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Tax on Sweet Drinks Would Help US Health
Columbia study affirms findings of several prior analyses; Surveys suggest public support if revenue is targeted at health programs.
1/16/2012
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By Craig Weatherby
 
Anyone who follows research on the health impacts of the average American’s decidedly sugary, starchy diet knows how unhealthful that eating/drinking pattern is.
 
For example, see “Sugar Takes another Heart-Health Hit” and “Starchy Diets Linked to Cancer, Diabetes, and Heart Disease”, which come from the Foods & Metabolic Health section of our news archive.
 
As we reported in “The Calories We Quaff”, so-called “liquid candy” – what scientists call sugar-sweetened beverages – account for an astonishing one in five of the calories consumed by the average American.
 
Three years ago, a team from the Harvard School of Public Health and other academic research centers came to a clear conclusion about the impact of sugar-sweetened beverages:
“The science base linking the consumption of sugar-sweetened beverages to the risk of chronic diseases is clear.” (Brownell KD et al. 2009).
 
That study on sugar-sweetened beverages – which scientists call SSBs for short – was preceded and followed by several analyses that came to similar conclusions.
 
Currently, some 33 states have sales taxes on SSBs (average of 5.2%), but the Harvard-led team found that those taxes have been too small to affect consumption.
 
Columbia study supports tax on soda
A new study from Columbia University adds yet more evidence that a penny-per-ounce tax on “liquid candy” would improve public health, and reduce rates of diabetes, heart disease and obesity substantially.
 
As the authors wrote, “Sugar-sweetened beverages are cheap to buy, but they cost the U.S. plenty: about $174 billion per year on diabetes treatment costs and $147 billion on other obesity-related health problems.”
 
Columbia epidemiologist Y. Claire Wang, M.D., and her colleagues calculated that a penny-per-ounce tax on SSBs could bring the U.S. these benefits over a 10-year period:
  • Prevent 26,000 premature deaths.
  • Cut sugar consumption by 15 percent.
  • Reduce cases of diabetes by 2.6 percent.
  • Prevent 95,000 adverse heart events and 8,000 strokes.
  • Save $17 billion in medical costs for adults aged 25-plus.
  • Generate approximately $13 billion in annual tax revenues.
Americans consumed up to 13 billion gallons of SSBs over the last 10 years, the authors wrote, making such drinks the largest source of added sugar and excess calories in the U.S. diet.
 
The Columbia group agreed with prior studies showing that current state-level soda taxes are too low to impact consumption.
 
They also dealt with objections that a soda tax would be regressive, and hit low-income households – more likely to purchase sugar-sweetened beverages than higher-income households – disproportionately.
 
Dr. Wang’s team says it’s clear that lower-income consumers – along with racial and ethnic minorities – suffer more from obesity, cardiovascular disease and diabetes and stand to benefit most from a steeper tax.
 
Oddly, they also cited a lack of evidence that lower-income and minority consumers are more price-sensitive. But studies on tobacco taxes show that lower-income smokers are sensitive to price changes (Powell LM, Chaloupka FJ 2009).
 
Dr. Wang noted that while there is some uncertainty as to what drinks people would choose instead of SSBs, their conclusion that a penny-per-ounce tax would reduce consumption by 15 percent is actually a conservative estimate.
 
Better beverage choices
The Columbia team found that a combination of water, diet drinks, and “more nutritious caloric beverages” could viably replace sugar-sweetened beverages, resulting in an estimated saving of up to 60 calories for every 100 calories of sugar-sweetened drink not consumed.
 
They didn’t define “more nutritious caloric beverages”, but presumable meant things like vegetable juice.
 
Fruit juices certainly qualify as “more nutritious” as well, but are much higher in sugar, with levels comparable to those in soda.
 
Interestingly, a Dutch study found that a successful program designed to reduce teenagers’ intake of SSBs did not seem to work because the kids drank more water or diet drinks instead (Veitch J et al. 2011).
 
"With the estimated number of 860,000 fewer obese adults aged 25-64, and given the greater reductions in consumption among younger people, the longer-term health benefits would be far greater than the impacts during the first 10 years," Wang said.
 
What about diet drinks?
The evidence that they help control weight is mixed at best.
 
As the Yale University author of a recent review wrote, “A rise in the percent of the population who are obese coincides with an increase in the widespread use of non-caloric artificial sweeteners, such as aspartame (e.g., Diet Coke) and sucralose (e.g., Pepsi One) ... research studies suggest that artificial sweeteners may contribute to weight gain.” (Yang Q 2010)
 
Last year, we reported on two studies presented at the American Diabetes Association's Scientific Sessions in San Diego, which suggest that replacing SSBs with diet drinks might be a losing strategy.
 
