Tax Beverages in India to Curb Rising Obesity and Diabetes, Study Suggests
Rupali Mukherjee
Times of India
January 7, 2014

This is sure to cause a headache to beverage companies. Concerned with the rising epidemic'' of diabetes in the country, health researchers have for the first time advocated imposing a substantial tax on fizzy colas in the country.

India's health issues of rising obesity, overweight and incidence of diabetes may be tackled by imposing a substantial tax of 20% on sugary soda, a new study published in the medical journal, PLOS Medicine says. While the link between sugar sweetened beverages and overweight and diabetes has been established earlier, a study for the first time advocates a substantial tax in India to mitigate increase in type 2 diabetes and obesity levels.

Rising levels of obesity and risk of diabetes have prompted many states in the US to have food taxes that affect sugar-sweetened drinks, while some countries have started restricting sales, and even substantially tax sugary soft drinks.

The study led by Sanjay Basu says that a 20% soda tax may lead to a reduction of 3% in obesity (or prevent 11.2 million new cases) , and a 1.6% decline in type 2 diabetes, or prevent 400,000 cases., over a decade 2014-2023.

The study used consumption and price variation data from a nationally representative survey of 100,855 Indian households. Researchers and doctors first calculated how changes in price of sugar-sweetened beverages (SSB) alter their per capita consumption, and to the extent substitution with other beverages happens. They incorporated trends in sales of beverages, body mass index (BMI), and diabetes incidence data stratified by age, sex, income, and urban/rural residence into a validated microsimulation of caloric consumption, glycemic load, overweight/obesity prevalence, and type 2 diabetes incidences among Indian subpopulations facing a 20% SSB excise tax.

However, acceleration in SSB consumption trends consistent with industry marketing models would be expected to increase the impact efficacy of taxation, averting 4.2% of prevalent overweight/obesity and 2.5% of incident type 2 diabetes from 2014-2023, the study adds.

Dr Anoop Misra, chairman of Delhi-based Fortis-C-DOC said "I think it is a good study and first one of its kind in India. Both approaches are important to curb diabetes, bottom up (awareness, screening) and top down (legal provisions for taxation on offending food items, less tax on green vegetables and fruits, legal ban on junk food in schools etc). The evidence is there for all to see, regarding link between sugar-sweetened beverages and obesity/diabetes. We need not reinvent the wheel and wait for further evidence. A firm political commitment is a must to achieve this".

An earlier study led by Misra had established the ill-effects of colas on children: "approximately 1.8 cans of cola per week (540 ml/wk) per person consumption was noticed (1 can or 300 ml = 132 kcal and 33-40 g sugar) among children and adolescents, which would result in nearly 1.3 kg (3 lb) weight gain per child per year. "

Researchers in the soda tax study concluded that a sustained SSB taxation at a high tax rate could mitigate rising obesity and type 2 diabetes in India among both urban and rural subpopulations.

"Given current consumption and BMI distributions, our results suggest the largest relative effect would be expected among young rural men, refuting our a priori hypothesis that urban populations would be isolated beneficiaries of SSB taxation", it says.

The findings come at a time when health researchers have advocated a combination of awareness, and disincentives should be used to curb the consumption of soft drinks and fatty foods.

A global market database suggests that sales of soft drinks in India have increased by 13% year-on-year since 1998. The new study suggests that at this growth rate, the prevalence of overweight people or obesity among adults between 24 and 65 years of age would increase from 39 to 49%, and type-2 diabetes would increase from 319 to 336 per 100,000 people per year between 2014 and 2023.

The researchers analysed soft drink consumption from over 100,000 households during 2009-2010, studying how they responded to price changes in the past, then using that information to predict how a tax on soft drinks would influence consumption trends.

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