Sugar tax - a sweet idea?

The introduction of a sugar tax has met public backlash. The basis of this initiative is to provide a financial penalty for eating unhealthy foods. This plan should reduce intake of unhealthy foods, reduce weight and improve the nation's health. Although the intention may be good, we must also consider the impact of a babysitting approach to healthcare. It may also affect the poorer population who rely on cheap, sugar-dense foods. Careful consideration of the rationale must be met with patient expectation.

There is little doubt in healthcare that obesity is unhealthy. It is associated with increased early death through heart disease, diabetes (type 2)stroke and a host of cancers. Cardiovascular disease is the greatest killer in the western world, and this is only set to increase. Type 2 diabetes is on the rise as the country gets heavier, and this confers a huge burden on quality of life. The financial and societal burdens of obesity-related disease are staggering and provide a huge cost to the NHS.

Cardiovascular disease describes the effects of high blood pressure, increased blood fat, salt, sugar and body weight on the body's ability to provide blood and oxygen to its cells. The formation of plaques, formed of fat, precipitates clots in the heart and head. We call these strokes and heart attacks and they carry a high mortality. Type 2 diabetes occurs when receptors for sugar on our cells wear out from overuse, and occurs faster with amount of sweet foods eaten. In this scenario, high- sugar foods increase the rate of failure. The body struggles to survive.

Together, the combination of cardiovascular disease and diabetes is lethal. People who have diabetes can die decades early. We know that larger people die sooner. We also know that healthy eating lengthens and improves life. Avoiding high-sugar foods and limiting fat intake combat the development of these diseases and reduce the risk of death and disability. Lean meats, fruits and vegetables can be sourced cheaply and provide excellent nutrition. It also enables local agriculture and trade.

A more sedentary lifestyle, increased availability of high-calorie foods, body positivity movements and increasing population age have led to increased weight. The government's rationale is to take healthcare decision making out of the population's hands by financial penalty. Although this may actually provide a national health benefit, the real solution is to empower people to take control of their own health.

The process will likely work, but it risks alienating a population. As doctors we encourage patient-led treatments, and a patient who is coerced into a plan often fails. Intention is key to success. This tax may just provide an extra safeguard for those who may struggle, whilst providing a greater funding source to the NHS for dealing with these diseases. The real victory would be that the tax incentivises patients to take control of their own diet and lifestyle.

In conclusion, the sugar tax would likely improve general health in this country through reducing intake of high-calorie foods. The effect would improve quality of life, reduce disease and cost burden on the NHS, and provide more funding. It may also usher in a more health-conscious culture. The only downside is the parental approach taken by the government. The sugar tax is a sweet idea, but it may leave a sour taste in the mouth.

Ben is a young NHS doctor in the Southwest. His interests including neurology, health communication, and medical ethics. He is also an avid advocate of compassionate care and quality improvement, running a project in the southwest around medical humanities.


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