Intended for healthcare professionals

Rapid response to:

Editor's Choice

Evidence is sweet

BMJ 2019; 366 doi: https://doi.org/10.1136/bmj.l4617 (Published 11 July 2019) Cite this as: BMJ 2019;366:l4617

Rapid Response:

Re: Evidence is sweet

The Editorial reads: "Whether they decide to pass this additional cost on to consumers remains to be seen." Anyone visiting food and drink outlets in the United Kingdom will find reduced container sizes with proportionally higher prices. These plans were revealed a year ago by The Guardian newspaper[1]. The question should be, what is the aim of the tax - presumably to reduce population obesity. Can it do that?

The consumption of high energy food and drink contributes to individual weight gain and so is important. However, it is not the cause of the population upward trend in obesity in Britain. Per person consumption by total energy has reduced (both fats and sugar consumption have reduced more dramatically) since the 1970s (MAFF National Food Surveys Great Britain) while per person physical activity has also reduced (DETR National Travel Surveys Great Britain). The trends reflect our addiction to fossil fuels which is a much harder target and has more unsettling global consequences. Distractions like this may simply lead to greater numbers of plastic containers at higher cost.

This widely available (but rarely published) evidence should pose public health practitioners and media commentators the question "what is the abnormality which requires correction?" However, it does not, which is baffling. But if we are determined to be distracted, to reduce the consumption of sugary drinks the logical solution would be as follows. Force a mandatory return to glass containers with return deposits which may even encourage some physical activity, would leave a healthy reminder of your own consumption by the back door, and create greater inconvenience (which always slows things down), limit volume (is 2L in glass even practical to carry or make outside champagne?) and negatively impact on the amount of plastic we produce.

[1] https://www.theguardian.com/society/2018/jan/05/coca-cola-to-sell-smalle... (accessed 12/07/2019)

Competing interests: No competing interests

12 July 2019
Gregory Rose
Public Health Specialist
Measured Change, international humanitarian consultancy
Upper Holloway, London, UK