Obesity is a rising concern in India. With India’s second most obese state levying a tax on junk food, experts debate if such measures help in the long run.(Getty Images/iStockphoto)
Obesity is a rising concern in India. With India’s second most obese state levying a tax on junk food, experts debate if such measures help in the long run.(Getty Images/iStockphoto)

Kerala’s Fat Tax: What will it take to win the fight against obesity?

A ‘fat tax’ can only be effective if it also focuses on awareness, advertising, and unbranded junk food
By Humaira Ansari & Ramesh Babu | Hindustan Times
UPDATED ON JUL 17, 2016 10:58 AM IST

The fat is in the fire in God’s Own Country, with the Kerala government planning to tax junk food at 14.5%.

The ‘fat tax’ will be levied on burgers, pizzas and processed foods served in organised fast-food outlets, including international brands such as McDonald’s, Burger King, Pizza Hut and Domino’s.

The idea is to try and slash fast-rising obesity rates in the state. Right now, 28.1% of women and 17.8% of men in the state are either overweight or obese, putting Kerala a close second to India’s most obese state, Punjab. (Here, 29.9% of women and 18.2% of men are either overweight or obese).

Obesity fuels lifestyle diseases such as diabetes, heart disease and hypertension, and the Kerala numbers are way above the national average of 12.6% of women and 9.3% of men, found the last National Family Health Survey, in 2005-06.

Read: How America is grappling with its most common ailment - obesity

So, what are junk foods, and how much is too much? “Junk foods are foods that have empty calories and zero nutrition. All refined and processed foods fall in this category, including deep-fried vada pav, kachoris, pakoras and samosas,” says Karishma Chawla, a nutritionist who runs a health clinic in Mumbai.

“Most of the essential sugars and fats that our body needs are present in our daily diet. Invisible sugar, for instance, comes from fresh fruit and dry fruit, and fats from cooking oil, meat, eggs and nuts,” Chawla adds.

Still, seven of every ten patients who come to Chawla have skin and weight problems linked to junk food consumption.

The ‘fat tax’ has been introduced to dissuade people from eating junk food such as burgers, pizzas and processed food like ready-to-cook noodles, all of which have empty calories and little nutrition. (HT File Photo for representation only)
The ‘fat tax’ has been introduced to dissuade people from eating junk food such as burgers, pizzas and processed food like ready-to-cook noodles, all of which have empty calories and little nutrition. (HT File Photo for representation only)

A TAX AS THE ANSWER?

Worldwide, 39% of adults are overweight; 13% are obese.

Responding to this growing crisis, Denmark in 2011 imposed a special tax on food items such as butter, milk, meat, cheese and oil containing more than 2.3% 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.

“Introducing a ‘fat tax’ can potentially arrest a whole spectrum of junk food-related illnesses such as obesity, hypertension and diabetes,” says Dr Pratit Samdani, a physician at Mumbai’s Jaslok Hospital. “Besides making foods such as burgers and pizzas more expensive, it would also remind consumers that what they are about to consume is unhealthy and dangerous.”

But public health advocates are questioning the impact of a populist fat tax that targets multinationals and excludes traditional foods.

Since the announcement of the fat tax, there has been a question mark over traditional junk food such as tikkis and samosas, which are not branded and therefore would not be taxed, but which are also unhealthy. (Praful Gangurde/Hindustan Times)
Since the announcement of the fat tax, there has been a question mark over traditional junk food such as tikkis and samosas, which are not branded and therefore would not be taxed, but which are also unhealthy. (Praful Gangurde/Hindustan Times)

“What about the hawkers selling samosas, vada pav and colourful candy outside schools,” says Samdani.

What we really need is policy intervention, points out Hemal Shroff, assistant professor at the School of Health Systems of Mumbai’s Tata Institute of Social Sciences. Shroff is leading an ongoing study of 643 students from Classes 7 and 8 in Mumbai. Early findings suggest that 10% eat junk food daily and another 13% eat it almost every day — across low-and middle-income students from English-medium schools.

“We need a crackdown on advertisements that use colourful visuals, happy images, toys and friendly mascots to entice kids to eat junk food,” she says. “In all this happy messaging, people forget how unhealthy junk food is.”

That’s certainly true of Delhi schools. In 2010, the non-profit Uday Foundation filed a petition in the Delhi High Court asking that the sale of junk food be banned in schools.

The court’s 2015 decision asked the state to consider issuing healthy eating guidelines without waiting for regulations or directions from the food authority.

“Most Delhi schools have since stopped selling processed soft drinks, instant noodles and chips in their canteens, but Indian snacks such as samosas, bread rolls, bread pakoras and chhole bhature are still available and they are as unhealthy,” says Rahul Verma, founder of Uday Foundation.

Should the state then consider regulating all high-fat, high-sugar, high-calorie foods?

“A structured public health education strategy would probably yield better results,” says Dr Jothydev of the Jothydev Diabetes and Research Center, Thiruvananthapuram.

Read: It’s not only obesity that is rising in India but weight-loss surgeries

PARENTAL INVOLVEMENT

Roping in parents to catch them young is another key element in the battle.

Mumbai’s Sangeeta Kulkarni, a former teacher, for instance, has raised her children on a steady diet of freshly cooked home food.

Her son Kartikeya is now 16 but dislikes pizzas and colas. Her daughter Tulika, 13, has developed a taste for them but is mindful of how much she has.

“Even though she is not fond of fruits, she makes sure to eat one a day,” says Sangeeta, 45. It helps that their school, Jamnabai Narsee, has banned aerated drinks, replaced colas with flavoured milk and has teachers who monitor what’s in the lunch boxes.

(Illustration: Siddhant Jumde)
(Illustration: Siddhant Jumde)

MONEY MATTERS

The one purpose Kerala’s fat tax could serve is to trigger a serious conversation on healthy eating, says Dr Vijay Agarwal, chief of paediatric cardiac surgery at Mumbai’s Fortis Hospital.

“If for no other reason, more Indian states should follow their lead,” he adds. “Even if 1% of our 1.2 billion Indians amended their diet, that would be a big achievement.”

Thiruvananthapuram techie K Vinod would probably not be among that 1%.

“I don’t think a tax can alter one’s food habits,” he says. “I love eating cheesy pizzas with aerated drinks and I will continue to do so, just as tipplers have continued to tipple even after the state imposed a 150% to 200% tax on liquor.”

Read: Why is India having an obesity problem in the first place

Only time can tell how well Kerala’s fat tax will work. For now, the trolls are having a field day on social media.

“Thomas Isaac, Kerala Finance Minister, should also tax jeans size with waistline of 32 and above,” said one tweet. “What is the difference between beef-baiter Modi and pizza-hunter Isaac? Tax will fatten Isaac’s wallet, but it won’t repulse one’s palate,” said another.

The Kerala Hotel and Restaurant Association has already dubbed the fat tax a publicity stunt. “Here, places selling branded junk food are few. They don’t do business worth Rs 10 crore, then how did the finance ministry expect Rs 10 crore in taxes?” a spokesperson said.

Healthy eating habits need to be inculcated in children from the start. If parents make the child aware of nutritious options, fitness becomes a conscious habit for life. (HT File Photo for representation only)
Healthy eating habits need to be inculcated in children from the start. If parents make the child aware of nutritious options, fitness becomes a conscious habit for life. (HT File Photo for representation only)

GUIDELINES FOR HEALTHY EATING AT SCHOOLS

* Sale of foods high in fat, salt and sugar should be restricted in schools and for a 50-metre radius around them. The restricted items should include chips, all fried foods, all sugar-sweetened beverages, pizzas, burgers, potato fries, confectioneries and ready-to-eat noodles.

* Healthy options should be offered in school canteens instead, including fruit and fruit salads, paneer / veg cutlets, khandvi, poha, uttapa, upma, idlis and kathi rolls, low-fat milk shakes with no added sugar, smoothies, almond milk and lassi.

* Nutritional education and awareness should be promoted in schools.

* Children, parents and teachers may complain about non-compliance without waiting for guidelines to be given the force of a direction or regulation.

Source: Delhi High Court order, February 25, 2015

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