Should We Tax Meat and Dairy Like We Do Cigarettes?

One of the most effective ways to decrease the harms of smoking is by increasing the cost of cigarettes through tobacco taxes. Indeed, an increase in the cost of cigarettes by only 10 percent could prevent millions of tobacco-related deaths. What about taxing unhealthy food? In general, public health decision makers have had three main options: inform through labeling, nudge with incentives, or directly intervene in markets using more heavy-handed approaches like instituting regulations or taxes.

“Policy approaches have proven crucial for other public health priorities, such as reducing tobacco use, alcohol abuse, and deaths from motor vehicle crashes.” In fact, installing air bags, for example, helped more than either “driver education alone or by labeling cars with information on crash risk.” Given that heart disease kills more than ten times more people than injuries on the road, maybe the “current epidemic of nutrition-related disease requires a similar multifaceted approach…[E]ven modest resulting dietary improvements could help reduce the burden of chronic disease significantly.” Perhaps a national system of subsidies for good foods, as well as taxes for bad ones, could “facilitate more sensible dietary choices.” Would they work? I discuss this in my video Would Taxing Unhealthy Foods Improve Public Health?.

A systematic review of the available evidence suggests such taxes and subsidies would in fact work. As I show in my video at 1:30, it seems the more unhealthy foods are taxed, the more consumption drops. Likewise, the more healthy foods like fruits and vegetables are subsidized and their prices drop, the more consumption increases. A small price difference between leaded and unleaded gasoline, for example, succeeded in decreasing our exposure to lead. What about a tax to decrease our exposure to saturated fat? As you can see from the data at 1:52 in my video, such a tax could potentially save thousands of lives.

Wouldn’t such a tax disproportionally affect the poor, though? Yes, it would benefit them the most—just like cigarette taxes. The classic tobacco industry argument is that cigarette taxes are “unfair” and “regressive,” burdening the poor the most. The public health community’s response? “Cancer is unfair” and “[c]ancer is regressive,” disproportionately burdening the poor such that a cigarette tax could result in the greatest health gains for the least well-off. The so-called Committee Against Unfair Taxes was actually just a front, “organised and funded by the tobacco industry,” one front group among many, as you can see at 2:42 in my video. This is a common tactic used by the industry to hide its role in fighting tobacco taxes, in addition to trying to overtly buy off politicians. The fact that the industry fights tooth and nail suggests that tobacco taxes can indeed affect consumption. Much of the data on food taxes and subsidies, however, have been based on models or “stated preferences” to hypothetical scenarios where people merely say they’d change consumption patterns based on prices. There hasn’t been as much real world data.

Researchers have put people through high-tech, 3D supermarket simulators, which you can see depicted at 3:15 in my video, and found that a 25 percent discount on fruits and vegetables appears to boost produce purchases by 25 percent. That’s nearly two pounds a week, but virtual fruits and veggies don’t do you any good. Does this work out in the real world? Yes. In fact, South Africa’s largest health insurance company started offering up to 25 percent cash back on healthy food purchases to hundreds of thousands of households—up to $500 USD a month. Why would the insurance company do that? Why give money away? Because it works. The healthy food cash-back program was associated with an increase in the consumption of fruits, vegetables, and whole grains, as well as a decrease in  foods high in added sugar, salt, and fat, including processed meats and fast food.

Subsidies are more common than taxes, though, in Europe, where a number of countries have instituted taxes on foods that are sugary or salty. Denmark was the first to introduce a tax on saturated fat, such as meat, dairy, and eggs, but it only took the food industry about a year to squash it, demonstrating that “public health advocates are weak in tackling the issues of corporate power.”

There’s “an enormous imbalance” between the influence exerted by public health professionals compared to the political might of the food industry. It brings to mind the fight over proposed “traffic light labelling” on food in the European Union. Apparently, it was much too easy to understand, simple and straightforward, so the industry lost its mind and spent more than $1.4 billion USD killing it in favor of the confusing “daily amount” labeling guidelines that require a “bring-your-calculator-to-the-grocery-store” approach to make grocery shopping as confusing as possible, as you can see at 4:51 in my video.

