Taxes, Triceps, and Tunnel Vision: An Open Letter to Mr. So-and-So
David L. Katz, MD, MPH
CMO, Tangelo. Founder: Diet ID; True Health Initiative. Founding Director, Yale-Griffin PRC (1998-2019). Health Journalist. COVID Curmudgeon
I don’t know the writer in question from a hole in the wall. But I woke to find this note of esteem and affection in my in-box: “Mr. So-and-So mentioned you in a comment: ‘when this jerk off David L. Katz, MD, MPH wants to tell me what he squats and or what his bodyfat % is then we can start talking about how we should be putting a tax on soda...’ "
Those so inclined are welcome to join me in celebrating my correspondent's display of presumption, arrogance, and puerile incivility- whatever your views of soda taxes.
As for soda taxes, I am by no means a leading proponent. I much prefer the carrot to the stick, a position reinforced several times a week when I wield literal stick and actual carrots in my interactions with Troubadour, my horse. He, too, much prefers carrots to stick- and sees plenty of the former, and the latter only very rarely when he misbehaves dangerously.
Translating that equestrian perspective to my day job in public health, I prefer empowering people to policing them. I prefer the combination of nutrition GPS with associated financial incentives for better choices, to the penalty of a tax for ‘bad’ choices. I think policy and legislation should be used selectively when they are clearly the best answer, but I think they can easily be taken too far into objectionable intrusions on personal liberty. It’s not all one way or the other; between the nanny state, and the ninnies who think we would be better off with no regulation of anything- is a middle path that best combines personal liberty with public responsibility. That’s where I would like us to be.
That said, I support the proposed soda tax in question. The missive inducing Mr. So-and-So's compliments of the day was a link to a Mark Bittman column in the New York Times entitled Introducing the National Soda Tax, and my appended comment: “amen. We are very fortunate to have Rep. DeLauro in our CT delegation!”
I prefer carrots to sticks, and financial incentives to taxes. But if a nominal tax on soda is an iron stick, it is in a velvet sheath. However we might best operationalize the definition of “junk food,” soda is clearly on the wrong side of the line. So, if we are going to apply disincentives to any foods, it’s a very reasonable place to start. The disincentive proposed is too small to preclude anyone who really wants a soda from getting one- but maybe enough to get them to think twice, which is the point. It’s also enough to generate a significant fund to support the development and dissemination of empowering public health programming. Whether or not that would happen remains to be seen, but it is clearly what Representative DeLauro intends. The stick in this case, in other words, is mostly proposed for turning the soil- and planting carrots.
We are, indeed, very fortunate to have Representative DeLauro as a long-time member of our congressional delegation here in Connecticut. She has always taken positions that best defend the most defenseless, and empower the disempowered- whether there has been political advantage or disadvantage in it. Soda tax or no soda tax, Congresswoman DeLauro epitomizes what we hope for in public servants. She has my admiration and gratitude.
But I have been remiss, neglecting Mr. So-and-So's questions. As it happens, I practice what I preach: I eat optimally, exercise regularly, and attend to my health across the short list of other top priorities I espouse routinely. The result is my percent body fat, when last checked, was just over 8% (the photo of me above was taken by my wife last week). I don’t do squats, having had multiple surgeries on both of my knees as a result of adventures on skis and horseback, but can say that I can bench press 150% of my own weight, and do a continuous set of 25 chin-ups with full arm extension between. I hasten to note that these, and related marvels of human performance, will get me on the subway, provided I have a token.
In other words: who cares? In what way is my percent body fat remotely relevant to public strategies devoted to curtailing the spread of epidemic obesity and chronic disease, in children as well as adults? When I advocate for a specific exercise program, you may want to know that I apply it successfully myself. But a soda tax is about something else altogether. It is predicated on the recognition that cultural forces are systematically disempowering individuals with regard to health and weight control, at times by rather nefarious means. It acknowledges that some of the defense of the human body must reside with the body politic. It by no means obviates personal responsibility, but allows for some application of public responsibility, too.
Which leads us back to squats. If we were relying on our triceps preferentially, we Homo sapiens would still be squatting in our caves. The strongest of us ever to live is still a rather weak animal, the capacity of our muscles trivial in comparison to those of gorillas, or horses, or tigers. The smartest Homo sapiens, however, are another matter altogether. They have placed us at the top of the food chain, for better or worse.
So in response to provocations about my anthropometry, and apparent tunnel vision about public policy, I have a reciprocal concern to share. Be careful that whatever you are doing in the gym with your triceps and pecs- isn’t cutting off the blood flow to your brain.
