The Canadian government is deliberating the implementation of a tax on sugar-sweetened beverages (SSB tax). In deciding whether this tax should be implemented, a series of questions can be considered.
1) Are SSBs healthy for the general population?
No. A 16-ounce serving of pop contains ~52g of sugar constituting 190 calories. Calories in this form contain no nutritional value and provide unnecessary calories.
2) Are SSBs the cause of obesity and the associated health problems?
No. The consumption of sugary drinks has been declining since the 1990s. This decline in soda consumption has been occurring as obesity rates have been rising. The relationship is going in the wrong direction.
3) Does the science support the implementation of an SSB tax to improve health?
Not as much as we would think, but there is a bit of drama.
Last month, a paper published in the Annals of Internal medicine by Dr. Bradley Johnston, a clinical epidemiologist at the Hospital for Sick Children in Toronto, reported on the evidence describing the negative health effects of sugar consumption. His conclusion was simply that the evidence linking sugar consumption to compromised health is quite weak. The study designs are poor and the observed detrimental effects of sugar on health are less than impressive. Importantly, Johnston does not suggest people consume more sugar, just that the science should be improved to generate better guidelines. Within the discussion of this paper, the authors openly state that they have been funded by the many of the “Big Food” companies and thus can be accused of carrying a conflict of interest.
The “anti-sugar” community quickly pointed out this conflict of interest and likened this study to the previous Big Tobacco efforts to downplay the negative effects of smoking (think “merchants of doubt”). When describing the article, Professor of Nutrition, Food Studies and Public Health at New York University Dr. Marion Nestle stated:
“This is a classic example of how industry funding biases opinion. It’s shameful.”
The “non-anti-sugar” campaign responded to this criticism by reminding everyone that it was the nutritional scientists who concluded that fat was unhealthy based on poorly designed studies back in the 1980’s. We now know that fat is not the enemy but these poorly designed studies directly led to the low-fat movement, which led to food companies adding sugar to everything, which got us into this mess in the first place.
4) Will an SSB tax improve health and reduce obesity?
Maybe, but not in the way we think it will.
The real-life experiment surrounding the efficacy of a Soda Tax is currently being performed down in Mexico. A 10% tax on sugary drinks was implemented in 2014, however, after three years’ obesity rates are still climbing. Results from Mexico’s 2016 National Health and Nutrition Survey found that overweight and obesity affects 72.5% of Mexican adults. In 2012, that number was 71.2%. The prevalence of diabetes also rose slightly, from 9.2% in 2012 to 9.4% in 2016. In addition, the consumption of SSBs seem to be creeping back towards pre-tax levels. Thus, the tax did not stave off obesity, nor has it reduced SSB consumption long term.
So why implement the SSB tax in the first place? Considering the evidence, you could interpret the SSB tax as government paternalism and simply another strategy to take the citizens’ money.
But consider where the tax money could be utilized. The Heart and Stroke Foundation urged the government to impose an SSB tax of five cents per 100 milliliters, which would generate $1.8 billion per year. The revenue from the SSB tax could be used to support other obesity fighting policies such as building new sports complexes, promoting water consumption and lowering the cost of fruits and vegetables. This tact is being employed in Britain where revenue from SSB taxes will fund childhood obesity interventions. In Philadelphia, an SSB tax will fund an array of community and education initiatives, including universal pre-kindergarten classes, building new community schools, and improving recreation centers, parks, and libraries throughout the city.
Accordingly, it is doubtful an SSB tax will autonomously reduce obesity, however the revenue generated from an SSB tax may fund initiatives that result in a reduction in obesity. The success of these initiatives will highly depend on the government team assigned.
So, should Canada implement a Soda tax? I would say that I am not against the idea, but to be an advocate is currently a stretch for me. Healthy living will never depend on sugar, or fat, or any one factor in isolation. This reductionist approach is like training to become an NHL player by only taking slap shots. Narrowing our view to focus on sugar may compromise our ability to see the bigger lifestyle picture.
By Brennan Smith, PhD