Denmark ended up canceling the fat tax and shelving their sugar tax because the farming and food company interests claimed too many jobs would be lost if people ate healthier. Apparently, a healthy economy was more important than a healthy population. Ironically, it was abolished just when evidence of its effects started to appear. Researchers “conclude[d] that the introduction of the saturated fat tax contributed to reducing the intake of saturated fat among Danish consumers” from some meat and dairy products—but not from sour cream, though. The public ate so much more low-fat sour cream that it outweighed the smaller reduction in consumption of high-fat sour cream.

Indeed, we always have to think about the unintended consequences. Swapping out sugary cookies for salty chips, for example, might not do the public’s health many favors. One field study of a tax on soda found that it may drop soft drink purchases, at least in the short term, but households may just end up buying more beer.


This idea is the flip side of sorts to my video Taxpayer Subsidies for Unhealthy Foods.

For more on how the food industry has borrowed from the tobacco industry playbook, see

What about those who insist that sodium really isn’t bad for you? Check out:

And those who insist that saturated fat really isn’t bad for you? See The Saturated Fat Studies: Buttering Up the Public and The Saturated Fat Studies: Set Up to Fail.

What about those who insist that sugar really isn’t bad for you? Watch Big Sugar Takes on the World Health Organization and Does Diet Soda Increase Stroke Risk as Much as Regular Soda?.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

The Effects of the Hops Phytoestrogen in Beer on Breast Cancer Risk

Hops have been used for centuries as a flavoring agent in beer, but “[o]ver the years, a recurring suggestion has been that hops”—and therefore beer—may be estrogenic, thanks to a potent phytoestrogen in hops called 8-PN, also known as hopein. Might beer drinking affect our hormones? I discuss this in my video What Are the Effects of the Hops Phytoestrogen in Beer?.

Even just the alcohol in beer can reduce testosterone levels in men, so when beer was tested as a source of estrogens, the alcohol was first removed. Researchers tested the equivalent of one can of beer every day for a month on the hormone levels of postmenopausal women, so as to not confound the results with her own estrogens, and they found significant alterations of hormonal levels during the beer month and then a return to baseline a week afterwards. But does this have any clinical effects, whether good or bad?

A cross-sectional study of about 1,700 women found that beer drinkers appear to have better bone density, perhaps because of the pro-estrogenic effects. They don’t recommend women start drinking beer for bone health, but suggest it may have beneficial bone effects for women who already drink.

What about helping with hot flashes? About half of postmenopausal and premenopausal women in the United States suffer from hot flashes, whereas the prevalence in Japan may be ten times lower, presumed to be because of their soy consumption. What about hops? There have been a few studies showing potential benefit, leading to a 2013 review suggesting that “hop extract may be somewhat effective in treating menopausal discomforts especially against hot flushes,” but that was before a study reported extraordinary results with about a half teaspoon of dried hop flowers. In the placebo group, the women started out having 23 hot flashes a week and continued to have 23 hot flashes a week throughout the three-month study. In the hops group, the women started out even worse with about 29 hot flashes a week, but then got down to 19 at the end of the first month, then 9, and finally just 1 hot flash a week. And similar findings were reported for all the other menopausal symptoms measured.

Animal estrogens work, too. Millions of women used to be on horse hormones—Premarin, from pregnant mares’ urine. That drug also took care of hot flashes, as well as  curtailed osteoporosis, but caused a pesky little side effect called breast cancer. Thankfully, when this was realized and millions of women stopped taking it, breast cancer rates fell in countries around the world.

The question, then, is: Are the estrogens in hops more like the breast cancer-promoting horse estrogens or the breast cancer-preventing soy estrogens? The key to understanding the health-protective potential of soy phytoestrogens is understanding the difference between the two types of estrogen receptors, alpha receptors and beta receptors. Unlike animal estrogen, the soy phytoestrogens bind preferentially to the beta receptors, and in breast tissue, they’re like yin and yang with the alpha receptors signaling breast cell proliferation. This explains why horse hormones increase breast cancer risk, whereas the beta receptors, where the soy binds, oppose that proliferative impact. So, do the hops phytoestrogens prefer beta, too? No. 8-PN is a selective estrogen receptor alpha promoter. “Surprisingly and in clear contrast to genistein [the soy], 8-PN is a much weaker” binder of beta than of alpha. So, that explains why hops is such a common ingredient in so-called breast enhancing supplements—that is, because it acts more like estrogen estrogen. Given the breast cancer concerns, use of such products should be discouraged, but just drinking beer could provide the exposure to the hops estrogen, which could help explain why beer may be more carcinogenic to the breast than some other forms of alcohol.


