Wednesday, April 15, 2009

Taxing soda to make you stop drinking it

The food police are closing in on their next target: a soda tax. New York City's health commissioner, Thomas Frieden, is leading the way. He's the guy who purged trans fats from the city's restaurants and made them post calorie counts for menu items. Lately he's been pressuring food companies to remove salt from their products.

Now he's going after soda. Writing in the New England Journal of Medicine, Frieden and Kelly Brownell, the director of Yale's Rudd Center for Food Policy and Obesity, propose a penny-per-ounce excise tax on "sugared beverages." That's nearly $3 per case. Why so much? Because this tax, unlike the petty junk-food taxes of yesteryear, is designed to hurt. Its purpose is to discourage you from buying soda, on the grounds that soda, like smoking, is bad for you.

Persuading Americans to regulate soda the way we regulate cigarettes won't be easy. Isn't soda a kind of food? Isn't food a good thing? And isn't it a matter of personal choice? Doesn't taxation to control people's eating behavior cross a fundamental line of liberty? In their article, Frieden and Brownell methodically attack these objections. Going well beyond science, they lay out a political battle plan for the war on junk food.

Step 1 is to convince us that soda isn't really food. If you think this can't be done, wake up: Frieden has already done it to trans fats. In the NEJM article, he and Brownell spurn the notion that soft drinks are sacred because "because people must eat to survive." They tartly observe that "sugared beverages are not necessary for survival."

Step 2 is to associate soda with products we already stigmatize and regulate as harmful. On this point, the authors quote Adam Smith: "Sugar, rum, and tobacco are commodities which are nowhere necessaries of life, which are become objects of almost universal consumption, and which are therefore extremely proper subjects of taxation."

Step 3 is to persuade you that one person's soda consumption harms others, thereby transcending personal liberty. The authors write: "The contribution of unhealthful diets to health care costs is already high and is increasing—an estimated $79 billion is spent annually for overweight and obesity alone—and approximately half of these costs are paid by Medicare and Medicaid, at taxpayers' expense. Diet-related diseases also cost society in terms of decreased work productivity, increased absenteeism, poorer school performance, and reduced fitness on the part of military recruits, among other negative effects."

The Medicare argument is dubious, since, as my colleague Daniel Engber points out, fat people die younger and thereby save the program years of coverage. But the really cheeky pitch is the one about military recruits. Apparently, Coke is now a menace to national security.

Step 4 is to target kids, because our urge to protect them makes us more amenable to paternalism. "Sugared beverages are marketed extensively to children and adolescents" and "now account for 10 to 15% of the calories consumed by children and adolescents," Frieden and Brownell observe. In fact, soda makers "exploit the cognitive vulnerabilities of young children, who often cannot distinguish a television program from an advertisement." New York Mayor Michael Bloomberg echoes this plea: "We have to do something to help our children."

Step 5 is to tempt policymakers with cash flow. "A third consideration is revenue generation," the authors note. "A penny-per-ounce excise tax would raise an estimated $1.2 billion in New York State alone."

Step 6 is to persuade voters that the tax is for their health, not for cash flow. Frieden and Brownell note the political importance of this message: "[A] poll of New York residents found that 52% supported a 'soda tax,' but the number rose to 72% when respondents were told that the revenue would be used for obesity prevention."

Three years ago, I thought the movement to legislate against junk food was politically futile. But that was before the successful assaults on trans fats, calorie counts, and opening fast-food restaurants. Those victories, apparently, were just the appetizers. The next course is behavior modification through taxation. And this article is the recipe.


Scientists find drug that destroys Alzheimer's protein

A NEW approach to treating Alzheimer's passed its first clinical test when a drug developed by scientists was shown to clear the brain of a damaging protein linked to the disease. The drug completely removed a protein called SAP from the brains of five Alzheimer's patients, suggesting that it may be a potential therapy for the incurable degenerative condition.

While the study was not designed to investigate whether the drug had therapeutic benefits, its results were so promising that the scientists behind it are now seeking up to £4 million ($8 million) to test it on a larger group. "There is a severe need for a treatment for Alzheimer's, and there is nothing available that works well," said Mark Pepys, of University College London, who is leading the research. "Nothing else looks promising at the moment, and this is a pretty good, safe option. We can't guarantee it will work, but it's got a good shot."

The drug, known as CPHPC, was first developed by Professor Pepys almost 10 years ago as a possible treatment for amyloidosis, a disease in which amyloid proteins accumulate in the body's organs, often with fatal results.

While Professor Pepys is still investigating the drug for this purpose, and has signed a deal with GlaxoSmithKline to develop it, he is also pursuing it as a possible Alzheimer's therapy. Alzheimer's also features the build-up of amyloid plaques, in this case in brain cells, making CPHPC a good candidate for treatment.

In the new study, published in Proceedings of the National Academy of Sciences, CPHPC was given to patients aged between 53 and 67 who had mild to moderate Alzheimer's disease. After three months the drug cleared all SAP from their brains. The study was too short to show whether this had any clinical effect but none of the patients deteriorated during the research period. "The complete disappearance of SAP could not have been confidently predicted, and the drug, also to our surprise, entered the brain," Professor Pepys said.

Martin Rossor, of UCL Institute of Neurology, who also worked on the research, said: "The safety of CPHPC, together with the novel action of the drug in removing SAP, is very encouraging."


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