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NLMA resolution on a soda tax passes at CMA General Council


NLMA representatives presented a resolution to CMA General Council on taxing sugar-sweetened beverages (SSBs) last week in Quebec City. The resolution, The Canadian Medical Association calls on the federal government to implement a federal excise tax on sugar-sweetened beverages and artificially-sweetened drinks sold in Canada to subsidize healthier food options, was successfully passed.


The motion was proposed by NLMA President Dr. Lynn Dwyer and President-Elect Dr. Tracey Bridger. The resolution stems from a members motion passed at the 2016 NLMA AGM, where delegates called on NLMA to advocate for a tax on SSBs.


Other international jurisdictions have successfully applied taxes on SSBs as a means to deter sugar consumption and redirect revenues toward health promotion initiatives. After further research, the NLMA Board of Directors agreed that a tax on SSBs would have the most impact if applied to manufacturers at the point of production or importation (excise tax), rather than to consumers at the point of purchase at the cash register. The Board also agreed that a tax on SSBs should be implemented nationally given the inconsistencies in SSB definitions and tax regimes across provinces.


The biggest contributor to free sugars, which are added by manufacturers as sweeteners or preservatives, come from sugary drinks like soda, fruit juices, sweetened milk products, yogurt drinks, powdered fruit-flavored drinks, energy drinks, vitamin waters and sweetened iced teas.


Physicians have raised concerns about the high level of free sugars in SSBs because of their association with poor dietary quality, obesity and risk of non-communicable diseases, including diabetes, cardiovascular diseases and certain types of cancer. Newfoundland and Labrador leads the country as the province with the highest prevalence of these diseases.


In 2014, Statistics Canada reported that Newfoundland and Labrador had the highest prevalence of obesity of any Canadian province at around 30 per cent, compared to the national average of about 20 per cent.


In 2015, Memorial University published Vital Signs: A province-wide check-up of the quality of life in Newfoundland & Labrador communities for 2015, which reported that 68 per cent of the population are overweight. It further reported that 43 per cent of youth between the ages of 12 and 19 are overweight or obese – nearly 70 per cent higher than the national average. Research shows that overweight and obese children are more likely to stay the same into adulthood.


“As a family physician, I see the effects of unhealthy diets in my practice on a daily basis. And I’m sure that most family physicians across the province would tell you the same,” said Dr. Dwyer.


“It sometimes takes a life altering event for someone to change their lifestyle, but we want to encourage people to make changes before they are faced with an illness that, in some cases, could have been prevented.” said Dr. Dwyer.


When natural sugars are consumed through foods with fibre, like fruits or vegetables, it takes the body longer to digest and metabolize those sugar molecules and it leaves people feeling full. Because nutrient poor calories in sugary drinks do not provide the same feeling of fullness as solid foods, it can be consumed faster and in larger amounts. These beverages deliver rapid doses of sugar that must be metabolized quickly by the liver and, in response, it converts sugar molecules like fructose into fat. Fat in the liver is linked to insulin resistance, and is a risk factor for developing Type 2 diabetes.


Brain scan research has shown that foods that are high in sugar can also stimulate the same parts of the brain as drugs and alcohol. Some researchers have even argued that it can be just as addictive. These addictive properties are then reinforced by constant marketing and advertising, which is often directed at children.


The total volume of sugary sweetened beverages available to Canadians is about 3.5 billion litres, the equivalent of 110 litres per person per year or over 300 ml per day. In 2015, Memorial’s Vital Signs reported that for every 10,000 people in Newfoundland and Labrador, there are about 14 fast food outlets and 8 convenience stores. The majority of drinks sold in these establishments are sugary beverages. 


“We’re hopeful that an excise tax on sugar sweetened beverages might make consumers consider healthier choices in their lives, so that instead of their diet having a negative impact on their overall health, it will have a positive one.”


Other organizations that have recommended a tax on SSBs include the Canadian Diabetes Association, the Dieticians of Canada, the Heart and Stroke Foundation, Childhood Obesity Foundation and the Disease Prevention Alliance of Canada. Internationally, the British Medical Association has been calling for a tax on SSBs since 2015 and the American Medical Association released its recommendations for an excise tax on SSBs in June 2017.

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