Can a ‘junk food tax' work?

Juggling deadlines, socializing and trying to stay in shape can sometimes create the perfect opening for fast, or junk, food. The flavours, the presentation and, most importantly, their easy availability make these foods—pizzas, burgers, colas, chips, samosas—the convenient choice if one is feeling stressed, is pressed for time, or even just out to have a good time.

But wait. Take a step back and look at these numbers: India has the highest number of obese and overweight people after the US and China, according to a 2015 survey by the Malnutrition Mapping Project, an education and advocacy tool created to map global malnutrition trends by the non-profit Global Alliance for Improved Nutrition, in association with the direct-selling company Amway. The percentage of overweight or obese people in most Indian states has doubled in the past decade, according to the 2015-16 National Health Survey. One-third of teenagers in metros—Delhi, Mumbai, Chennai and Bengaluru—are obese. And 80% of these teenagers will continue to be obese even in adulthood, says Pradeep Chowbey, chairman of the Max Institute of Minimal Access, Metabolic and Bariatric Surgery at the Max Super Speciality Hospital in Saket in the Capital.

“Those are scary numbers, considering that the trend started only in 1999, owing to globalization, increase in income and sedentary lifestyles,” says Dr Chowbey, who is also the vice-chairman of Max Healthcare.

Yet Kerala’s proposal to levy a 14.5% “fat tax” on the burgers, tacos, sandwiches, doughnuts and pizzas sold in fast-food restaurants in the state still came as a surprise to most people.

“This is more of a preventive measure as Kerala’s food habits are changing dramatically. People are eating a lot of junk food and rejecting traditional food,” Kerala’s finance minister T.M. Thomas Issac told BBC in an interview recently.

Nutritionists are welcoming the move. Swati Bhushan, chief clinical nutritionist at the Fortis Hospital in Navi Mumbai, believes that the tax is a step in the right direction. “Fast foods contain too many calories and too little nutrition. They are high in sugar, sodium, trans fat (it gives the burger that tasty smell) and saturated fat (it makes the burger addictive), all of which increase the risk of cardiovascular and kidney diseases, cholesterol, diabetes, cancer, even depression,” she says.

New Delhi-based dietitian Ishi Khosla too welcomes the move, but doesn’t want the tax to be restricted to a few fast-food chains. “Our (Indian) junk food is as bad for health. Samosas, banana chips, kachoris and jalebis available in various sweet shops are also high in trans and saturated fat and have no nutritional value whatsoever. The government should focus on them as well, only then can we fight obesity,” says Khosla, who is also the founder of the health-food chain Whole Foods India.

Expanding choices

Obesity was not a problem even 30 years ago. People generally had home-made food, and the concept of eating “outside” food was restricted to some selective restaurants on special days, says G. Vijayaraghavan, cardiologist and vice-chairman of the Kerala Institute of Medical Sciences Hospital in Thiruvananthapuram. “But today we are spoilt for choice, thanks to the entry of fast-food joints and increase in spending power. ‘Don’t feel like making food, let’s order pizza or Chinese’—it has become a regular conversation. No wonder Kerala has the second-highest number of obese children (Punjab is first),” he says.

Of the 34 million people in Kerala, over 30% above the age of 30 have diabetes, 22% suffer from high blood pressure and 12.5% from heart disease, says Dr Vijayaraghavan, adding: “The tax is targeted towards the middle class, which makes for a large chunk of the population. Whether it will work remains to be seen, but at least it will make people think about the harmful effects of junk food and obesity.”

What to junk

With so much information available today, it shouldn’t be too difficult to understand what’s healthy and what’s not. Shamsul Wahid, executive chef of Social and Smoke House Deli, restaurant chains run by Impresario Entertainment & Hospitality Pvt. Ltd, doesn’t agree, however. “Junk (food) is a vague term,” he says. “Outside food is generally tagged as junk. But that’s not the case. A steamed/grilled chicken is not junk, a fried chicken is. It all depends on the preparation. Instant noodles are not fried, but they are still junk.”

So what should you look out for? “Whenever you buy a product, look at the nutrition labelling—if it has trans fat/saturated fat, high sodium, high salt, high sugar, keep it back. Basically, anything starchy, say ‘No’; anything too oily or sweet, say ‘No’; anything fried, say double ‘No,’” says Bhushan. She adds that home-made junk food might be high in calories, but it is made in good oil which is not reheated again, so it’s not likely to be as unhealthy if consumed occasionally. “Trans fat is the biggest culprit. The fries that we eat in burger joints are fried in oil that has been reheated many times, and reheating oil increases trans fat (a known carcinogen) by almost 50% each time,” says Bhushan, who believes the tax should be extended to metro cities as well.

Wahid believes the Kerala fat tax won’t affect sales in any way. “In the past, the government had imposed taxes on alcohol and cigarettes, but do we see any marked change in people’s attitude?”

Been there, done that

Kerala might be the first in India, but it was Denmark that introduced the world to the concept of tax on saturated fat—in 2011. It levied a fat tax on all foods with a saturated fat content above 2.3%. These included butter, milk, cheese, pizza, meat, oil and other processed items. The Danish government, however, withdrew the tax just a year later, citing “increasing prices for consumers, increasing companies’ administrative costs and putting Danish jobs at risk”. In that year, Danes even ventured across the border to purchase their unhealthy snacks.

Mexico introduced a “soda tax” on sugar-sweetened beverages in 2014 to try and control the country’s growing obesity epidemic. It worked. Within a year, soda consumption in the country declined by 12%, according to a study whose findings were published in January in the British Medical Journal. Researchers examined data from more than 6,200 households across 53 Mexican cities in the first 12 months after the tax was introduced.

Last month, Philadelphia in the US too introduced a soda tax—something Kerala hasn’t proposed. “Sugary beverages too are a form of junk and contribute significantly to the growing obesity numbers and hence should have been taxed too,” says Khosla.

Healthy eating: onus on people

The Danish tax may not have worked, but it had a silver lining: The extra charge made people change their shopping habits; they bought 4% less food with saturated fats, reported a study that was published earlier this year in the European Journal Of Clinical Nutrition. This study was conducted across 2,500 households in Denmark.

“Steps like these might be small but they help tackle the problem by addressing them,” says Jagdish Prasad, director general of health services, Union ministry of health and family welfare. Like Bhushan, Khosla and Dr Vijayaraghavan, he too favours a fat tax in all metro cities. “High salt intake is another big reason for obesity among Indians, which needs to be addressed as soon as possible,” adds Prasad.

What about arguments that such a tax will not work because people will still order food from outside? “At least the portion size will decrease. It will serve as a reminder that they paid extra for eating junk food. Shelling out extra pinches everybody; it makes them talk,” says Dr Chowbey, who too advocates a metro-wide fat tax.

Indians who don’t go to the big brand chains could still get their quota of unhealthy food from street hawkers selling samosas, vadas and pakodas—like burgers and pizzas, these are at the bottom of the nutritional value line. How can governments arrest this consumption? “It would be really difficult to monitor the unorganized sector. The onus here lies on us to make smart choices,” says Dr Chowbey.

Television commercials and awareness drives in schools, colleges and other institutes can help make people aware of the consequences of eating unhealthy food, says Khosla.

Bhushan believes your conditioning should start from childhood. “When it comes to healthy living, the responsibility is ours to watch what we eat. Yes, leading a healthy lifestyle when 10 people around you are eating unhealthy food seems unthinkable, but you are your choices.”