Blitz Chess Chats #2 | Dr Michael Bonning | Should we tax sugar sweetened drinks? 🤔
#blitzchesschats #interview #fourknights
Welcome to the second entry of this new series, Blitz Chess Chats! Here, I speak to medical academics and researchers about their field of expertise and program of research… and we start the interview under the pressure test of a game of 5-minute blitz!
Come for the chess and stay for the interview! ♟️🤪👍
On the 1st of July 2025 in The Lounge, a rather lovely restaurant for staff, alumni, and their guests on level 11 of the University of New South Wales library (amazing views!), I spoke with Dr Michael Bonning, a Specialist General Practitioner (a “Family Physician” in North America and some other regions), and the AMA (Australian Medical Association) Chair of Public Health. Dr Bonning’s has championed, and advised government, on policy to better price the health impacts of sugar sweetened drinks. Oh, and the bishop is his favourite piece!
the Leningrad Staunton from Royal Chess Mall
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5-min blitz: Four Knights Opening: Italian Variation, 4… Nxe4
Full transcript of the interview
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The game
Dr Michael Bonning played with the white pieces, and I’d be first to admit that this wasn’t a high accuracy game, and it does get chaotic at times! As we joke in the video, it’s surprisingly difficult to think, speak, and play chess at the same time! 🤣
Michael led with the very correct Four Knights Italian, to which I responded with an immediate opening attack (1. e4 e5 2. Nf3 Nc6 3. Nc3 Nf6 4. Bc4 Nxe4) which is usually good for Black as we have what could seem like a devastating fork to a naïve player (5. Nxe4 d5). Michael had probably played this before as he quickly played the “book moves” (6. Bd3 dxe4 7. Bxe4).
Unfortunately for Michael, the strain of multitasking resulted in him hanging his dark square bishop on g5 on turn 10 (10. c4??), and things then unravelled further with a hung knight a few turns later (13. Nxg5?? Qxg5). An insight? As a beginner chess player, and when playing 3D chess after a history of 2D chess, mindfully check the diagonals! I hung pieces frequently on diagonals earlier in my chess journey as well!
On turn 15, I blundered a bishop back when I distractedly picked up my b4-knight when calculating candidate moves, when my brain had intended to move the h3-bishop. I felt obliged to honour the “touch-move rule”. As seen in the video, I almost immediately recognised and announced my mistake! 😭
And with hilarious alacrity, Michael quipped:
What is chess but a collected set of mistakes that we make! 🤣
Luckly, I was far enough ahead that it didn’t matter too much. Michael had started feeling the pressure of running out of time. After I played (18… Bd6) with the bishop sniping his h2-pawn, Michael was spooked and convinced himself that he had to “get some of [my] firepower off the board”; but he did so with a daring trade of his queen (19. Qxd6? cxd6), which he regretted immediately, “so, that wasn’t a great swap…”!
With a queen up and two passed pawns on the d-file, I used an easy tactical approach that was time economical to calculate and play; I pushed my d-pawn to force White to trade one, and then the second rook into a completely winning endgame. This worked and Michael ran out of time on turn 27. Good game, GG!
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Interview synopsis
Note: click on the links to go directly to the video at the timestamp. 👆
The interview with Dr Bonning started [10:44] with a broad overview of why sugar sweetened beverages (soft drinks, pop, soda, cola, fizzy drinks) are such a major health problem, and the AMA’s policy proposal of a levy/tax on these drinks, including a summary of the mechanism of effect of such an intervention. We discuss [15:50] the mechanisms at some depth including some of the international evidence: the impact of the price signal on consumer behaviour [17:03], and on drink manufacturers [17:48] in terms of reformulation.
Michael and I then shared a couple of salient clinical cases [20:02] where sugar sweetened beverages specifically were the cause of severe health problems and disease. Michael reflected on his experiences and insights [22:49] of the broader environmental challenges faced by residents living in a disadvantaged community. The discussion turned towards the alignment of biology [28:02] and commercial interests [29:15] that tends to drive the excess consumption of sugar.
We're fighting biology and unfortunately commercial interests have hijacked biology to make these drinks and food as well, so palatable that we just want to eat more and more of it. And that's hard to overcome. You have to create some other signals to… help do that.
— Dr Michael Bonning, 1 July 2025
Next, we spoke regarding a broader conceptual approach to the purpose and role of taxation and government [31:31] as well as the behaviour of government in terms of policy formation, implementation, and evaluation.
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Post-game interview transcript
Dr Michael Tam
Now one of the things I wanted to talk to you about, as the Chair of Public Health of the AMA, the Australian Medical Association; I think one of the policies that you've been working on or championing has been around sugar sweetened drinks. So, fizzy drinks, pop, a number of names of things like Coca Cola and Sprite and things like that. So, tell me a little bit about your thoughts about that and the policy approaches that we potentially could take as a society.
Dr Michael Bonning
So, sugar sweetened beverages; and really focusing on cola, soda, pop, you know, soft drink, whatever you want to call it; has really, no nutritional value. So, let's start there. It's sugar, that is, in excess in our diets. It’s what we call free sugar. The challenge with it also is that it is drunk at increasing and increasing quantities, and it contributes to millions and millions of kilos of extra sugar in Australian diets. Now, the challenge with that is what we've seen with increasing rates of type 2 diabetes and increasing obesity.
