000. Life expectancy in Denmark is 79 years, at least two years below that in Japan or Iceland. The stated goal of the tax policies is to increase life expectancy as well as to reduce the burden and cost of illness from diet-related diseases.

Like all taxes, the “health” taxes are supposed to raise revenue: 2.75 billion Danish kroner annually ($470 million). The tax on saturated fat is expected to account for more than one-third of that. Since all food fats – no exceptions – are mixtures of saturated, unsaturated, and polyunsaturated fatty acids, the tax will have to be worked out food by food. Producers must do this, pay the tax, and pass the cost on to consumers.

Taxes on cigarettes are set high enough to discourage use, especially among young people. But the food taxes are low, 0.34 kroner on a litre of soft drinks, for example. The “fat” tax is 16 kroner per kilogram of saturated fat. In dollars, the taxes will add 12 cents to a bag of crisps and 40 cents to the price of a burger. Whether these amounts will discourage purchases remains to be seen.

Other countries are playing “me too” or waiting to see the results of Denmark’s experiment. Hungary has imposed a small tax on sweets, salty snacks, and sugary and caffeinated drinks and intends to use the revenues to offset healthcare costs. Romania and Iceland had such taxes but dropped them, whereas Finland and Ireland are considering them. Surprisingly, given his party’s anti-nanny state platform, UK prime minister David Cameron is suggesting food taxes to counter the nation’s burgeoning obesity crisis. The US has resisted calls for taxes on sugar-sweetened beverages, not least because the soft drink companies spent millions of dollars on defeating such proposals.

Leaving aside the usual criticisms, such as the impact on poorer people, I have a different reason for being troubled by tax interventions. They aim to change individual behaviour, but do little to change the behaviour of corporations that make and market unhealthful products, spending vast fortunes to make them available, desirable and socially acceptable.

Today, more and more evidence demonstrates the importance of food environment factors, such as processing, cost and marketing, in influencing food choices (The Lancet, DOI: 10.1016/S0140-6736(11)60813-1). Raising taxes is one way to change that environment by influencing the cost to the consumer. But governments seriously concerned about reducing rates of chronic disease should also consider ways to regulate production of unhealthy products, along with the ways they are marketed.

In the meantime, let us congratulate Denmark on what could be viewed as a revolutionary experiment. I can’t wait to see the results.

Marion Nestle is the author of Food Politics and What To Eat and is the Paulette Goddard Professor of Nutrition, Food Studies, and Public Health at New York University

Mar 17 2011

Soda companies vs. soda taxes: breathtaking creativity

I keep telling you.   You can’t make this stuff up.  Try these for food politics–in this case, soda politics–in action.

Beverage Association gives $10 million to Children’s Hospital of Philadelphia (CHOP)

From the Philadelphia Inquirer blog (March 16):

In keeping with a controversial pledge to made last year to City Council as part of an effort to ward off Mayor Nutter’s steep tax on sugar-sweetened beverages, the soft-drink industry will donate $10 million to the Children’s Hospital of Philadelphia to fund research into and prevention of childhood obesity.

The three-year grant is funded by a new organization, the Foundation for a Healthy America, created by the American Beverage Association, the national trade group representing manufacturers and bottlers. The ABA was instrumental in lobbying Philadelphia City Council to reject Nutter’s proposal to tax sugary drinks at 2-cents per ounce as a way to cut consumption and raise money for the general fund.

In a press release Wednesday, CHOP insisted that it will “retain absolute clinical and research independence,” as the source of its funding for the research is likely to come under attack from those wary of the beverage industry’s influence. That includes funding for clinical studies to be submitted to peer-reviewed publications.

Atkins Obesity Center publishes review of effects of soft drinks on obesity

In a delicious irony, the latest review of this topic comes from the Atkins Center at Berkeley.  Yes, the Atkins Diet Atkins, the one that promotes high-fat, low-carbohydrates, and has everything to gain from proving that sugars are bad for you.

With that duly noted, set the irony aside.  The review was funded by independent agencies and organizations.  Let’s take its results at face value.

