British Medical Association Calls for 20% Sugar Tax on Sodas

July 13, 2015

The UK doctors union, the British Medical Association (BMA), is calling for a tax of 20% to be added to the cost of sugar-sweetened beverages, which could then be used to subsidize the price of fruit and vegetables, as part of a sustained attempt to improve the quality of the UK diet.

In a new report, entitled "Food for Thought: Promoting Healthy Diets Among Children and Young People," the BMA says: "Doctors are increasingly concerned about the impact of poor diet on the nation's health. This is not only a significant cause of ill health and premature mortality, but a considerable drain on National Health Service (NHS) resources."

If collaborative policies to reduce consumption of salt, trans fats, saturated fats, and sugars do not hit target within the next few years, mandatory regulations to limit intake should be instituted, it argues.

Author of the report, BMA board of science chair Prof Sheila Hollins, a former GP and a psychiatrist, said, "I am particularly distressed that poor diet is such a feature of the lives of our children and young people. We should not tolerate that the next generation is growing up with the normality of regularly consuming processed and fast food or that there are children who have no concept of where their food comes from.

"Central to this is creating an environment where it is normal, easy, and enjoyable for children and young people to eat healthily," she noted.

To Legislate or Not? That Is the Question

There have previously been calls in the United Kingdom for a "sugar tax," but the government has so far resisted introducing such legislation.

In response to the BMA call, the UK Food and Drink Federation notes that both Belgium and Denmark rejected the notion of a tax in 2013, "and evidence from France shows that while sales of soft drinks initially fell after a tax was introduced in 2012, they have increased since."

Rather, the way forward is to work collaboratively with government, says the organization, which represents UK food and drinks manufacturers. "We welcome [the UK government] recently unequivocally ruling out a sugar tax and committing to a partnership approach to public health," said Ian Wright, director general of the Food and Drink Federation, in a statement.

The United Kingdom has already managed to reduce the amount of salt in many processed foods through a collaborative process with industry rather than any mandatory requirement.

The BMA recognizes this in its report, noting that "as one of the first European countries to develop a national salt-reduction strategy, some progress has been made in the UK in reducing the salt content of many processed foods and in reducing average salt intakes."

But there is still a way to go, it stresses. As mean salt intake for adults and children remains above recommended levels and previous voluntary salt-reduction targets have not been met, a target should be set to achieve the recommended maximum population intake of 6 g [about 2.4 g of sodium] per day by 2017, it adds.

"Regulatory measures should be considered if these targets are not met."

And with regard to trans fats, the same approach has been taken, "but the introduction of mandatory limits has been found to be the most effective strategy in other countries," says the BMA.

"A 1-year target should now be set for industry to eliminate artificial trans fats from all products sold in the UK, with legislation introduced if this target is not met."

Mr Wright said: "British food and drink companies are cutting the salt, saturates, and calories in their products, which are offered in a range of portion sizes. They have virtually eliminated artificial trans fats in UK products."

And for well over a decade, UK producers have voluntarily provided clear nutrition information on packaging, he added, with the food industry "helping health professionals to encourage people to use the information provided."

But Prof Hollins argues this is not enough: "It is not uncommon for reports like this to elicit cries of 'nanny state' and forceful objections that governments have no place in telling people how to live their lives. This view needs to be squarely challenged. My belief is that it is commercial interests that are excessively influencing people's decisions about their diet," she asserted.

Poor Diet: More Disease Than Smoking, Inactivity, and Alcohol Combined

The BMA report stresses that an unhealthy dietary pattern "is strongly associated and causally linked with a number of chronic, complex conditions such as obesity, cardiovascular disease, cancer, and type 2 diabetes."

Indeed, worldwide, poor diet "contributes to more disease than physical inactivity, smoking, and alcohol combined. The burden of diet-related ill health in the UK is substantial, estimated to lead to 70,000 premature deaths annually, which represents around 12% of the total number of deaths, and costs the NHS around £6 billion per year," it continues.

The report therefore urges comprehensive action to promote healthier diets among children and young people and particularly among individuals from low socioeconomic classes.

As well as calling for legislation in certain areas, including a prohibition on the mass marketing of unhealthy foods, the report calls for improvement in education and health promotion, including clearer labeling on food products for consumers.

It also calls for legislation to ensure only healthy food is available in schools and hospitals and that the "sale of all unhealthy food and drink products should be phased out in all NHS hospitals."

The aim is to create an environment "where dietary choices default to healthy options," it concludes.

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