Scientists from The University of Texas Health Science Center San Antonio linked diet soft drinks to bigger waistlines in people … and their second study found that aspartame raised fasting blood sugar levels in diabetes-prone mice (see “Diet Drinks Added Fat, Aspartame Made Mice Diabetic”).
 
According to co-author Helen P. Hazuda, Ph.D., “Data from this and other prospective studies suggest that the promotion of diet sodas and artificial sweeteners as healthy alternatives may be ill-advised. They may be free of calories but not of consequences.” (UT 2011)
 
Australian researchers who examined the evidence and complex metabolic responses to artificial sweeteners found that, ironically, consumption of aspartame results in a craving for carbohydrates that could eventually result in weight gain (Humphries P et al. 2008).
 
And concerns about aspartame – the most commonly used artificial drink sweetener – persist (see “Artificial Sweetener Raises Lifelong Concerns”).
 
Don’t like to drink water? Enjoy some low-sugar veggie juice (easy on the carrots and beets) or unsweetened tea and coffee … and leave the soda on the shelf!
 
Public attitudes toward junk-food taxes
Americans’ support for food and beverage taxes to curb obesity has grown steadily over the past several years.
 
Questions about taxes in polls have been asked in various ways, so the results are not directly comparable from year to year, but overall trends are clear.
 
Support for food taxes rose from 33 percent in 2001 to 41 percent in 2003 and then to 54 percent in 2004 (Brownell KD et al. 2005).
 
And a 2008 poll of New York State residents showed that 52 percent of respondents supported a soda tax, while 72 percent endorsed such a tax if the revenue were used to support programs for the prevention of obesity (Brownell KD et al. 2005).
 
 
Sources
  • Aeberli I, Gerber PA, Hochuli M, Kohler S, Haile SR, Gouni-Berthold I, Berthold HK, Spinas GA, Berneis K. Low to moderate sugar-sweetened beverage consumption impairs glucose and lipid metabolism and promotes inflammation in healthy young men: a randomized controlled trial. Am J Clin Nutr. 2011 Aug;94(2):479-85. Epub 2011 Jun 15.
  • Andreyeva T, Chaloupka FJ, Brownell KD. Estimating the potential of taxes on sugar-sweetened beverages to reduce consumption and generate revenue. Prev Med. 2011 Jun 1;52(6):413-6. Epub 2011 Apr 3.
  • Brownell KD, Farley T, Willett WC, Popkin BM, Chaloupka FJ, Thompson JW, Ludwig DS. The public health and economic benefits of taxing sugar-sweetened beverages. N Engl J Med. 2009 Oct 15;361(16):1599-605. Epub 2009 Sep 16.
  • Brownell KD. The chronicling of obesity: growing awareness of its social, economic, and political contexts. J Health Polit Policy Law 2005;30:955-964
  • Dallongeville J, Charbonnel B, Desprès JP. [Sugar-sweetened beverages and cardiometabolic risk]. Presse Med. 2011 Oct;40(10):910-5. Epub 2011 Jun 17. French.
  • de Koning L, Chiuve SE, Fung TT, Willett WC, Rimm EB, Hu FB. Diet-quality scores and the risk of type 2 diabetes in men. Diabetes Care. 2011 May;34(5):1150-6. Epub 2011 Apr 4.
  • de Koning L, Malik VS, Rimm EB, Willett WC, Hu FB. Sugar-sweetened and artificially sweetened beverage consumption and risk of type 2 diabetes in men. Am J Clin Nutr. 2011 Jun;93(6):1321-7. Epub 2011 Mar 23.
  • Humphries P, Pretorius E, Naudé H. Direct and indirect cellular effects of aspartame on the brain. Eur J Clin Nutr. 2008 Apr;62(4):451-62. Epub 2007 Aug 8.
  • Powell LM, Chaloupka FJ. Food prices and obesity: evidence and policy implications for taxes and subsidies. Milbank Q 2009;87:229-257 University of Texas Health Science Center at San Antonio (UT). Related studies point to the illusion of the artificial. June 27, 2011. Accessed at http://www.eurekalert.org/pub_releases/2011-06/uoth-rsp062711.php
  • Veitch J, Singh A, van Stralen MM, van Mechelen W, Brug J, Chinapaw MJ. Reduction in sugar-sweetened beverages is not associated with more water or diet drinks. Public Health Nutr. 2011 Aug;14(8):1388-93. Epub 2010 Oct 29.
  • Wang YC, Coxson P, Shen YM, Goldman L, Bibbins-Domingo K. A penny-per-ounce tax on sugar-sweetened beverages would cut health and cost burdens of diabetes. Health Aff (Millwood). 2012 Jan;31(1):199-207.
  • Yang Q. Gain weight by "going diet?" Artificial sweeteners and the neurobiology of sugar cravings: Neuroscience 2010. Yale J Biol Med. 2010 Jun;83(2):101-8. Review.
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