Obesity may be a lifestyle disease, but it is clear that most people who are obese can’t help it. In other words, they are obese because of their circumstances.
“But people’s ability to take personal responsibility is shaped by their circumstances. People cannot take responsibility if they cannot control what happens to them.” Michael G. Marmot, The Health Gap: The Challenge of an Unequal World
Obesity is a risk factor for many diseases including all-cause dementia and multiple sclerosis. This is why it is so important for us to think about ways to reduce obesity. I am convinced by the evidence that obesity is a relatively new disease that is linked to the current food environment and the metabolic chaos it causes. To change the diet of the population we need legislation. This is why it is heartening that the sugar tax, although in my opinion too low, is beginning to have a small impact on sugar consumption.
This study below compared trends in the volume of soft drinks purchased before and after the introduction of the sugar tax. Although soft drink volumes purchased did not change, the amount of sugar in those drinks was 30 g, or 10%, lower per household per week after the tax. Although this is only a very modest reduction in sugar consumption, it is a small step in the right direction. Do you agree?
“But people’s ability to take personal responsibility is shaped by their circumstances. People cannot take responsibility if they cannot control what happens to them.” Michael G. Marmot, The Health Gap: The Challenge of an Unequal World
Obesity is a risk factor for many diseases including all-cause dementia and multiple sclerosis. This is why it is so important for us to think about ways to reduce obesity. I am convinced by the evidence that obesity is a relatively new disease that is linked to the current food environment and the metabolic chaos it causes. To change the diet of the population we need legislation. This is why it is heartening that the sugar tax, although in my opinion too low, is beginning to have a small impact on sugar consumption.
This study below compared trends in the volume of soft drinks purchased before and after the introduction of the sugar tax. Although soft drink volumes purchased did not change, the amount of sugar in those drinks was 30 g, or 10%, lower per household per week after the tax. Although this is only a very modest reduction in sugar consumption, it is a small step in the right direction. Do you agree?
Now, what else can be done outside of the taxation system to reduce sugar consumption?
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| Fig 3 Observed and modelled amount of sugar in drinks liable to the Soft Drinks Industry Levy and confectionery purchased by each household weekly, March 2014 to March 2019. Points are observed data; coloured lines are modelled data; the first vertical line indicates the announcement of the SDIL; the second vertical line indicates the implementation of the SDIL; the Y-axis varies in scale between panels to maximise the resolution of figures; modelled purchases are presented as smoothed lines, including averaged effects for seasonality and the impact of Christmas and January, and, for confectionery, Easter |
Objective: To determine changes in household purchases of drinks and confectionery one year after implementation of the UK soft drinks industry levy (SDIL).
Design: Controlled interrupted time series analysis.
Participants: Members of a panel of households reporting their purchasing on a weekly basis to a market research company (average weekly number of participants n=22 183), March 2014 to March 2019.
Intervention: A two-tiered tax levied on manufacturers of soft drinks, announced in March 2016 and implemented in April 2018. Drinks with ≥8 g sugar/100 mL (high tier) are taxed at £0.24/L and drinks with ≥5 to <8 g sugar/100 mL (low tier) are taxed at £0.18/L. Drinks with <5 g sugar/100 mL (no levy) are not taxed.
Main outcome measures: Absolute and relative differences in the volume of, and amount of sugar in, soft drinks categories, all soft drinks combined, alcohol, and confectionery purchased per household per week one year after implementation of the SDIL compared with trends before the announcement of the SDIL.
Results: In March 2019, compared with the counterfactual estimated from pre-announcement trends, purchased volume of drinks in the high levy tier decreased by 155 mL (95% confidence interval 240.5 to 69.5 mL) per household per week, equivalent to 44.3% (95% confidence interval 59.9% to 28.7%), and sugar purchased in these drinks decreased by 18.0 g (95% confidence interval 32.3 to 3.6 g), or 45.9% (68.8% to 22.9%). Purchases of low tier drinks decreased by 177.3 mL (225.3 to 129.3 mL) per household per week, or 85.9% (95.1% to 76.7%), with a 12.5 g (15.4 to 9.5 g) reduction in sugar in these drinks, equivalent to 86.2% (94.2% to 78.1%). Despite no overall change in volume of no levy drinks purchased, there was an increase in sugar purchased of 15.3 g (12.6 to 17.9 g) per household per week, equivalent to 166.4% (94.2% to 238.5%). When all soft drinks were combined, the volume of drinks purchased did not change, but sugar decreased by 29.5 g (55.8 to 3.1 g), or 9.8% (17.9% to 1.8%). Purchases of confectionery and alcoholic drinks did not change.
Conclusions: Compared with trends before the SDIL was announced, one year after implementation, the volume of soft drinks purchased did not change. The amount of sugar in those drinks was 30 g, or 10%, lower per household per week—equivalent to one 250 mL serving of a low tier drink per person per week. The SDIL might benefit public health without harming industry.
Trial registration: ISRCTN18042742.
CoI: multiple
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