Healthcare System Trying to Prevent Price Hikes on Nutritional Foods

Anticipated jumps in food prices disproportionately harm the poor and have health officials worrying about a rise in obesity. A few new initiatives seek to redistribute the (nutritional) wealth.

When the price of food goes up, it’s always the healthy stuff that suffers most. Bamba and Bissli, the junk foods that seem to be staples in the Israeli diet, remain relatively consistent in cost. But food that actually provides vitamins and nutrients and contains ingredients that even grandma would recognize: that’s considered a luxury item and, as such, is subject to stiff fluctuations in price.

Of course, the ones affected most are low-income households who don’t have the dispensable money to “splurge” on fresh, wholesome products when processed, preserved alternatives cost a fraction of the amount.  And a consistent diet of such feeble fare leads to disproportionate cases of obesity and related illnesses such as diabetes.

With economic analysts predicting additional price hikes on food in the near future, the Israeli healthcare system is proposing ways to prevent the increase from further harming the lower classes, in hopes of staving off an outbreak of obesity in the next generation.

The tax increases approved last week by the government, in addition to the jump in the cost of raw goods and the drought now plaguing the United States, will soon affect our wallets. When prices go up at the supermarket chains, it’s not the candy isle that will be affected.

In recent years, food prices in Israel have gone up faster than in the West. From 2005 until 2008, food prices rose by seven percent, compared to an average of four percent in the developed nations, according to data provided by the Kedmi Committee, the panel charged last year with studying competitiveness in the food and consumer goods market.

These pessimistic assessments are leading senior health officials to propose a broad initiative to protect the cost of healthful foods by expanding the government price-control agency and, for the first time in Israel, enact price control on a basic basket of healthful foods.

"The cost of food is going to go up dramatically, and to prevent damage to our citizens' health it's necessary to maintain sane prices on nutritious foods," says Dorit Adler, head of the clinical dietitians' unit at Hadassah University Hospital, Ein Karem, and the leader of the new initiative.

Adler warns that the recommendations of the Kedmi and Trajtenberg committees (another government-created body to examine socioeconomic issues), which aim to counter the high cost-of-living in Israel, may contribute to the risks to public health.

"They decided to cut taxes on imports of unhealthful foods, such as full-fat cheeses, deli meats and sugar-loaded juices,” Adler says. “Abroad, these items are inexpensive, so the idea is to import them here to make prices drop. But it's a dreadful idea.”

Adler advocates a food basket that includes legumes – like split peas and lentils – which she calls the “perfect carbohydrate and a hallmark of Mediterranean nutrition” and which are expected to soar in price by 30-40 percent.  Additional essential items should include fruits and vegetables, whole grain breads and pastas, brown rice, some kind of fish, chicken, turkey, canola oil, nuts and low-fat milk products.

“A nutritious food basket is a fundamental human right, according to the World Health Organization,” she says.  “At this point, government control is the only way to make sure it happens. Anyone opposed to tight price controls on healthful foods doesn't understand the real price society pays in terms of rising rates of illnesses."

The link between the cost of food and obesity was diagnosed long ago in peer-reviewed journals in the West. In January 2004, researchers from the School of Public Health at the University of Washington found that the inexpensive cost of high-fat foods is a key factor in the rising rates of obesity in the United States. An article published by The American Journal of Clinical Nutrition claims that junk food - potato chips, soft drinks, candy and cookies - is actually the most affordable choice in the supermarket chains.

The topic has also been studied in Israel, first by a research team headed by Vered Kaufman-Shriqui from the S. Daniel Abraham International Center for Health and Nutrition at Ben-Gurion University of the Negev, which looked at the cost of food for children ages six to 18 on the basis of the nutritional guidelines issued by the Health Ministry. The findings indicated that 40 percent of all Israeli households, and 66.9 percent of the poorest tenth of the population, cannot afford to feed their children up to the nutritional standards recommended by the Health Ministry because of food costs.  According to the Central Bureau of Statistics, these run from NIS 1,450 to NIS 1,980 a month per child.

"In recent years, we've been following the findings, and food prices just keep going up so the situation keeps getting worse," says Kaufman-Shriqui.

In July 2011, at the beginning of the social justice protests, the Rami Levi supermarket chain worked together with Adler on an initiative to reduce the cost of healthful foods by selling a reduced-cost basket of goods that changed every two weeks. But in recent months, the project lost some of its momentum, and Adler decided to promote the new initiative instead.

"The goal is to produce an initiative in which food manufacturers and marketing chain participate on a voluntary basis to call on the state to control prices on the basic basket of food," she says.

Taxing Willy Wonka and his chocolate factory

Another food-related initiative, reported last week in Haaretz, is one supported by the Health Ministry and Israel Tax Authority that calls for taxing junk food, based on a model used in some Western countries. Dieticians insist that if the move is implemented, the revenue generated from the tax must be used to cut the cost of nutritious foods.

Of the 40 policy makers questioned, about half assumed that the public would oppose taxation of unhealthy foods.  But a survey administered by the Gertner Institute for Epidemiology and Health Policy Research at Sheba Medical Center, headed by researcher Orly Tamir, found otherwise.  The results showed that one-third of adults favor taxing junk food, despite tax increases in recent years.  

“We have to find ways to make healthful food accessible to the poorer populations," says Prof. Shuki Shemer, one of the survey's researchers and board chairman of Assuta Medical Centers.  He said a tax on unhealthy foods can be used to promote public health, provide coupons to low-income families to purchase more healthy foods, and finance a national nutrition program for children.  

“When you tax sugary soft drinks and fatty foods, you're hurting the weakest populations,” Shemer points out. “People in the higher socioeconomic percentiles are usually more aware of good nutrition."

Eran Yaakov, deputy director general of the Israel Tax Authority, notes the advantages of establishing a committee to look at a comprehensive solution to food prices, part of which would be taxing junk food.

"The solution has to be holistic and involve both the Health Ministry and Education Ministry to encourage better eating habits," he says. Nonetheless, Yaakov stresses that there is no intention to use the revenue of such a future tax to underwrite the cost of healthful alternatives: "In Israel's economic policy, all tax revenue goes to the treasury."

The Industry, Trade and Labor Ministry, in charge of price controls on food, responded with the following statement:

"The committee looking into the high cost of food and consumer goods, which included representatives from the Health Ministry and Agriculture Ministry, has not expressed an opinion and has not dealt with taxation on more nutritious versus less nutritious foods. It has instead focused on its main task: to make proposals to lower the cost of living, while looking at the ramifications for the economy and the labor market. The Industry, Trade and Labor Ministry is not responsible for price controls of food in general, but only for a limited list of foodstuffs. When looking at the foods to become price-controlled, the ministers will consider the gamut of factors and their implications."