Researchers cite a win-win for health care and obesity, but beverage industry balks at proposal
WEDNESDAY, Sept. 16 HealthDay News) -- A national tax of 1 cent per ounce of soda and other sugary drinks could stem the United States' obesity epidemic, while generating $14.9 billion the first year alone, health experts say.
That windfall could help finance proposed health care reform, while also funding programs to prevent obesity, say a group of prominent researchers in an article in the Sept. 17 issue of the New England Journal of Medicine.
The authors believe such a tax would deter people from buying non-nutritious sweet drinks, thereby helping Americans to lose weight and reduce their health risks.
The United States spends some $147 billion -- 9 percent of all health care expenditures -- on medical costs associated with overweight and obesity, the article states.
For consumers, the tax they suggest would increase the cost of a 20-ounce soft drink by 15 to 20 percent and lead to a minimum reduction of 20 calories a day per person from sweetened beverages. The revenue collected would benefit individual states and the federal government.
"There are certain products which make a strong contribution to the obesity epidemic while, conversely, there is no plausible public health benefit [from them]," noted Dr. David Ludwig, senior author of the paper and associate professor of pediatrics at Harvard Medical School.
"None of us are arguing that sugar-sweetened beverages should be banned, but the government needs to raise revenues where we have a huge national deficit," said Ludwig, who is also director of the Optimal Weight for Life Program at Children's Hospital Boston. "We have critical health legislation pending and the requirement to do so without further increasing the deficit.
"What better way to accomplish both lowering health care costs through obesity prevention and funding expansion of health insurance coverage than to add a tax to unhealthy foods," he continued.
The idea of levying a "fat tax" or "Twinkie tax" first gained attention in 1994, when Yale University psychology professor Kelly D. Brownell made the proposal in an op-ed piece in The New York Times. Brownell is lead author of the current paper.
Earlier this month, President Barack Obama said such taxes could help cover the cost of overhauling the U.S. health care system.
Meanwhile, studies continue to link consumption of beverages sweetened with sucrose (regular sugar), high-fructose corn syrup or fruit-juice concentrates to obesity, diabetes and heart disease, not to mention dental decay.
One such study found that each additional serving of sugar-sweetened beverage increased the risk of obesity in middle-school students by 60 percent, Ludwig said.
In another study involving 100 high-school students, eliminating such drinks led to a significant decrease in body weight.
"There are very few comprehensive interventions, let alone single dietary factors, whose modification have led to changes in body weight," Ludwig said. "Identifying a single factor is quite remarkable."
While the tax strategy has reduced cigarette and alcohol use, there's no guarantee it would work with food.
Dr. Stephen Cook, assistant professor of pediatrics at the University of Rochester Medical Center, does not think this 1-cent threshold is enough to drive down consumption.
A wiser approach, he said, would be to focus on the programs such a tax could benefit and to offset the price of healthier foods and drinks, such as fruits and vegetables and low-fat, non-flavored milk.
The beverage industry opposes a soda tax and also disputes the connection between consumption of sweetened drinks and obesity.
"Excise taxes on soft drinks simply do not reduce obesity rates," the American Beverage Association said in a statement issued Wednesday. "West Virginia and Arkansas are two prime examples -- both have excise taxes on soft drinks, yet rank fifth and sixth highest in the nation for obesity rates, " it said.
"Taxing soda and other sugar-sweetened beverages to reduce obesity is simply the wrong public policy for such a complex problem," the ABA said. Instead of "demonizing any one particular food or beverage," the government should promote nutrition education, the trade association said.
Would a soda tax be just the first of many such initiatives? Not so, according to Ludwig, who stressed that he does not have "a long list of other products that I'm ready to suggest taxing."
"I don't think we can make the argument that ice cream has anywhere near the negative impact that sugar-sweetened beverages do," he said. "We believe this is in a class by itself. It is a very discrete category with no health benefits, very strong evidence of harm and high consumption rates."
Some other nutrition experts support the proposal.
"I think this would make an impact," said Marianne Grant, a registered dietician and health educator at Texas A&M Health Science Center's Coastal Bend Health Education Center in Corpus Christi. "I've been hearing a lot about the need to attack the obesity epidemic like we attacked tobacco and smoking, and the only thing that significantly reduced the number of people smoking was the price of cigarettes."
Calculate soda taxes in different cities and states at Yale University.
SOURCES: David Ludwig, M.D., Ph.D., associate professor, pediatrics, Harvard Medical School, and director, Optimal Weight for Life Program, Children's Hospital Boston; Marianne Grant, R.D., registered dietician and health educator, Texas A&M Health Science Center's Coastal Bend Health Education Center, Corpus Christi; Stephen Cook, M.D., assistant professor, pediatrics, University of Rochester Medical Center, New York; Sept. 17, 2009, New England Journal of Medicine
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