No Sugar-Coating This Chef's Warning on Obesity

A sugar tax may have a small impact, but the debate over one will make a big difference.

His knives are out against Big Sugar.

Photographer: Richard Vines/Bloomberg

Sporting dark-washed jeans and a V-neck cardigan, the 40-year-old superchef Jamie Oliver cut an unusual figure at a recent breakfast in London to discuss public health. But his message to a few dozen guests, including mayors from cities around Europe and the U.S., was anything but casual: In the war on obesity, the companies that sell sugary drinks and foods are rolling out heavy weaponry. Sounding eerily like a dissident in Vladimir Putin's Russia, he told them: "If I disappear in the next three to four years, you will know why. This is a very powerful force and industry."

Oliver, a well-known broadcaster, has promised not to back down. And he has called on the British government to "be brave" and adopt a sugar tax. So far, Prime Minister David Cameron has resisted. The government isn't convinced a sugar tax will make a great deal of difference and officials note that it's regressive, disproportionately affecting poorer consumers. Both arguments miss the point that Oliver has mastered: The goal isn't to find a single silver policy bullet to tackle obesity (there isn't one); it is to seize control of the message. 

Almost 25 percent of adults and 19 percent of 10- and 11-year-olds in England are obese, costing the National Health Service 5.1 billion pounds ($7.8 billion) every year, according to a report published Thursday by Public Health England. Some 68 percent of people in British hospitals are there with diet-related diseases. A disproportionate share of that number comes from poorer families.

The global costs of obesity are even more startling -- amounting to $2 trillion and rising, according to the McKinsey Global Institute, in line with the costs associated with tobacco and armed conflict. The number of people with Type 2 diabetes, a major health-care cost of obesity, has increased more than tenfold to about 382 million diagnosed cases today from 30 million worldwide in 1985. That figure is expected to nearly double by 2035, accounting for an estimated 12 percent of global health-care costs.

Obesity by deprivation

Source: Public Health England

Sugar consumption has skyrocketed because of low prices and intensive marketing. Counteracting those forces will require initiatives by national and local governments, consumer-goods companies, restaurants, employers, retailers, educators and, well, you get the picture. Everyone has to do their part. The 2014 McKinsey report analyzes 74 interventions to address obesity and identifies 44 where there is sufficient evident to estimate the impact and costs. A perfect world where some 15 government departments cooperate in rolling out dozens of targeted and costed interventions to fight obesity could reduce the number of overweight and obese individuals by 20 percent, the report says.

Chef Oliver is rightly skeptical that this kind of coordination will happen any time soon. To him, the appeal of a sugar tax is less in the predicted result that the message it sends. It says: We aren't going to drop this.

France introduced a tax in January 2012 of 11 euro cents per 1.5 liters of soda. A 4 percent decrease in sales followed (while sales of bottled water increased 1.6 percent). In 2013, however, sales volumes grew again, by 0.5 percent, and then by 6 percent in the first quarter of 2014. Some producers may not be passing on the tax to consumers. One lesson from the French tax, however, is that public support rose to more than 60 percent when the government publicized that the revenue would be used for health expenditure.

Mexico introduced a tax of 1 peso (6 U.S. cents) per liter of sugar-sweetened drinks in January 2014, along with a junk-food tax. The data is still being evaluated but so far shows about a 10 percent reduction in the purchase of sugar-sweetened beverages and an increase in the purchase of bottled water (which had been undercut by aggressively priced colas before the tax was introduced). One of the most interesting comments in the U.K. report was this one, cited in an annex, from an unnamed Mexican:

"There may be also some psychological effect on the population if you tax something because it's harmful, maybe people start to realize more than before that they should reduce consumption. "

Finland's drive to limit sugar consumption targets mainly price-sensitive children and teenagers with taxes on candy, ice cream, soft drinks and chocolate. Hungary taxes energy drinks and sugary drinks. Neither country has released data yet on how that's working out.  

The U.K. study suggests that fiscal policy may affect sugar consumption. It found that discounted foods account for around 40 percent of all expenditure on food, and that products with more sugar are subject to more promotions and more aggressive pricing than other items. Promotions "increase the amount of sugar purchased from higher-sugar foods and drinks by 6 percent overall and influence purchasing by all socioeconomic and demographic groups," the study found.

Detailed labels with recommended daily allowances don't seem to move the needle much on sugar consumption. Oliver favors a strategy of showing the appropriate number of teaspoons of sugar on soda bottles. The clearer the message, and the louder, the greater the impact. Public Health England concludes in its report that a tax on sugary drinks of between 10 percent and 20 percent would have a small but significant impact on buying habits, and has called for more regulation of food promotion, advertising and games featuring the mascots of sugary items. 

Experience in the U.S. may be instructive here. An attempt in New York under former Mayor Michael Bloomberg (the founder and majority owner of Bloomberg LP) to put limits on jumbo-sized sugary drinks was struck down in 2014 by New York's highest state court. Other soda taxes have been quashed by corporate lobbying and political opposition elsewhere in the U.S. And yet a strange thing happened when the dust cleared: The publicity surrounding the battle seems to have helped the message get out. Americans started drinking less soda."The drop in soda consumption represents the single largest change in the American diet in the last decade," wrote the New York Times a few weeks ago.

If Oliver's instincts, and New York's experience, tell us something, it is that we need not worry too much about whether Britain gets a sugar tax. What's more important is the bruising, knock-down, drawn-out, publicity-filled fight, which keeps the issue on the table and in the headlines. Let the gloves come off. 

(Corrects U.S. dollar-peso conversion in eighth paragraph.)
This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.

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