Cardiologist suggests fat tax to combat obesity

New Delhi : A fat tax on high calorie foods to encourage healthier lifestyle choices needs to be enforced universally on all foods containing trans fats rather than partially on fast foods, a leading cardiologist has suggested.

Without universal application such laws would only reinstate the belief that only certain foods are unhealthy and this would not help in bringing down obesity, said Dr (Col) Anil Dhall, Director of Cardiovascular Sciences at Venkateshwar Hospital here.

Trans fats are a type of unsaturated fats that are uncommon in nature but since the 1950s have been commonly industrially produced from vegetable fats for use in margarine, snack food, packaged baked goods and frying fast food.

The Kerala government recently said it was mulling a 14.5 per cent fat tax on pizzas, burgers, sandwiches and tacos sold through branded outlets. The move has been hailed as an important decision towards public health coming as it does in the wake of WHO's advocacy of using fiscal methods to curb obesity.

Other states in the country were also understood to be pondering similar cess after concerns were raised about increasing obesity which fuels lifestyle diseases such as diabetes, heart ailments and hypertension.

But, is it the right way to go, wonders Dhall, pointing out that with 39 per cent of adults worldwide being overweight and 13 per cent being obese, involvement of the government in leading people into living a healthy lifestyle was not something new.

Responding to the growing obesity crisis, Japan was the first to implement the "metabo law" that requires men and women above 45 years of age to undergo an annual waist measurement. On failure to meet the required size, the person has to undergo counselling and consult a doctor. The law, that went into effect in 2008, has helped Japan cut back on obesity by 3.5 per cent.

Subsequently, Denmark, in 2011, imposed a special tax on food items such as butter, milk, meat, cheese and oil containing more than 2.3 per cent fat. That same year, Hungary levied a tax on foods high in sugar and salt. And last year, Philadelphia became the first city in the US to impose a "soda tax" on sugary beverages.

But implementation has been plagued by problems. Denmark, for instance, rolled back its fat tax in 15 months, after people started bypassing it by buying from across the border.

Mexico levied a tax on sugar sweetened beverages two years ago. But after an initial dip, the sales figures are back to original levels.

Dhall stressed the need to be clear as to what is being targetted as a result of such legislation.

"Are we targetting obesity, which is a risk factor for heart disease, or do we want to bring down the atherosclerotic risk," he wondered, pointing out that India was the global leader in cases of diabetes mellitus, thin-fat metabolism and atherosclerotic coronary heart disease.

Kerala itself has a large number of diabetics and obesity is also a significant concern. Right now, 28.1 per cent of women and 17.8 per cent of men in the state are either overweight or obese, putting Kerala a close second to India's most obese state Punjab, where 29.9 per cent of women and 18.2 per cent of men are either overweight or obese.

Dhall averred that if we are to target the population risk, we have to curb carbohydrates excess as well. "We all notice a recent sharp increase in sweetened beverage consumption," he pointed out.

Fast food, also known as junk food, is considered unhealthy since in many cases it is highly processed, containing large amount of sodium, carbohydrates and trans fats. "The food is mainly empty calories with no nutrition," the cardiologist noted.

However, in the process of demonising fast foods and blaming them for the increasing obesity and decreasing public health, we don't realise that trans fats, which are largely responsible for the increased atherosclerotic risk, are also present in the everyday Indian snacks that we eat, Dhall pointed out.

From samosas to deep-fried pakodas which are easily available for less than Rs 10 at every street corner and even in locally branded outlets they all contain trans fats, he said.

They are prepared in industrially-processed vegetable oils which are largely used to fry snacks at the local food vendors. Also, when these oils are heated repeatedly above their smoking point, they lose their integrity and break into a smaller compound which harms our health.

Trans fats raise our bad (LDL) cholesterol levels and lower the good (HDL) cholesterol levels. Eating trans fats increases our risk of developing heart disease and stroke, and of developing type 2 diabetes.

Making international cuisine provider food more expensive may be easy but is not really relevant to the bulk of the population. Our Indian snacks which are more widely consumed and are a lot cheaper than conventional fast foods are equally unhealthy, Dhall said.

The unregulated neighbourhood halwai often uses 30 per cent trans fats as compared to the permissible one per cent. Still, there has been neither any regulation on them nor any awareness campaign against it.

This can also be attributed to the fact that most of the studies that have been carried out in the field of dietary fats have been Western where the main source of trans fats are fast foods, said Dhall.