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In fact: Diabetes fat in fire, Kerala tax may provide pioneering remedy

The World Health Organisation estimates that sales of sugar-sweetened beverages in India have increased by more than 10% year-on-year since 1998, exceeding 11 litres per capita per year.

Written by Abantika Ghosh |
July 15, 2016 12:31:04 am
kerala, fat tax, kerala imposes fat tax, fat tax kerala, kerala fat tax, what is fat tax, fat tax 14.5%, kerala news India has only just started to examine the pros and cons of a sugar tax.

In a country where notions of ‘sin’ are intrinsically associated with morality, it cannot be easy to market a tax proposal based on the very western concept of “sinful” — as represented by juicy burgers and choco lava cakes. So, when Kerala Finance Minister Thomas Isaac smartly chose to call his pathbreaking 14.5% tax on pizzas, burgers and sandwiches “fat tax” instead, barring expected noises of disgruntlement from fast food chains, he didn’t quite stir the hornet’s nest.

It could be a while before it sinks in that Isaac, tasked with ensuring Kerala’s fiscal health, may be remembered as the man who led an epoch-making public health intervention in India. That is, if political or other considerations do not force him to backtrack — like Denmark, which was among the first to introduce a sin tax in food but was forced to withdraw it after some time.


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It has long been acknowledged that in India’s fight against non-communicable diseases, given the country’s status as the putative diabetes capital of the world, food taxes cannot be ignored indefinitely. Policy interventions, however, have been a fairly recent phenomenon, the focus so far having been on cutting supply of refined wheat products like pizza and burgers to children and adolescents by banishing them from school canteens — arguably an ostrich-like strategy given that these age groups generally comprise the largest section of the clientele of fast food chains. For the record, the number of people living with diabetes in India is said to be in the range of 70 million currently.

Kerala’s tax rate — denounced immediately by the chains for being too high — is incidentally in line with the global experience that shows that a tax of this nature does not work unless it is steep enough. An analysis published in 2013 in the American Journal of Public Health that tried to look at the efficacy of taxation to discourage junk food consumption, concluded: “…A junk food consumption deterrent in the form of a modest tax on selected nutrients, snacks, or SSBs (sugar sweetened beverages) would yield substantial revenues to governments, but is unlikely to affect obesity rates.

“Several studies suggest that high taxes (greater than or equal to 20%) may lead to measurable decreases in obesity on a population level, particularly if combined with additional interventions (e.g., healthy food subsidies, health education).These considerations are important and may be especially relevant for obesity prevention in high-risk populations. Although unwilling politicians may oppose them, high taxes would have the greatest impact on adolescents, persons of low socioeconomic status, and populations at risk for obesity.”

Where Isaac may have fallen short is in not bringing sugary drinks under the ambit of his tax. Contrasting imagery of obese men consuming large portions of cheesy foods, and lean models, sportspersons and filmstars peddling aerated fizzy drinks as the next horizon in “cool” notwithstanding, the fact is that internationally, the idea of a sin tax, beyond alcohol and tobacco, starts with sugary drinks.

The World Health Organisation estimates that sales of sugar-sweetened beverages in India have increased by more than 10% year-on-year since 1998, exceeding 11 litres per capita per year. While the debates over the addictiveness of sugar continue, it remains a fact that the “hidden sugar” content of fizzy beverages often escape attention in Indian lists of high-calorie foods.

“Sugar-sweetened beverages contain added sugars such as sucrose or high fructose corn syrup (HFCS), and a 330 ml or 12 oz portion of sugar-sweetened carbonated soft drink typically contains some 35 g (almost nine teaspoons) of sugars and provides approximately 140 kcal of energy, generally with little other nutritional value. Evidence suggests that sugar-sweetened beverages are generally consumed quickly and do not provide the same feeling of fullness that solid food provides such that consumers tend not to reduce intake of other foods sufficiently to compensate for the extra calories… Excess calories contribute to overweight and obesity as they can be readily converted to body fat and stored within various tissues. Overconsumption is likely exacerbated by an increase in the serving sizes of sugar-sweetened beverages over the last several decades,” says a WHO position paper. Recently, doctors from the US, UK, Brazil, Mexico and India wrote to Indian MPs urging them to push for the imposition of a sin tax on sugar-sweetened beverages.

Hungary, France, and some US states already have such a tax. According to WHO, in Mexico, a 1 peso (Rs 3.65) per litre (approximately 10%) tax on sugar-sweetened beverages is projected to decrease consumption by 10%-12%, and may have a substantial impact on reducing the prevalence of obesity.

India has only just started to examine the pros and cons of a sugar tax. Senior health officials say this is the next big challenge — having finally enforced the larger pack warnings on cigarette packets. Whether fizzy drinks giants who have weathered controversies ranging from pesticide content to differential standards for the developed and the developing world manage to blunt or stall such a move, remains to be seen.

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