In today’s budget George Osborne announced that a sugary drinks tax would come into effect from 2018.  It is estimated that this tax will raise around £580 million per year, which the Government claims will be spent on more sports funding for primary schools (1). It is clear that this measure is particularly aimed at targeting childhood obesity, but how successful is it likely to be?

With this much sugar in popular drinks, does a tax make sense?

Compelling Connections?

The majority of evidence suggests a link between sugary drinks consumption and weight gain in children and adolescents (2, 3).  In Britain, children aged 11-18 consume more sugary drinks than any other sector of the population (4). Substituting sugary drinks with water or milk may help children avoid gaining excess weight in their teens (5).  One mathematical model optimistically claims that a sugar tax of 20% could result in 2,400 fewer diabetes cases, 1,700 fewer strokes and heart disease cases, and 400 fewer cancer cases in England every year (4).  Surely the sugary drinks tax is a no brainer?

Teenagers get more added sugar from soft drinks than from any other single source.

It isn’t quite that simple.  In Mexico, where a sugar tax was introduced in 2014, sugary drink consumption has been affected less than anticipated.  It is not clear whether children are consuming fewer sugary drinks, and it is far too early to say whether there is any impact on obesity (6).  Even the most optimistic mathematical forecast suggests that a 20% sugar tax in Britain will only reduce caloric intake by an average of 24.69 calories per day in 11-18 year olds (4).  It is not at all clear that this would have any impact on obesity.  In other words, there is insufficient evidence to know whether the sugary drinks tax will help with the problem it is meant to tackle.

Piecemeal or Policy?
More importantly, the sugar tax seems to have been brought in as an isolated measure rather than as part of a wider policy.  Nobody really knows how much this tax will make, because it is not clear how high the tax will be.  Assuming the tax is successful in discouraging people from buying sugary drinks, what might they buy instead? It has been suggested that when people drink fewer sugary drinks, they crave more salty foods (4).  In the case of youngsters, this may well encourage them to buy crisps or similar snacks; hardly a healthy alternative!

Linking the money raised to school sports suggest that the Government believes that doing more sport at primary school will be an effective anti-obesity measure. For several reasons, I would question this.  Firstly, it reinforces the premise that eating fewer calories and being more physically active is effective in obesity prevention and control.  This model is over-simplistic and incorrect; physical activity is beneficial for many things, but weight loss is rarely one of them.

How did you feel about games at school?

Physical activity is one of the most important things that can be done for overall health (7), and encouraging people of all ages to be more active is a laudable aim.  But is funding school sports the best way to do this?  How many people hated games at school and found that school sports discouraged them from being active later in life?  I know I did, and I was not the only one.  In any case, the Government continues to sell off school playing fields at the rate of 1 every 3 weeks (8), so where exactly will increased physical activity at a rate sufficient to make a difference take place?  In my opinion it would be far better if the Government were to focus on supporting community initiatives and public spaces where fun and interesting physical activities are available to all, so that being active is seen as a pleasure rather than a penance.

An Integrated Approach.
The sugary drinks tax is not necessarily a bad idea, but it needs to be part of an integrated programme of support for healthy lifestyle measures, particularly for low-income families.  Obesity is a multi-faceted and complex issue.  Therefore any anti-obesity strategy must be multifactorial, and supportive rather than punitive.  It needs to be based on current research rather than outdated theories, to address beliefs as well as behaviours, and to garner support at grass-roots level.  Only then does it stand any chance of success.

For more on my views on the sugary drinks tax, and what should be done alongside it, see my article ‘Jamie Oliver, Ninja or Whinger’.

References:

1. http://www.bbc.co.uk/news/health-35824071 [Accessed 16 March 2016].
2. Pan, L., Li, R., Park, S., Galuska, D.A., Sherry, B., & Freedman, D.S., (2014).  A longitudinal analysis of sugar-sweetened beverage intake in infancy and obesity at 6 years.  Pediatrics, 134, Supplement 1, S29-S35.
3. Keller, A., & Bucher Della Torre, S., (2015).  Sugar- Sweetened Beverages and Obesity among Children and Adolescents: A Review of Systematic Literature Reviews. Childhood Obesity 11(4), 338-346.
4. Collins, B., Capewell, S., O’Flaherty, M., Timpson, H., Razzaq, A., Cheater, S., Ireland, R., & Bromley, H., (2015).  Modelling the Health Impact of an English Sugary Drinks Duty at National and Local Levels.  PLOS ONE, DOI:10.1371/journal.pone.0130770
5. Zheng, M., Rangan, A., Olsen, N.J., Andersen, L.B., Wedderkopp, N., Kristensen, P., Grontved, A., et al, (2015).  Substituting sugar-sweetened beverages with water or milk is inversely associated with body fatness development from childhood to adolescence.  Nutrition, 31(1), 38-44.
6. Sanders, T., (2016).  Much fizz, little pop.  New Scientist Special Issue February 2016.
7. Penedo, F.J., & Dahn, J.R., (2005).  Exercise and well-being: a review of mental and physical health benefits associated with physical activity.  Current Opinion in Psychiatry, 18(2), 189-193.
8. http://www.telegraph.co.uk/education/keep-the-flame-alive/10516870/One-school-playing-field-sold-off-every-three-weeks-since-Coalition-was-formed.html [Accessed 16 March 2016].