PUBLIC HEALTH
THE SUGAR TAX: WHAT WE KNOW SO FAR Kit Kaalund Hansen Specialist Adult Metabolic Dietitian, University College London Hospitals NHS Foundation Trust Kit works in the National Hospital for Neurology and Neurosurgery in Queen Square, London where she set up and leads the first UK-based NHS funded Adult Ketogenic Diet Therapy Dietetic Service for individuals with epilepsy.
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In March 2016, the government announced that a tax on sugary soft drinks would be introduced in the UK from April 2018, in an attempt to halt childhood obesity, Type 2 diabetes and tooth decay, all of which are preventable and cost the National Health Service billions of pounds each year.1 This article sets the scene for what we know so far. In December 2016 the government announced plans for a tax on drinks that “have no nutritional benefit and contain more than 30g of sugar per serving”.2 For instance, a can of coke contains 35g of sugar and Coca-Cola are set to bear the brunt of the tax because it currently has no plans to change the recipe of its classic drink.3 The government’s reasoning for implementing a sugar tax was to try and reduce overall sugar intake, particularly in teenagers, and to combat childhood obesity (Parliament, 2016). Unsurprisingly perhaps, the drinks industry reacted by saying that it’s ironic that they’re being singled out when they, in fact, started reducing the sugar content of their products in 2012, and they’ve already set a target to reduce overall calories of sugary drinks by 2020.4 In December 2016, we were given a little more detail on what products would be affected: all soft drinks containing more than 5g of sugar per 100mls and the tax will depend on the sugar content per 100mls. Fruit juices were exempt, but the recommendation is no more than 150mls per day. Milk and yoghurt-based drinks will be exempt due to the worry around low intake of dairy in teenage girls. It was further announced that the money raised will go to Education for School Sports.5 In March 2017, the level of tax was announced. There are going to be two arms: drinks containing 5g of sugar or more will be taxed 18p and the consumer cost will increase by 6p, whereas soft drinks that contain 8g of
sugar or more will be taxed 24p per litre and consumer cost will increase by 8p.6 As already mentioned, the soft drink companies have already taken action to reduce the sugar content of their drinks before April 2018; this might also impact on revenue for the Education for School Sports, as the estimated profit was set at £1 billion (Patrick Collins, The Guardian, March 2017). The sugar tax was left out of the Autumn 17 Budget due to what I can only assume to be more pressing issues, such as homeland security and the NHS crisis. However, the levy has been welcomed by health campaigners who have argued that fizzy drinks are contributing to the country’s obesity crisis. But where might the sugar tax leave our health service and dietetic practice? In inborn errors of the metabolism, patients who require an emergency regimen are either prescribed a glucose polymer or advised to choose an alternative, i.e. sugary drinks with the carbohydrate equivalent. However, the British Inherited Metabolic Diseases Group advises that all metabolic centres prescribe glucose polymers for all patients requiring an emergency regimen to prevent adverse events.7 In turn, this might put an extra cost burden on GP practices, as standard glucose polymers cost an average of £0.50p per serving. This is an area to watch and there have been speculations as to whether the sugar tax might also eventually include sugary foods. Time will tell. www.NHDmag.com February 2018 - Issue 131
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