The reviewers looked at five kinds of evidence: secular trends, mechanisms, observational studies, intervention trials and meta-analyses.  All supported the idea that

The currently available evidence is extensive and consistently supports the hypothesis that sweetened beverage intake is a risk factor for the development of obesity and has made a substantive contribution to the obesity epidemic experienced in the USA in recent decades.

Sweetened beverages are an especially promising focus for efforts to prevent and reduce obesity for two reasons: (i) the evidence supporting the association between sweetened beverage intake and excess weight is stronger than for any other single type of food or beverage; and (ii) sweetened beverages provide no nutritional benefit other than energy and water.

Coca-Cola funds North Carolina School of Public Health campaign against Childhood Obesity

Isn’t that nice of them?  The apparently unironical slogan of the campaign : “Everything in moderation.”

Robert Wood Johnson Foundation report, “F as in Fat”, features piece by PepsiCo’s CEO

Melanie Warner, writing on bNET, explains that the RWJ Foundation is usually scrupulously independent but that putting Pepsi’s PR piece into its document makes no sense.

A third of the way into the report, up pops a bizarre “personal perspective” from PepsiCo’s (PEP) CEO Indra Nooyi in which she details the many ways her company is working to make America healthier. “Helping consumers by building on our portfolio of wholesome and enjoyable foods is not just good business for PepsiCo -– it’s the right thing to do for people everywhere,” Nooyi chirps in a two-page soliloquy that reads like a press release and touts everything from Pepsi’s pledge to reduce the sodium in its products by 25% by 2015 to its reduced sugar drinks like Trop50 and G2. No other food company is mentioned, just Pepsi.

[This inclusion]…also ties into the ongoing debate about what role the food industry should play in helping Americans slim down. Are food companies trusted partners who are committed to fundamental changes, or is getting people to eat healthier versions of processed food really a whole lot of Titanic deck chairs?

As the research linking soft drinks to obesity gets stronger and stronger, it is no wonder that the Beverage Association is buying off city councils, and soft drink companies are eager to position themselves as helping to solve the problem of childhood obesity, not cause it.

Do these actions remind you of any other industry’s behavior?  Cigarette companies, anyone?

Jul 3 2010

Soda taxes: politics vs. public health

By analogy with cigarettes, taxes on sodas might discourage people—especially young people—from consuming sugary drinks.  This might help with weight issues.

According to a new analysis by USDA economists,

A tax-induced 20-percent price increase on caloric sweetened beverages could cause an average reduction of 37 calories per day, or 3.8 pounds of body weight over a year, for adults and an average of 43 calories per day, or 4.5 pounds over a year, for children. Given these reductions in calorie consumption, results show an estimated decline in adult overweight prevalence (66.9 to 62.4 percent) and obesity prevalence (33.4 to 30.4 percent), as well as the child at-risk-for-overweight prevalence (32.3 to 27.0 percent) and the overweight prevalence (16.6 to 13.7 percent).

Soft drink companies know this all too well.  Hence, intense industry lobbying.  In the case of New York State, the lobbying succeeded.  Soda taxes are history (for now).

New York Times 7-2-10

As the New York Times explains:

Final lobbyist filings are not yet in, but estimates of the amount spent…range from $2.5 million, by Mr. Finnegan’s count, to $5 million, by the beverage industry’s count. The American Beverage Association spent $9.4 million in the first four months of the year to oppose New York’s soda tax, according to a search of public lobbying records by the New York State Healthy Eating and Physical Activity Alliance. Most of the money was spent on advertising, media and strategy.

This is a setback, but probably temporary.  Sooner or later, soda taxes will come.  Bring on the research!

Addition, July 5: Harvard researchers have just published a paper in the American Journal of Public Health showing that raising the price of sodas in a hospital cafeteria does indeed discourage sales.

Jan 29 2010

Not sure about soda taxes? Read this!

The New York City Health Department has produced a handy guide – a tool kit, actually – to soda tax legislation.    It explains the rationale, reviews the evidence supporting the use of such taxes, provides fact sheets, and answers Frequently Asked Questions.  For the academics among us, it provides loads of reference citations.  Take a look and put it to good use!

