By now many of you have seen or heard about an opinion piece in Sunday’s New York Times by food writer Mark Bittman, in which he advocates revamping the American diet through economic incentives and disincentives (“Bad Food? Tax It, and Subsidize Vegetables“):
Simply put: taxes would reduce consumption of unhealthful foods and generate billions of dollars annually. That money could be used to subsidize the purchase of staple foods like seasonal greens, vegetables, whole grains, dried legumes and fruit.
Bittman’s idea is not new, of course; many experts and policy groups have long recommended soda taxes, for example, or government-issued vouchers for farmers’ market produce, and some municipalities in the U.S. (and some countries outside the U.S.) have toyed with, or in fact implemented, such taxes or similar concepts. But Bittman’s piece is notable for making a persuasive argument for the use of taxes and subsidies to reshape our diet, systematically laying out the benefits and dispatching the arguments of potential detractors, in a widely-read newspaper.
As regular readers of TLT could probably predict, I’m fully on board with the program Bittman outlines. As he points out, economic incentives have already played a key role leading to the current public health crisis (via government corn and soy subsidies that favor the manufacture and purchase of unhealthful foods), so why not apply common sense and throw that system in reverse? As Bittman notes, staple foods like fruit, whole grains and legumes would then be as widely available as chips and soda are today:
We could sell those staples cheap — let’s say for 50 cents a pound — and almost everywhere: drugstores, street corners, convenience stores, bodegas, supermarkets, liquor stores, even schools, libraries and other community centers.
The benefits of such a program, according to Bittman:
A 20 percent increase in the price of sugary drinks nationally could result in about a 20 percent decrease in consumption, which in the next decade could prevent 1.5 million Americans from becoming obese and 400,000 cases of diabetes, saving about $30 billion.
My quibbles with Bittman’s piece are these:
First, he mostly overlooks another critical factor in the obesity crisis, which is a widespread abandonment of home cooking by many Americans. (Remember the single dad on this past season’s Food Revolution, who fed his kids fast food nine times a week because he didn’t know how to cook?) Unfortunately, many Americans wouldn’t possess the necessary knowledge — or the desire — to cook up a bag of navy beans and a sack of brown rice, even if they were readily available in their neighborhood 7-11 for 5o cents a pound. Bittman does suggest that some of the funds raised by his program could be used for “recipes, cooking lessons, even cookware for those who can’t afford it,” but we’re really talking about not only the need for major cultural re-education with respect to cooking, but also a huge shift in the public’s expectation that food should always be tasty, cheap, fully prepared — and immediately available.
My deeper concern, however, is that Bittman just doesn’t want to acknowledge today’s political reality. That is, I’m glad Bittman makes the point that we will never get anywhere if we look to major food manufacturers to fix our current problems for us. As he writes:
. . . the food industry appears incapable of marketing healthier foods. And whether its leaders are confused or just stalling doesn’t matter, because the fixes are not really their problem. Their mission is not public health but profit, so they’ll continue to sell the health-damaging food that’s most profitable, until the market or another force skews things otherwise. That “other force” should be the federal government, fulfilling its role as an agent of the public good and establishing a bold national fix.
But Bittman never squarely addresses the fact that the federal government, his proposed Agent of Good, is presently hamstrung by the financial influence of the very same food industry he opposes; corporate and agricultural lobbyists would wage a full scale war, the likes of which we may not have seen, against the program he suggests.
Does that mean we shouldn’t pursue it? Of course not. But as a tiny reality check, let’s remember that the food industry, with the enthusiastic assistance of House Republicans, this year quite successfully warded off purely voluntary federal guidelines on the marketing of junk food to children. (“Score One for Big Food: Industry Preempts New Fed Guidelines on Marketing Food To Kids.“) Let’s also remember how First Lady Michelle Obama has been repeatedly bashed by the far right (“More From the Food Culture War Front“) for her Let’s Move! initiative, which, in general, promoted more parental – not governmental — involvement in kids’ food choices.
