10 Key Facts: Food taxes - what role might they have in the battle against obesity? 1. The British Nutrition Foundation facilitated a meeting to provide a platform for an informed discussion on a topic that has attracted polarised opinions – food and beverage taxation as a means to drive public health improvement and in particular to lower current rates of obesity. 2. There was uniform agreement about the need to address the obesity crisis and recognition of the stark socio-economic gradient that exists. Obesity prevalence is considerably higher among the most deprived than among the least deprived in our society; for example in English children aged 11, rates range from 11.7% in the most prosperous 10% of households to 24.3% in the most deprived. Around a quarter of the UK’s adult population is now obese and about a third of children are already overweight or obese, giving rise to concerns about chronic diseases such as type 2 diabetes that often go hand in hand with obesity. 3. Several speakers discussed real life and modelled taxation approaches. According to Christopher Snowdon, Director of Lifestyle Economics at the Institute of Economic Affairs, efforts in Denmark to use taxation to reduce saturated fat intake in order to decrease diet-related illness failed; the tax proved to be politically unacceptable and the law was repealed after 15 months. Instead of changing dietary habits, there was evidence of stock-piling of food before the tax was introduced, and people switching to discount stores to buy the taxed products or travelling to neighbouring countries to shop. The tax applied to foods containing more than 2.3g saturated fat per 100g and was part of wider reform to the Danish tax system with the general aim of decreasing taxation pressure and financing it by health, environmental and energy taxes. Information presented indicated that the tax proved very bureaucratic to administer, not least because it applied to the food as consumed, and its short existence made the likelihood of a measurable health impact unlikely. 4. Modelling studies conducted in the UK by Professor Richard Tiffin, Director of the Centre for Food Security at University of Reading, and colleagues at the University of Oxford have predicted that a tax on the saturated fat content of foods would reduce the risk of obesity by only a small amount and that a 20% tax on soft drinks would reduce adult obesity by 1.3% and overweight by 1.9%. The modelling also predicted that food taxes would impact most on those least able to pay. 5. Several speakers emphasised the limitations of current understanding of the substitutions people might make if taxation were to be introduced. Dr Laura Cornelson, a Research Fellow at the London School of Hygiene and Tropical Medicine, cautioned that there are many unanswered questions around the indirect, potentially contradictory effects of food taxes (and also possibly subsidies) and that not enough is known about what people might choose to consume instead, and whether these food substitutions might undermine the hoped-for health benefits of a food tax. She suggested that there is also uncertainty about how the food industry might respond to the taxes (e.g. via reformulation if the tax focuses on a single nutrient) and whether the taxes would be passed on to consumers in their entirety, thus influencing the impact of the tax. 6. Dr Hannah Timpson, Health and Wellbeing Research Manager at the Centre for Public Health, LJMU, presented results of research conducted among children, adolescents, parents, families and adults in the North West of England, the region with the second highest rate of obesity in the UK. The study concluded that while parents with lower income might be influenced to change their consumption behaviour by taxation, a 20% increase in price of sugar-sweetened soft drinks would not generally be enough to motivate people to reduce how much they consume. The research found that while people considered sugar-sweetened drinks to be detrimental to dental health, the majority do not associate them with weight gain. She concluded that “while taxation may not have the desired effects, there is a real need for education to raise awareness of the potential negative health implications of overconsumption of foods and drinks high in sugar and fat”. 7. As the challenges associated with obesity and chronic disease prevention are complex, it is already recognised that reversing current obesity levels requires government leadership of a package of diverse approaches that are evidence-based and designed to modify dietary and lifestyle patterns, including promoting regular physical activity. 8. Taxation is one of a number of routes that can be taken and taxation could potentially take a number of forms; for example, a tax on foods that provide added sugar or fat could be coupled with subsidies on fruits and vegetables. 9. A theme that emerged was that part of the solution to tackling obesity may lie in broader social policies that incorporate population segmentation, recognising that not everyone will respond in the same way, and are based on a more in-depth understanding of why people make the choices they do. Professor Tiffin, said: “A piece-meal approach to ‘bad’ nutrients applied at a population level fails to acknowledge the complexity of individual and social behaviour which leads to growing inequalities in health”. 10. An important point emphasised in discussion was that food taxes as currently defined are unlikely to have a major impact on population health. However, a better understanding is needed of the multiple drivers of food choice to quantify better the role food taxes may have in influencing diets in populations. Existing and planned food taxes urgently need stronger evaluation designs to provide critical learning for the academic and policy communities. Notes: This is a summary from the British Nutrition Foundation meeting, held on 7th April 2014. Speakers were Professor R Tiffin (University of Reading); Christopher Snowdon (Institute of Economic Affairs); Dr Laura Cornelsen (London School of Hygiene and Tropical Medicine); Dr Hannah Timpson (Liverpool John Moores University) and Kate Halliwell (Food and Drink Federation). Professor Judith Buttriss, Director General of the British Nutrition Foundation, made some introductory remarks and chaired the meeting. The British Nutrition Foundation (BNF) was established in 1967 and exists to deliver authoritative, evidence-based information on food and nutrition in the context of health and lifestyle. The Foundation’s work is conducted and communicated through a unique blend of nutrition science, education and media activities. BNF’s strong governance is broadbased and is weighted towards the academic community. We are honoured to have Her Royal Highness The Princess Royal as our Patron. BNF is a registered charity that attracts funding from a variety of sources, including contracts with the European Commission, national government departments and agencies; food producers and manufacturers, retailers and food service companies; grant providing bodies, trusts and other charities. For more information about BNF, see our website: www.nutrition.org.uk or contact us at: Imperial House, 15-19 Kingsway, London, WC2B 6UN. Tel: 020 7557 7930, Fax: 020 7557 7958, E-mail: [email protected]