Tax ‘ terror’ for healthier India?

‘ Fat tax’ is an impractical solution to fight obesity

Today consumers in India are overburdened with several indirect taxes, which even the poorest of the poor pay towards inefficient and ineffective governance. Imposing tax on popular food for a few high- end consumers in an irrational and discriminatory manner only reaffirms lack of farsight and narrow consideration to score a certain political agenda rather than tackling public health issues like obesity.

We are yet to define what is healthy food and what is junk food. We don’t even have credible data on the daily food intake of a consumer in India and fat consumption in a moderate manner is considered a necessity to tackle malnutrition. According to Nobel laureate Angus Deaton, malnutrition in India is not just related to calorie intake, but India’s dependence on a carbohydrate- based diet with low protein and fat content. India’s Global Hunger Index ranking is 67 of 80 nations and places us even below North Korea or Sudan. 44 per cent of children under the age of five are underweight, while 72 per cent of infants have anaemia. In India a lot more needs to be done to tackle the menace of malnutrition rather than imposing a 14.5 per cent “fat tax” on burgers, pizzas and other junk food.

Take the case of Denmark. This was the first country to levy a tax on food items containing saturated fats above a threshold. However, the country’s attempt to fill its coffers while making people leaner fell flat on its face. The fat tax was rolled back in January 2013, within 15 months of its implementation, and has now become a case study of what not to do when trying to make people eat healthy. Governments should impose high taxes on tobacco products to cover the deficit incurred due to the ban on sale of alcohol in Kerala rather than on branded food, which hardly has any adverse effect on the health of our most vulnerable consumers.

What the Kerala government should have done is to have agreed to work with the FSSAI and launched a campaign on rational use of salt, sugar and fat in all food items rather than targeting only 50- 60 outlets of organised fastfood restaurant chains in Kerala. The Kerala government should cut down expenditure on corporations and municipal bodies that have a lot of fat rather than further burdening the consumer and interfering with their freedom of choice.

If the Kerala government is serious about reducing consumption of unhealthy food, then it should have adopted the following: it should have first set a threshold limit for fat and/ or calorie and tax all foods items that are above this limit. There is no reason why sugar- sweetened drinks, refined products, packaged food items that have high salt content should not have been made accountable to the consumer under the fat tax. Indians are known to consume a few times more than the WHO’s recommended limit of five grams of salt per day. Similarly, what excuse can there be for not charging a very high rate of tax on food items that contain trans fat? There are a number of food items sold in India that contain as high as 35- 40 per cent of trans fat. Trans fatty acids, made through the process of hydrogenation of oils, which improves the stability or shelf life of the foodstuff that contains them, pose serious coronary risks. Taxing “bad” foods should be accompanied by cross- subsidies of healthy and wholegrain food items. Only a holistic approach such as this will be effective in making a real change in our food consumption behaviour.

When I did my MBBS, we were taught that fat was the main culprit for obesity and heart diseases.

Saturated fats were also considered the main culprits. Saturated fats increase bad cholesterol. Then came the era of trans fats, which not only increase bad cholesterol but reduces good cholesterol too.

But in today’s era, fat is no more the culprit. Eggs are no more enemies. If saturated fats, meat and eggs were the cause of heart attacks, all wild animals would have suffered heart attacks, but the fact is that wild animals don’t get heart attacks.

Levying fat tax, therefore, will not reduce heart disease and obesity.

India has an epidemic of pot belly obesity, which is due to high consumption of refined carbohydrates and not fat. Abdominal circumference of more than 80 cm in females and more than 90 cm in men is linked to pot belly obesity, normal weight obesity, high blood insulin levels and insulin resistance. High insulin levels are linked to artery inflammation and they in turn help bad cholesterol get deposited in heart arteries causing blockages.

Medically, this is called metabolic syndrome, and clinically it leads to fatty liver, high blood triglyceride levels, low high- density lipoprotein good cholesterol levels, high blood sugar levels and high blood pressure.

The present obesity epidemic is linked to the high consumption of white sugar, white maida and white rice. If one has to tax, one should tax high sugar food. Most soft drinks contain more than 10 per cent sugar, most non- chasni sweets have 30 per cent sugar and most chasni sweets contain 50 per cent sugar. Sugar is now considered as a slow poison. It’s a bigger culprit than high fat or high salt intake, which is linked to high blood pressure.

Scientists worldwide are now advocating sugar tax to reduce its consumption.

In the Vedic era there is mention of anna dosha or disease caused by eating wheat grains. Being an Indian is a risk factor for heart disease. An Indian doctor settled in the US is 17 times more likely to get a heart attack than an American. If Indians are genetically more prone to get heart attacks, then why were heart attacks not known in the Mahabharat or Ramayan? Probably the reason was Vedic teaching of not eating carbohydrates once a week, additionally once a month extra on Ekadashi and twice yearly for nine days each during Navratri.

Indian women also were more immune to heart attacks possibly due to their weekly carbohydrate fasts. A typical Indian spiritual fast is eating less, eating once and not eating wheat carbs on that day.

Animals do not suffer from heart attacks as they do not consume white maida, white sugar and white rice.

Jaggery, brown sugar, white wheat flour and brown rice are comparatively less harmful.

White sugar is addictive. To de- addict one needs three months of persistent sugar- free efforts. The craving lasts for three months. Gurmar is a herb which can be used. With its leaves juice kept on the tongue, one will lose the sweet taste for the next 15 to 30 minutes.

Studies have shown that a high tobacco tax reduces its consumption. Therefore a high sugar tax and not a fat food tax will work. Even if the consumption does not decrease, it will create enough awareness in society.