Palm oil taxes and cardiovascular disease mortality in India: economic-epidemiologic model
BMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f6048 (Published 22 October 2013) Cite this as: BMJ 2013;347:f6048
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Populations that consume palm oil and coconut oil generally have a low incidence of cardiovascular disease. Trials show that vegetable oils including olive oil cause cardiovascular disease. Heart disease in India has other causes such as the epigenetic effect of poor nutrition in pregnancy or the increasing consumption of sugar and carbohydrates.
Palm oil consumption should be encouraged, not taxed.
Reference:
The Palm Oil Miracle by Dr Bruce Fife
Competing interests: No competing interests
Sir
No doubt the rise in palm oil prices result in reduction of its consumption will reduce the CVS mortality and morbidity(1) . But in India there are many additional risk factors involved.
India is becoming a capital of infectious (tuberculosis, Dengue, Chikengunia, hepatitis, encephalitis, chicken pox, HIV), parasitic (malaria, filarial, tapeworm, echinococus granulosus) and non-infectious (Malnutrition, diabetes, hypertension, coronary heart diseases, mental illness) diseases. Government of India is attempting and trying its best to alleviate the above diseases, however, illiteracy, poverty and huge corruption at all levels arrest the improvement.
Though Gutekha is banned, still police collect tones of Gutekha in raids. Irrespective of ill effects such as cancer, hypertension, coronary heart disease, peripheral vascular disease, cynacobolamine deficiency and raised level of homocysteine due to consumption of tobacco (cigarette, Bidi Smoking, chewing tobacco), wide advertising in television and posters did not affect the total sale of these products.
Government is lethargic in banning tobacco products and alcohol because heavy taxation is one of its major sources of income. Irrespective of strict laws of food and drug administration, still saturated fat (Vegetable Ghee) is routinely used for preparation of sweets.
Because of heavy corruption still many lives are killed by consumption of illicit liquor (Khopadi).
Improvement of education status, strict laws and their practical applications, immediate punishment of corrupt officers and regular health camps and health education will improve the health status rather than providing free grains.
References
1- Basu S, Babiarz KS and Ebrahim S . Palm oil taxes and cardiovascular disease mortality in India: economic –enpidemiologic model. BMJ : 2013;347:f6048 (Published 22 October 2013)
2- Reddy SK, Perry CL , stigler MH and Arora M. differences in tobacco use among young people in urban India by sex , socioeconomic status , age and school grade: assessment of baseline survey data. Lancet 2006;367:589-94.
Conflict of interest NIL
Competing interests: No competing interests
Re: Palm oil taxes and cardiovascular disease mortality in India: economic-epidemiologic model
We read with interest the article by Basu. (1) and accompanying editorial by Shankar (2).
The role of saturated fat in coronary heart disease (CHD) is still unclear (3). Many older research articles failed to indicate whether the fat measured was trans-fat, natural saturated fat or processed saturated fat. Many older papers also failed to detail whether the cholesterol measured was the ‘good’ variety namely HDL or the ‘bad’ variety i.e. LDL/VLDL. Hence, basing an economic assumption on an uncertainty surely creates an uncertain conclusion.
Palm oil is around 50% saturated and in its crude form as red palm oil contains antioxidants as well as beta-carotene, tocotrienols, and tocopherols (4), all important contributors to a healthy diet. Red palm oil is the type used in cooking and seems to be the type of oil referred to in the first part of the article. Hydrogenated palm oil i.e. palm oil that has been refined, has detrimental effects on lipid profiles and general health. This is the type of palm oil found in baked/packaged goods and is included in these foods to prevent spoiling. Clearly it is this type of palm oil and not raw red palm that should be vilified.
If red palm oil was a major contributor to CHD deaths in India as a result of the rush of imports in the 1990s one would expect this to be accompanied by a rise in deaths from CHD during this period, when in fact the increase in deaths began well before this time period (5).
Rather than focusing economical modeling on spurious assumption, would it not be more appropriate to focus on more clear associations such as tobacco consumption (6), or would this represent too much of a political hot potato?
Hence I can agree with neither the article nor the editorial in their assumption and conclusions regarding palm oil. Unrefined red palm oil is arguably part of the economic non-drug solution to the CHD epidemic in developing nations.
1. Basu S, Babiarz KS, Ebrahim S, Vellakkal S, Stuckler D, Goldhaber-Fiebert JD. Palm oil taxes and cardiovascular disease mortality in India: economic-epidemiologic model. BMJ. 2013;347:f6048.
2. Shankar B, Hawkes C. India has a problem with palm oil. BMJ. 2013;347:f6065.
3. Knopp RH, Retzlaff BM. Saturated fat prevents coronary artery disease? An American paradox. Am J Clin Nutr. 2004;80:1102-1103.
4. Oguntibeju OO, Esterhuyse AJ, Truter EJ. Red palm oil: nutritional, physiological and therapeutic roles in improving human wellbeing and quality of life. Br J Biomed Sci. 2009;66:216-222.
5. Gupta R. Recent trends in coronary heart disease epidemiology in India. Indian Heart J. 2008;60:B4-18.
6. Reddy KS, Yusuf S. Emerging epidemic of cardiovascular disease in developing countries. Circulation. 1998;97:596-601.
Competing interests: No competing interests