A phytoestrogen in beer? For more on the background of this issue, see The Most Potent Phytoestrogen Is in Beer.

Other videos on phytoestrogen include:

To learn more about dietary effects on testosterone, see:

What about “natural” hormones for menopause? See my video Plant-Based Bioidentical Hormones.

For more on the risks of alcohol in terms of breast cancer risk, see Breast Cancer and Alcohol: How Much Is Safe? and Breast Cancer Risk: Red Wine vs. White Wine.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Beer Phytoestrogens

Why do alcoholic men develop so-called man boobs and other feminine traits? We know estrogens produce feminization, and our liver clears estrogens from the body. As such, the original theory was that alcohol-induced liver damage led to the retention of excess estrogens. The problem was that when researchers measured estrogen levels, they weren’t elevated. What’s more, even those with cirrhosis of the liver appeared to clear estrogens from the body normally, and men’s testicles started shrinking even before serious liver disease developed.

So, alternative explanations were considered. If it’s not due to estrogens produced endogenously, meaning within the body, maybe alcoholics are being exposed to “exogenous estrogenic substances from dietary sources”—perhaps from phytoestrogens in the plants that alcoholic beverages are made from. The discovery that plants could contain hormonal compounds was made back in 1951 by two Australian chemists charged with finding out the cause of an “epidemic of infertility in sheep that was ravaging their nation’s wool industry.” It took them ten years, but they finally figured out the cause: a compound called genistein, present in a type of clover, and the same phytoestrogen found in soybeans.

You can read about the dreaded clover disease on scare-mongering websites, but you’ll note they never talk about the difference in dose. To get as much as the sheep were getting from clover, you’d have to drink more than 1,000 cartons of soymilk a day or eat more than 8,000 soy burgers or about 800 pounds of tofu a day.

This is not to say you can’t overdo it. There are two case reports in the medical literature that describe feminizing effects associated with eating as few as 14 to 20 servings of soy foods a day. But at reasonable doses, or even considerably higher than the one or two servings a day Asian men eat, soy phytoestrogens do not exert feminizing effects on men.

So, back in 1951, we realized plant compounds could be estrogenic. Two German researchers realized that perhaps that’s why women who handle hops start menstruating, and, indeed, they found estrogenic activity in hops, which is the bittering agent used to make beer. They found trace amounts of the soy phytoestrogens, but in such tiny quantities that beer would not be expected to have an estrogenic effect. In 1999, however, a potent phytoestrogen called 8-prenylnaringenin was discovered in hops, which I discuss in my video The Most Potent Phytoestrogen Is in Beer. In fact, it’s the most potent phytoestrogen found to date, fifty times more potent than the genistein in soy, “provid[ing] an obvious explanation for the menstrual disturbances in female hop workers in the past.” Today, we have machines to pick our hops, so our only exposure is likely via beer consumption, but the levels in beer were found to be so low that they shouldn’t cause any concern.

Then in 2001, a study on a hops-containing “dietary supplement for breast enhancement” raised the concern that another phytoestrogen in hops called isoxanthohumol might be biotransformed by our liver into the more potent 8-PN, which would greatly augment the estrogenic effect of hops. This study was conducted on mice, though. Thankfully, a study using human estrogen receptors found no such liver transformation, so all seemed fine…until 2005. “[T] he liver is not the only transformation site inside the human body.” The human colon contains trillions of microorganisms with enormous metabolic potential. It’s like a whole separate organ within our body, with a hundred livers’ worth of metabolizing power. So, let’s effectively mix some beer with some poop and see what happens.

Indeed, up to a 90 percent conversion was achieved. Up to then, “the concentration of 8-PN in beer was considered too low to affect human health. However, these results show that the activity of the intestinal microbial community could more than 10-fold increase the exposure concentration.” This can explain why you can detect 8-PN in the urine of beer-drinkers for days: Their gut bacteria keep churning it out. Obviously, the amount of straight 8-PN in beer is not the only source of estrogen effects given this conversion. So, a decade ago, the question remained: Might drinking too much beer cause estrogenic effects and feminize men? See my video What Are the Effects of the Hops Phytoestrogen in Beer? for the update.


Other videos on phytoestrogen include:

What about GMO soy? See GMO Soy and Breast Cancer.

For menstrual health videos, see:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations: