Wednesday, July 29, 2009

Reflections on Urban Institute event - Reducing Obesity: Policy Lessons from the Tobacco Wars

Researchers at the Urban Institute, a US think tank that researches issues like health, criminal justice, education, housing and welfare, have recently produced a report called Reducing Obesity: Policy Strategies from the Tobacco Wars. The report itself is quite long at 72 pages, but can be summarized thus:

The consumption of fatty snacks and foods and sugary soft drinks has elements in common with tobacco use. Accordingly, the strategies used to combat tobacco use are worth considering -

1. Tax foods that cause obesity. The UI researchers referenced research by Rayner et al in the UK; these authors divided foods based on calorie and macronutrient content into healthy, moderate and unhealthy. To leave no gaps in the market, we should consider levying a tax on all unhealthy foods (e.g. potato chips, french fries, bacon, fast food cheeseburgers, high fat cheeses, sugary cereals, etc). [For example, if you only tax sugary sodas, consumers might shift to potato chips instead, so you want to tax all unhealthy foods. Consumers might shift to moderately healthy foods while still consuming the same number of calories, but they'd still probably be better off.]

2. Put simple, graphic warning labels on the packaging of unhealthy foods. These should be simpler and starker than the current nutritional labels. Additionally, restaurant chains can be required to show similar information on menus.

3. Banning advertising of unhealthy foods.

The researchers also emphasized that much of the money raised by these taxes must go to the poor. The reason is equity - the poor generally eat more unhealthily, partly because of the lack of healthy alternatives and partly due to less education. The World Health Organization said that tobacco taxes were the most successful part of anti-tobacco campaigns around the world. However, a tax on unhealthy foods must occur in the context of an intense public education campaign and investments must be made to ensure that the poor in the US have access to good alternatives. If not, all you're doing is taxing the poor.

The term "food desert" is a US term that is applied to many poor inner city areas. In these areas, there isn't easy access to grocery stores with fresh produce and other good foods. The easiest stores to access are convenience stores, which have frozen foods and junk snack foods (not to mention the convenience stores are more expensive than grocery stores). It is definitely a problem in US inner cities; I'm not sure to what extent this problem occurs in Europe.

Judith Thorman, a representative from the American Beverage Association (aka Big Soda) was there, mainly to speak against taxing soft drinks. She argued that Big Soda has been at the forefront of ensuring low-calorie tasty alternatives to sugary sodas and has is in the process of voluntarily withdrawing full-calorie sodas from US schools. This is true, and good for them. However, she was poorly received by the audience. Frankly, Ms. Thorman, you came across as being more interested in protecting Big Soda's profits than in helping offer solutions. A tax on unhealthy foods would not be the end of Big Soda, and it would give consumers the incentive to seek healthier foods - and Big Soda as well as the restaurant industry can help us get healthier foods that are cheap and tasty if they try.

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