How could you encourage widespread adoption of a healthier eating habit? Not so much in the form of Justice Antonin Scalia’s broccoli comment, but something less controversial and more like a tax on, say, Pop-Tarts so that they’d be the same price as something healthier, like broccoli. And then it’s still your call which - if either - to choose to eat for dinner.
A recent study in the British Medical Journal tested a simulated 20 percent tax on saturated-fat-laden palm oil designed to reduce its consumption – and adverse health effects – in India. (Earlier this year, John Farquhar, MD, professor of medicine and health research policy, emeritus named palm oil among his top foods to avoid.) Authored by scientists from Stanford School of Medicine, Stanford Woods Institute for the Environment and collaborators in London, Oxford and Delhi, the study used an economic-epidemiologic model to predict whether increasing the price of palm oil would have an effect on the death rate from hyperlipidemia-induced cardiovascular disease in the years 2014-2023. It also considered a palm oil tax’s possible implications for food security – a measure of confidence about the availability of food and lack of fear of starvation.
As discussed in the paper, the researchers chose to study India because the country “is not only expected to face the greatest burden of cardiovascular disease mortality among low and middle income countries but is also considered a policy leader in the prevention of chronic disease among these countries.”
Looking at household expenditure data in subpopulations of Indian residents age 20-79, the researchers forecasted a 1.3 percent reduction in cardiovascular deaths over the next 10 years in people who were to stop using palm oil and not substitute another oil for it, and an additional benefit to those who introduced heart-healthier oils and the benefits of polyunsaturated fats to their diet.
The study’s findings predicted more benefit to males and urban-dwelling people than females and rural residents, owing to differences in consumption and cardiovascular risk. Researchers determined the palm oil tax would lead to a dietary reduction of about 13 calories a day, and an increase of food insecurity of about 0.59 percent, over the 10-year period.
I asked study author and Stanford internist Sanjay Basu, MD, PhD, to comment on the significance of these findings. He said, "the 1.3 percent reduction in cardiovascular deaths is huge because India has such a large number of these deaths." Still, he said, "I think we're cautious about recommending such a tax because of the potential for food insecurity among the rural groups."
Asked whether the mathematical model he and his team developed could be used for other risk factors and health solutions within the Indian subpopulations studied, Basu replied that yes, “we're looking at taxes on sugar sweetened beverages and large-scale subsidies for fruits and vegetables.” As for the study’s possible implications for the United States, he said, “palm oil is of limited consumption in the United States, but this is analogous to the sugar taxes in the U.S. where there's a commonly-consumed good, primarily affecting obesity and type 2 diabetes among low-income groups.”
Previously: Can food stamps help lighten America’s obesity epidemic?, Stanford preventive-medicine expert: Lay off the meat, get out the sneaks and New evidence for a direct sugar-to-diabetes link
Photo by One Village Initiative