Obesity is a prevalent and challenging condition affecting more and
more people nowadays. In 2015 in the UK, 58% of women, 68% of men and 30% of
children were overweight or obese (NHS Digital 2017, British Heart Foundation
2015). In the past few years, there has been growing support for reducing the
amount of sugar contained in our diets.  Free
sugars are defined as sugars “added to food or those naturally present in
honey, syrups and unsweetened fruit juices, but exclude lactose in milk and
milk products” and their intake should be limited to 5% of daily dietary energy
intake according to Scientific Advisory Committee on Nutrition (SACN) (Gov.uk,
2016a). Overconsumption of sugar has negative health effects such as weight
gain from excessive calorie intake, increased risk of type 2 diabetes, certain
cancers and tooth decay (Gov.uk, 2014). National Diet and Nutrition Survey
(NDNS) results showed that the majority of UK population exceeds the
recommended free sugar intake of 30g per day with sugar-sweetened beverages
(SSBs) being among the main contributors to this, especially for children and
teenagers who consume an average amount of up to 212g/day (Gov.uk, 2016b). SSBs
contain a high number of calories yet they lack nutritional value and their
liquid form does not maintain satiety for long (Vargas-Garcia et al., 2015)
which is why SACN recommends that their consumption should be minimised (Gov.uk,
2014). While it has both advantages and disadvantages, a levy on sugary drinks
along with other measures such as marketing restrictions and product
reformulation might be one step further towards tackling obesity epidemic (British
Heart Foundation, 2015).

There is strong evidence demonstrating that one of the major health
outcomes associated with high calorie and high sugar intake diets is weight
gain. A double-blind randomised control trial conducted by de Ruyter et al.
(2012) showed sugar-free beverages to reduce body fat gain in children aged
4-11 years compared to SSBs. The findings were supported by Malik et al. (2013)
who reported a positive association between SSBs consumption and weight gain
and obesity both in children and adults. A systematic review led by Woodward-Lopez
et al. (2010) concluded that SSBs consumption contributed significantly to
obesity increase in the US population. Additionally, SSBs have a high glycaemic
index associated with postprandial hyperglycaemia and primary hyperinsulinemia
and their high fructose level has further implications for increasing visceral
fat deposits and liver fat synthesis (Popkin et al., 2012). A meta-analysis
concluded that the consumption of 1-2 daily servings of SSBs increased the risk
of developing type 2 diabetes by 26% (Malik et al., 2010). Furthermore, the
findings of a prospective study of Thai adults suggested that a high SSBs
intake is linked to increased chances of diabetes in women (Papier et al.,
2017). It has also been suggested that such drinks can modify and increase
preference for sugary foods (Cassady et al. 2012) by stimulating dopamine
release which has a rewarding effect and leaves the consumer wanting for more
(Cph.org.uk, 2013). Several limitations of the studies were: lack of intake for
non-carbonated sweetened beverages, self-diagnosis of diabetes, self-report of
beverages consumption, confounding diet and lifestyle factors, heterogeneity

Price is a major factor contributing to food choice which is why in
general people coming from lower socio-economic backgrounds display a higher
tendency towards consuming SSBs such as soda, fruit drinks and juices. This can
be further explained by the low cost of such beverages which has remained
constant throughout time irrespective of the inflation rates, which made them
more affordable compared to healthier foods which became more expensive
(Cph.org.uk, 2013). Gibson and Shirreffs (2013) noted that soft drinks
consumption was the highest among young adults with an average intake of
140g/day for women and 216g/day for men respectively, as well as among
adolescents for whom SSBs accounted for 14% of total energy intake as
documented by Ng et al. (2011). While the latest evidence showed that
consumption of SSBs declined in children aged 4-10 years from 130g to 100g per
day, the recommendations are still exceeded across all age groups (Gov.uk,,
2016b). In the UK, according to the Family Food Survey 2015 (Gov.uk, 2017b) there
has been a 6.3% decrease on soft drinks purchased between 2012 and 2015. Yet,
there is still a discrepancy between higher and lower household incomes with
people coming from the latter category including more free sugars in their
diet. From a social and cultural point of view, evening is regarded as “being
the time for eating and drinking” which is why drinks are consumed mainly
during this period (Gibson and Shirreffs, 2013). Furthermore, research
suggested that lacking food education can promote obesity (Kalavana et al.,
2010) and that parents play a crucial role in the development of children’s
food behaviours which are established early in life and remain for the long
term (Jimenez-Cruz et al., 2010).