-fin
David L. Katz, MD, MPH, FACPM, FACP is the founding director of Yale University’s Prevention Research Center, President of the American College of Lifestyle Medicine, principal inventor of the NuVal nutrition guidance system, and Editor-in-Chief of the journal, Childhood Obesity. He has authored roughly 200 scientific papers and 15 books, including three editions of a nutrition textbook for health care professionals and ‘Disease Proof.’ He has five children, all trying to talk him into competing in America Ninja Warrior. He is thinking about it…
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Photo: the Author
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10 年José F Perea
Senior Occupational Therapist at Advocate Health Care
10 年What an obnoxious article. I would like to see a title or leader on the article that actually says what it's about-this was a waste! Personally, I could care less about your triceps, knees or presses. Taxes are about money-period. If taxes worked that well to control people's behavior, we wouldn't have any smokers. And I'm still trying to see the logic of tax in some towns on bottled water. I don't drink soda, because I think it's poison, but I don't want to lose any more rights to self-righteous bureaucrats who spend their nights dreaming about how to suck more money from the masses while they collect outrageous benefits.
Presentation Specialist
10 年>>> @ John Stell: "This obesity epidemic COSTS the entire nation money. There is no getting around that fact." In that case, we must insist that AIDS costs the entire nation money, too. So following your inclination to tax individual food choices you disapprove of for health reasons, we should be consistent and require a tax on promiscuous homosexuals for indulging in sexual-partner choices that are high risk and injurious to health. There's no getting around that fact. You wouldn't be opposed to such a tax, right? If so, why? Why are individual food choices subject to taxation for the sake of public health but not individual sex-partner choices?
Presentation Specialist
10 年>It’s not all one way or the other; between the nanny state, and the ninnies who think we would be better off with no regulation of anything A revealing way of putting it. What would you think if someone said, "A person MUST have a central, exogenous, regulatory device, attached to his body in order to whip the heart into regular contractions! Without it, the heart would be 'unregulated' and cardiac anarchy — arrhythmia, fibrillation — would ensue!" Wouldn't the correct response be something like, "Er, uh, the heart cooperates with lots of other organs and systems in the body in a SELF-REGULATING, division-of-labor; and that little patch on the sino-atrial node does just fine whipping the heart without some extraneous central device interfering with the whole process and causing all kinds of unintended consequences." The choice is not between "regulated" vs. "unregulated." There is ALWAYS regulation in a market; the choice is, rather, WHO is doing the regulating: a single, central, exogenous (i.e., non-market) institution such as government? Or each individual economic actor, regulating his own plans, choices, and actions, and dovetailing them in the market with everyone else's individual plans, choices, and actions? Government's role as a non-market institution is simply to make sure that private property is respected, contracts enforced, borders protected. That's about it. The dovetailing of each person's plans with every other person's plans is accomplished mainly by means of the price system: rising and falling of relative prices and wages signaling to individuals where their actions are most highly (or least highly) valued by others. Markets are not inherently "unregulated". Left to themselves, they exhibit the same sort of self-regulation — a kind of homeostasis — as biological organisms.
Presentation Specialist
10 年https://acsh.org/2003/06/dr-elizabeth-whelan-president-of-acsh-debates-a-junk-food-fat-tax-on-the-today-show/ "[T]his proposal [i.e., a soda tax] has a premise that there is somehow some good foods and bad foods, and if we could only tax the bad foods, then we wouldn’t have an obesity problem. It doesn’t work that way. We face an obesity problem in the United States because we consume too many calories for our needs and we don’t exercise enough. It comes down to that. And, you know, there is room in life for potato chips and Twinkies and all these other maligned foods if you don’t eat huge amounts of them. There is no good or bad food, there are only good and bad diets. And I know that’s more complex than putting a tax on—on food. And, by the way, this would be just another tax. It’s just another way of trying to get revenue out of us." Reminder: you can also become obese by sitting and eating too many raw almonds and avocados. Politicizing other people's food choices you disapprove of is no different from politicizing other choices people make that you might disapprove of: e.g., reading material; or news sources; or movies; or televisions shows. It would be easy to define a category of "junk literature", "junk entertainment", and "junk news sources", and tax them for the purpose of "correcting" those choices to other choices that you find "more worthy." That would be both intolerant AND a sign of tyranny. And finally: since there's no evidence that high taxes on cigarettes have reduced smoking, why would anyone think that the same ineffective policy would suddenly be effective when applied to soda?