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Tax soft drinks more, save lakhs from diabetes

New Delhi, Jan. 1: India could prevent an estimated 400,000 people from becoming patients of diabetes over the next decade if the government imposes a 20 per cent extra tax on sweetened beverages, a new study has suggested.

The study by researchers at the Public Health Foundation of India (PHFI), New Delhi, and academic institutions in the US and the UK has also indicated that such a tax on soft drinks might avert 11 million cases of obesity or overweight between 2014 and 2023.

The study, published in the journal PLoS Medicine yesterday, is the first to estimate how a special tax to discourage the consumption of soft drinks might alter the numbers of obese people or diabetes patients in the country.

The findings come at a time when health policy makers have been arguing that a combination of education and disincentives should be used to curb the consumption of soft drinks.

“Consumer behaviour is not always influenced by education alone,” said K. Srinath Reddy, a cardiologist and president of the PHFI, who was not directly associated with the study. “At times, disincentives are needed to counter aggressive marketing.”

A global market database suggests that sales of soft drinks in India have increased by 13 per cent 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 per cent to 49 per cent, and type-2 diabetes would increase from 319 to 336 per 100,000 people 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.

Their model predicts that a 20 per cent tax would reduce obesity and overweight levels by 3 per cent and diabetes by 1.6 per cent over the period 2014-2023. This would mean keeping 11 million people from becoming overweight or obese and 400,000 from turning into diabetes patients.

The study has predicted an unexpectedly high impact of the tax in rural areas. “Our (initial) hypothesis was wrong,” Sanjay Basu, assistant professor at the Stanford University School of Medicine in the US and lead author of the study, told The Telegraph.

“We had thought the effects would be concentrated among urban residents, but across the country we find significant consumption among both urban and rural dwellers. And in young rural men, we see a combination of high consumption and high sensitivity to price changes.”

Several states in the US have examined the option of imposing taxes on sugar-sweetened beverages to curb obesity levels. Mexico, which has one of the highest obesity levels in the world, recently imposed a “soda tax” on sweetened beverages, Reddy said.

“A firm political commitment is an absolute must to impose such a tax,” said Anoop Misra, an endocrinologist and chairperson of the Fortis Centre for Diabetes Obesity and Cholesterol, New Delhi, who was not associated with the study. “The evidence linking sugar-sweetened beverages and obesity and diabetes is well-established — we need not reinvent the wheel and look for more evidence from India.”

Basu and his colleagues have calculated that the gains from the tax could be even bigger if sales of sweetened beverages in India grow in the coming years not at a linear 13 per cent as they have done in the past, but more steeply as predicted by the drinks industry marketing models.

Their model predicts that at a steeper growth rate, the 20 per cent tax would be able to keep nearly 15 million people from becoming overweight or obese and nearly 600,000 people from becoming patients of diabetes.

“Experience with tobacco shows that higher prices can reduce consumption,” Reddy said.