The scientific evidence considered in the essay so far points
towards the fact that overconsumption of SSBs is linked to excessive sugar
intake which promotes obesity and type 2 diabetes. Therefore, a sugar tax would
seem a sensible option to improve diet and health, but further implications
need to be taken into account. On the one hand, it would benefit the health
system by discouraging buying such beverages, thus reducing obesity rates and
costs for treating patients, but on the other hand it would add pressure to the
food industry. One reason why such a levy would be beneficial is because it is
applicable to a non-essential food group and it would focus on the major source
of free sugars in children’s and adults’ diet (Cph.org.uk, 2013). The
effectiveness of the levy can be analysed from countries such as Denmark, USA,
France, Ireland and Mexico which have implemented such taxation. For example in
Mexico, a rise in healthier drinks such as water has been observed compared to
previous year after an introduction of 10% per litre SSBs tax in 2014 (IBT,
2015). Contrary to Mexico, however, the 5% soft drinks tax in the USA was not
effective on reducing obesity rates and in response, the food industry spent
70$ million on lobbying campaigns against soda taxes (Sustain, 2013). The
results of a comparative risk assessment modelling study conducted by
University of Oxford estimated a 1.3% reduction (180,000 people) for obesity
and 0.9% reduction (285,000 people) for those overweight based on a 20% tax on
SSBs in the UK (Briggs et al., 2013).

Statistics show that currently in the UK there is difference of 20
years spent in good health between individuals coming from the most deprived
and least deprived areas (Gov.uk, 2017a). According to Mytton et al. (2012)
“health related food taxes are regressive” which means that poor people end up
paying more from their income compared to those with money, yet their health
benefits are progressive and can further lead to diminishing inequalities. A
study conducted at University of Oxford revealed that a 20% tax on SSBs would
prove most effective for young people and its low level would minimally impact
across different income groups (Briggs et al., 2013). Given the fact that those
coming from lower socio-economic backgrounds consume more SSBs they are
affected more by the price fluctuations and are thus more likely to benefit
from a positive change in their diet (Powell and Chaloupka, 2009). In order to
help with the regressive aspect of the levy, Cornelsen and Carreido (2015)
proposed making healthier foods more affordable along with an expansion of the
Healthy Start programme which proved effective at increasing fruit and
vegetables consumption. Another argument in favour of the tax would be related
to the role parents play in shaping children’s eating behaviours. Changing low
income parents food behaviour by preventing them from buying SSBs due to
economic reasons could further have positive implications. For instance, this
would enable a better parental control of the child’s diet by limiting the
consumption of sugary drinks as a reward (van der Horst et al., 2013). Finkelstein
et al. (2010) recognised the positive contribution such taxes might have on
weight outcome for middle income families and suggested that the revenue
generated from them to be reinvested in programs for prevention of obesity.

To sum up, overconsumption of SSBs is linked to negative health
effects and there is strong evidence supporting the benefits of limiting such
beverages. Keeping in mind the price importance when purchasing a product, I
would say that a sugar levy on sugary soft drinks could lead to a reduction in
obesity and type 2 diabetes rates, but not entirely on its own. Changing eating
behaviours and educating individuals towards a healthier lifestyle is a lengthy
and complex process. The fact that the last few years in the UK marked a
reduction in consumption of SSBs should be considered as a good sign and people
should be further encouraged to substitute them with healthier alternatives. The
Government and health organisations should come with policy interventions to
accompany and increase the effectiveness of the tax. As for the health inequalities,
the benefits the lower socio-economic groups would gain from this definitely
outweigh the disadvantages. Based on the evidence from other countries which
have already implemented such taxes, a 20% levy seems a reasonable level to
begin with. This could be at first temporarily trialled in order to allow the
food industry to gradually adjust to the change. Additionally, it should be
accompanied by food reformulations to reduce the amount of free sugars and more
regulations on children marketing strategies for foods and drinks with a high
sugar content (British Heart Foundation, 2015). 


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