“The nation should have a tax system that looks like someone designed it on purpose.” William Simon, former Treasury Secretary
This week Denmark implemented legislation introducing a surcharge on any foods with 2.3% or more saturated fat. The purpose of this so-called “fat tax” is “to reduce the prevalence of a broad range of illnesses and improve life expectancy,” namely combating rising obesity and heart disease rates.
The Danish government has been at the front of the pack with respect to battling “unhealthy” foods since 2004 when industrially processed trans fatty acids (i.e., not naturally occurring trans fat) above a maximum of 2% were effectively banned. In July 2010, Denmark imposed a tax on sugary junk food – ice cream, chocolate and candy face a surcharge of 25%, and soft drinks are taxed based on sugar content.
Danish zeal for taxing unhealthy foods seems to fall in line with recommendations from the recent UN Summit Report on the Prevention and Control of Non-Communicable Disease to “implement population-wide interventions, including through regulatory and legislative actions“ for risk factors related to unhealthy diet (as well as smoking, excess alcohol and sedentary lifestyle). A recommendation, however, is nothing without an actual goal or outcome: the UN Report goes further to specify that taxation or subsidy should be for the express purpose of increasing “the availability of fruit, vegetables and other healthy foods.” Does taxation of unhealthy foods actually increase intake of healthy foods?
How does Canada stack up? Plans to set limits on acceptable trans fat in Canada AND enforce recommendations are progressing – the Trans Fat Task Force released a summary report (1) indicating the importance of imposing restrictions on trans fat in foods. Health Canada adopted Task Force recommendations in 2007 and “encouraged” manufacturers to reformulate their products and meet new targets within two years. Results from the most recent Trans Fat Monitoring Program data set released in 2009, however, are extremely disappointing. No word on whether manufacturers not meeting targets were penalized…
Municipally, in 2008, the Calgary Health Region set limits on artificial trans fats in restaurant foods of no more than 2%. Unfortunately, with the transition from the Calgary Health Region to Alberta Health Services (AHS) five months later, the trans fat ban no longer applied and AHS has not implemented new regulations.
Tax revenues, as a result of these surcharges, have been closely monitored and the 2004 legislation has effectively reduced trans fats in the Danish food supply (2). The health-related impact(s) of such changes are unknown. The Danish Obesity Research Centre (DanORC) and Danish government have not monitored the effects of this legislation on the health of Danes (or at least published information anywhere we could find) . Even correlational data would be of interest. The Stender et al. (2) study did demonstrate, however, that legislation was much more effective than voluntary reduction in limiting industrially produced trans fats in the food supply. Given that these trans fats are not known to have any health benefits, erring on the side of caution is sensible.
Policy implementation without follow-up analysis of the effectiveness of programs and their impact on health is rampant in public health initiatives. New York City banned artificial trans fats in 2006 and reports indicate that levels in restaurants declined from 50% in June of 2005 to 1.6% by December 2008 (3). Unfortunately, as with the Danish example, to our knowledge the actual impact(s) of this change on health and risk of CVD has not been evaluated.
Although there is an alarming lack of research regarding these policy changes, it is interesting to note that approximately 10 per cent of adult Danes are considered obese and approximately 3% of children (4), whereas more than one in every four Canadian adults and almost one in 11 children are obese (5). This suggests they may be on to something. We hope to see more research to determine which factors play a role in allowing Danes to maintain a healthier body weight than Canadians, related to legislative efforts or otherwise.
(1) Health Canada. Trans Fat Task Force.
(2) Stender S, Dyerberg J, and Astrup A. Consumer protection through a legislative ban on industrially produced trans fatty acids in foods in Denmark. Scandinavian Journal of Food and Nutrition 2006; 50:155-160.
(3) Angell SY et al. Cholesterol control beyond the clinic: New York City’s trans fat restriction. Ann Intern Med 2009; 151:129-134.
(4) Due P, Heitmann BL and Sørensen TIA. Prevalence of obesity in Denmark. Obesity Reviews 2007; 8:187–9.
(5) Canadian Institute of Health Information and Public Health Agency of Canada. Obesity in Canada; 2011.