A 20% Sugar Tax: Should Australia Do It?

This post was kindly requested by a friend who wanted me to share my thoughts on the Cancer Council’s push for a sugar tax in Australia. You can find the Cancer Council’s statement here

“Healthy eating” is as clear as a politician’s intentions.

The traditional food pyramid. The low carb revolution. Veganism. Intermittent fasting. Eating like a caveman. Regardless of your nutritional belief system, when it comes to weight loss and well-being, there is one consensus.

Added sugar sucks.

Why does added sugar have such a bad reputation?

As a junior doctor, I witness an epidemic of chronic (i.e. long term) and preventable diseases. The hospital rooms are filled with very familiar faces. The faces of obesity, diabetes, cardiovascular (heart and vessel) disease. Ahhh the classics.

Part of this epidemic comes down to too much shi**y food and drinks entering our system. Part of this sh**y food and drinks takes the form of excessive added sugar consumption. Part of this excessive added sugar consumption is due to our “good friend” sugar sweetened beverages. Just to be clear, this is the type of good friend that you block on Facebook and conveniently forget to invite to your wedding.

 

In short, sugar sweetened beverages suck as well.

But it’s so tasty! 100% agree. As the name suggests, it is sweetened with sugar. You can put some sugar on your last bowel motion and it will feel like a party in your mouth and the whole Trump administration is invited. Regardless of this, the strong links to being overweight or obese as well as developing diabetes, cardiovascular disease or poor dental health does ironically leave a bitter taste in my mouth.

What is the sugar tax?

A minimum 20% additional tax on sugar sweetened beverages which can include sodas, flavoured mineral water, energy drinks, sports drinks, cordials as well as various fruit and vegetable drinks.

Here are some numbers to illustrate how the 20% sugar tax will look like to the general public.

Coca-Cola (250ml): $1.60 becomes $1.92

Gatorade (600ml): $3.74 becomes $4.49

Flavoured vitamin water (500ml): $3.47 becomes $4.16

Red Bull (250ml) ]#wingssoldseparately: $3.14 becomes $3.77

Cordial (2L): $2.20 becomes $2.64

What do you think? Will these price changes affect whether people will buy or not?

What does this sugar tax aim to achieve?

1) Health

Based on the results from other countries who are already implementing a variant of this tax, we can expect to see a reduction in the consumption of sugar sweetened beverages. Modelling studies have estimated that a 20% sugar tax could reduce consumption of sweetened beverages by 12.6% and reduce obesity by 2.7% in men and 1.2% in women. It is worth noting that this study was modelled over a 25 year period.  

2) Dollar dollar bills y’all

This 20% sugar tax has the potential to provide a huge economic boost in the health sector. Even after taking into account the reduced consumption of sugar sweetened beverages, recent studies on the beautiful people of Australia estimate that the tax can generate an annual revenue in excess of $400 million! This money can be spent on subsidising healthier food and drink options or health promotion campaigns or improving the school food environment as well as other positive goodness.

Who has already implemented a sugar tax and has it actually worked?

A growing list of countries have adopted various food and drink taxes with promising results. Mexico, Barbados, Belgium, Chile, Finland, France, Hungary and the UK to name a few.

Let’s take Mexico. A 10% tax on sugar sweetened beverages was accepted from September 2013. The results are promising. By the end of a 3 year study, they had noted a 12% reduction in the purchase of taxed beverages. An exciting finding was that there was a 4% increase in untaxed beverages, namely bottled water. As a Sri Lankan parent would say to their child after they achieve a perfect score of 99.25 in their final year exams, “Not a bad effort but, is that enough to get into Medicine?”

The numbers produced by Mexico and other countries is promising. But, is it enough? The answer is an overwhelming, maybe. To say that the tax truly works, it needs to be shown to improve quality of life. It needs to be shown to reduce not only consumption of sugar sweetened beverages but also rates of obesity, diabetes and heart disease. These diseases take time to develop and so longer term studies that track impact over decades is required.

So in the meantime, what do we do? Answer: we hire smart people with calculators to carry out some statistical models and essentially “guesstimate” what the future holds. While they run the numbers, you can watch this video of an amazing full court buzzer beater shot here.

And we’re back! Sorry for the unexpected tangent. I can’t help it.

A number of modelling studies have been done. Let’s have a look at a UK modelling study.  They have estimated that a 20% tax on sugar sweetened drinks will “reduce the number of obese adults in the UK by 1.3% or 180,000 people and the number of overweight people by 0.9% or 285,000 people…[with a] predicted annual revenue [of] £276million”. This is by no means proof that this sugar tax will work but, it definitely adds to the argument to give it a try!

My concerns about the sugar tax

  • The success of a sugar tax relies on the premise that consumption of sugar sweetened beverages will drop simply because it costs too much. In other words, the purchasing decision comes down to money and not a fundamental understanding that added sugar is linked to bunch of nasty diseases. Therefore, there is nothing to stop consumers from turning to cheap and unhealthy alternatives. Needless to say, donuts are cheap these days. This emphasises the importance of why any approach to our obesity epidemic must put education and awareness at its core. This way, it won’t matter if coca cola and donuts are sold for free as people will still hopefully choose the healthier option. Choice is underrated. Informed choice even more so.

 

  • Will a 20% sugar tax reduce consumption in the long term? Often the price increase is less than a dollar. People tend to adapt. It’s like the Aussie housing market. 10 years ago a million dollars would buy you a waterfront mansion but now, it will buy you a studio apartment in a school zone. And people do buy, sometimes irrespective of price, because they have adapted to what is considered “normal” in the housing market.

 

  • Get ready for a backlash. It is unlikely that industry super giants will just sit idly around a camp fire singing Kumbaya as their profits plummet and they lose part of their market share to the ultimate thirst quencher  known as water. In “Weighty Matters”, an amazing blog by obesity specialist Dr Yoni Freedhoff, a recent post talks about the resistance they have had in Canada from industry giants with regards to restricting food and drink marketing to children.  Have a read here if you have the time.

 

  • The sugar tax cannot be viewed as the solution. It may be part of the solution. This epidemic of obesity and related diseases needs to be attacked from all angles; the household, the classrooms, the workplace and in venues that serve or advertise food and drink. A coordinated onslaught in the form of national education campaigns, fair advertising and marketing restrictions and affordability of healthier food options with the overall goal of educating and building awareness would be something I would love to be a part of. Optimistically I hope this blog is contributing in its small way for now.

 

SUMMARY

  • Added sugar sucks and when you put it in drinks, then that sucks too.
  • Excess added sugar consumption is a risk factor for obesity, diabetes, cardiovascular disease as well as poor dental health.
  • Many countries have implemented a sugar tax with some promising results pointing towards a reduction in the consumption of sugar sweetened beverages. Is it Australia’s turn?

Comment and share if you think this post carries any value. As always, let’s start a constructive conversation about obesity and what can be done about it.

If anyone would like to request a topic, please do! It gives me a great opportunity to get immersed and learn about something in detail. Thanks again to the friend who requested this post (you know who you are).

Much love to you and of course, to myself

Dr G