So it felt a bit like an understatement when Bittman wrote, “though [the program] would take a level of political will that’s rarely seen, it’s hardly a moonshot.” More like a Mars-shot, in my opinion.
The thing is, I’m betting that in the long run, we actually will see a program like Bittman’s instituted in this country. The skyrocketing health care costs directly attributable to obesity-related disease (which Bittman pegs at “$344 billion by 2018 — with roughly 60 percent of that cost borne by the federal government”) simply aren’t sustainable, and Bittman made no mention of another very serious problem, i.e., the national security threat posed by rising obesity rates (see my interview with “Mission Readiness,” a group of retired military generals addressing this issue, here and here).
The only question is when the political climate will be ripe for change. On a national level, I don’t feel we’re remotely there yet. My guess is that, as Bittman suggests, it will take forward-thinking city governments to first begin instituting these policies, and the revenue stream they enjoy may just be too tempting for other cash-strapped cities to ignore.
So, that’s my take. What did you think about Bittman’s piece? Share your thoughts in a comment below.
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Taxing junk food may help reduce obesity and improve health, researchers have found.
Patients got significantly less of their calories from soda or pizza when there was a 10 percent increase in the price of either, Penny Gordon-Larsen of the University of North Carolina at Chapel Hill and colleagues reported in the March 8 issue of Archives of Internal Medicine.
"Policies aimed at altering the price of soda or ... pizza may be effective mechanisms to steer U.S. adults toward a more healthful diet and help reduce long-term weight gain or insulin levels over time," the researchers wrote.
Talk of a soda tax has sparked debate across the country, particularly in New York and Philadelphia, where such legislation is currently under consideration. However, not much research has been done to study how price changes would affect health outcomes.
So the researchers looked at data from 5,115 patients enrolled in the longitudinal Coronary Artery Risk Development in Young Adults (CARDIA) Study from 1985 to 2006.
During that time, the inflation-adjusted price of soda and pizza actually decreased, with the largest drop observed for soda, falling from $2.71 to $1.42 for a 2-liter bottle -- a 48 percent decline.
In their analyses, the researchers found that changes in the price of soda and pizza were associated with changes in the probability of consuming those foods, as well as in the amounts consumed.
A 10 percent increase in the price of soda was associated with a 7.12 percent decrease in calories consumed from it, while the same increase in the price of pizza led to an 11.5 percent drop.
Price was also significantly associated with total caloric intake and body weight. A $1.00 increase in soda prices, for example, was tied to a mean of 124 fewer total daily calories, which amounted to an average weight loss of 2.34 pounds.
The researchers noted that similar trends were seen for pizza, adding that a $1.00 increase in the price of both soda and pizza together was associated with even greater changes in total energy intake, body weight, and insulin resistance.
"Our results provide stronger evidence to support the potential health benefits of taxing selected foods and beverages," they wrote. "Similar taxation policies have proven a successful means of effectively reducing adult and teenage smoking."
They calculated that an 18 percent tax on junk food would result in a 56-calorie decline in total daily energy intake. At the population level, that would translate to about five pounds per patient per year, along with significant reductions in the risks of most obesity-related chronic diseases, they said.
Since their study looked at only a small number of foods, they called upon researchers to assess more in future studies.
In an accompanying editorial, Dr. Mitchell H. Katz and Dr. Rajiv Bhatia of the San Francisco Department of Public Health wrote that taxing is "an appropriate method of correcting for health and other social costs not accounted for in the private market cost."
However, they added, in addition to taxing unhealthy foods, policymakers should consider ways to reward healthy behaviors.
"Sadly, we are currently subsidizing the wrong things, including the production of corn, which makes the corn syrup in sweetened beverages so inexpensive," they wrote. U.S. agricultural subsidies should instead "be used to make healthful foods such as locally grown vegetables, fruits, and whole grains less expensive."
"In the end," Katz and Bhatia concluded, "putting our money where our mouth is means aligning our economic incentives so that we always serve up the healthful choice."