Update January 30: FoodNavigator.com did a report on reaction to the soda tax bill, “Fresh New York soda tax plans stir up the obesity debate.”  It’s got a great quote from the American Beverage Association:

What’s particularly disconcerting about this proposal is that the tax on a 12-pack of non-alcoholic beverages, like soft drinks, would be more than 9 times higher than the state tax on a 12-pack of alcoholic beverages, like beer.

This, as you might expect, has stirred up some counter-proposals, the most obvious being to increase the tax on alcoholic beverages.  Now that ought to generate some additional revenue!

While we are on the subject of alcohol, a forthcoming paper by Barry Popkin is said to have some interesting trend data:

Among adults aged 19 and over, SSB [sugar-sweetened beverage] consumption had almost doubled from 64 to 142kcal/day and alcohol consumption had increased from 45 to 115 kcal/day [from 1977-2006].

Popkin’s conclusion: “The consumer shift towards increased levels of SSBs and alcohol, limited amounts of reduced fat milk along with a continued consumption of whole milk, and increase juice intake represent issues to address from a public health perspective.”

Oct 1 2009

The soft drink industry strikes back

Today’s New York Times carries this full-page ad taking on the New York City Health Department’s campaign against sodas.

print_obesity_stupid

Although the ad says it’s paid for by the Center for Consumer Freedom (CCF), it doesn’t take much to guess who paid that group for it.  What better way to fight back than to hide behind this particular public relations agency, which specializes in defending purveyors of unhealthful products.

What CCF is about – and which companies pay for its work – are well known (for starters, see previous post).

I’m guessing the Health Department’s campaign must be having an effect if soft drink companies are so worried that they are willing to fund a group that is so consumer unfriendly.

Addendum:  no wonder they are worried.  According to a new report on soda taxation from Center for Science in the Public Interest, President Obama has said the idea is worth considering.

Scan10214

And thanks to Fred Tripp for giving me yet another CCF ad, this one from the September 30 A.M. New York.   All of this must be making soda companies worried enough to sign on with CCF.  Not a good idea.

Update October 2: I’ve just been send a link to Rachel Maddow’s comments on Rick Berman, the head of CCF.  Look for “Meet Rick Berman.”  It gives an overview of CCF accounts.  I’m not sure when it aired.

Sep 17 2009

Soda taxes: the new frontier

If I read the tea leaves correctly, soda taxes are on their way.  Kelly Brownell and Tom Friedan broached the idea earlier this year.  York state tried and failed to implement them.

Since then, as we learn more about the role of sugary drinks as a factor in obesity, public health support for the idea is growing.  Last week, Jim Knickman, President of NYSHealth wrote an op-ed in the New York Post in favor of the taxes.    Now the New England Journal of Medicine – as prestigious a journal as they come – is publishing another article from  Brownell, Frieden, et al on the public health and economic benefits of taxing sugary soft drinks.

And the evidence accumulates daily.  Children and adults who habitually drink sodas are more likely to be obese and have worse diets than those who do not.  The latest study from the California Center for Public Health Advocacy and a policy research group at UCLA makes just this point.

The study found that 41 percent of children (ages 2 – 11), 62 percent of adolescents (ages 12 – 17) and 24 percent of adults drink at least one soda or other sugar-sweetened beverage every day. Regardless of income or ethnicity, adults who drink one or more sodas or other sugar-sweetened beverages every day are 27 percent more likely to be overweight or obese.

The result of all this is what the New York Times is calling in its print headline, “tempest in a soda bottle.”  I’d call it a Category 5 hurricane.

As I love to point out, it did not used to be OK for kids to drink sodas all day long.  Now it is.  Taxes might encourage some changes in these recent practices.  It will be interesting to watch this idea progress.

Later in the day: as for pushback, here is a link to the ad from the “Americans Against Food Taxes.”  Why am I thinking this is an astroturf client of the Center for Consumer Freedom?  Just a wild guess.