We know that there's a commercial back story to this. That food, and high calorie food and drinks are more accessible than they've ever been. Even though we live in difficult times with cost of living, these kinds of foods and drinks are highly palatable, are highly available, and they are actually quite cheap. Yeah, comparatively to buying, say, an equivalent like water or buying fresh fruit and vegetables. When you look at foods, they are driving many people to look at these high calorie but low nutritional value products. And because of that, we're seeing that spike in our problems with type 2 diabetes and obesity.
The first paper that we wrote internally at the AMA was in about 2017, regarding a tax or levy on sugar sweetened beverages. The idea was always that you can achieve two things through this kind of levy.
The first one is that you change people's purchasing habits by a levy of about 20 cents per 100 grams. You work out a way in which sugar ends up being priced more expensively than other things that don't contain sugar, or contain artificial sweeteners or, don't contain any of these things. Now, that sends a price signal and people are quite sensitive to price, especially those who are making these choices based on having cost of living pressures.
The second is that you cause what we call reformulation, which is to deal with that price pressure problem that people might experience. Companies reformulate their drinks to have less sugar in them, and that ultimately ends up, when we look at it at scale, with millions of kilos of sugar that is taken out of our diet, even if people continue to drink exactly the same way. Because, companies have been brought to a compromise on their recipe. And, people have been brought to a different set of thinking with the price pressure, and they're price conscious about these things.
So those two things are really the endpoints or the outcomes that you know you seek to achieve. And there are lots of countries where this is in place. They're also in some other countries, there are states, such as in the United States, where there are levies applied. But your really good examples are Mexico and the UK, both of whom have seen really significant changes in purchaser behaviour since they introduced their sugar tax. Mexico is one of the first in the mid-last decade, and the UK followed not that long after. Those two things have meant that you reduce that.
And you only focus, at least initially, on sugar sweetened beverages, like soft drink or soda, because they have no nutritional value. Lots of people will talk to me about, well, why not orange juice? Why not flavoured milk? Well, both of those have some nutritional value. They may still contain lots of sugar, but you've got to start somewhere in this kind of long-term approach to, better public health.
Dr Michael Tam
Yeah, it's really interesting… so naively, when people talk about a levy on sugar… So basically, it's a tax, it's a tax on sugar in sugary drinks that it sends a price signal, but it sends a price signal by increasing the price. And for people from a certain perspective, you could make the argument that the people who are suffering most from this are also people who tend to be less well off. And so, we're actually worsening their cost-of-living challenges.
But the second aspect that it leads to a change in industry, so really in the environment of manufactured foods. From your understanding of countries where they have introduced these, these sort of policies, these sort of laws, which has been the greater effect? The change in consumer behaviour in terms of sugary drinks just being more expensive, or the effect of industry making changes in their formulation?
Dr Michael Bonning
Overall, what you see as a starting point is that the tax revenue goes up a small amount because of this. So, there is an outcome where people are spending more to purchase these drinks. That actually tails off over time because people change what they're purchasing, because reformulation comes in. So, the price signal and that concern actually only lasts for maybe a couple of years, and what we predominantly then see is a change to the industry as a whole. Because, as soon as people start moving to a lower sugar version, or a no sugar version, they actually find that that's where they stay.
What we see from manufacturers… however you set a law or regulation, you will see manufacturers come in immediately under it. So, you set your sugar content at, you know, 20 grams per litre, they will come in at 19.9. And so, part of this is you start with a signal at a certain point, and then you may over time, consider advancing that signal to continually drop the sugar content of these drinks.
There will still always be a market for someone who says I have a soft drink very infrequently. I want it to taste like it tasted when I was a kid and those products still remain on the shelves. But they are a smaller and smaller proportion of the products that are sold. And therefore, only a small proportion of the products sold end up being subject to that.
And you know, changing of behaviours requires some kind of signal. We haven't succeeded as a society in changing behaviour by talking just about the fact that sugar and diabetes are a potential problem. And, where you work, we have some of the highest rates of diabetes in the country and we're at same where I work. The challenge with that is that if we're not getting through on those measures, we have to start thinking of other policy approaches that you know might help us help us get somewhere.
Overall, I agree with you, it's a hard policy approach, but we may have been a bit soft on policy approaches to this point. And, we know that for a short term, you know for a short-term pain we get a significant behavioural change. Essentially, if I ask someone in practice to do more exercise, I'm asking for some short-term pain to improve their cardiovascular fitness so that they can have a long-term period where they are healthier and their lives are better off. So, just because this one is monetary doesn't necessarily always mean it's bad for that reason.
Dr Michael Tam
Yeah… I was reflecting that it's a complicated. Food is a complicated thing because obviously it's deeply cultural. Food is not just about nutrition and getting energy, it's also about pleasure and socialisation. You know, I personally quite like Coca Cola, but I've got diabetes, so I try to avoid it now. Maybe there's a bit of an association there for me!
But you're absolutely right. Like you know, I work predominantly with a population living with severe mental illness. So, not just anxiety, depression, but psychosis and bipolar disorder. And probably in the last 12 months, I've had three patients referred to me where initially on the referral, the HbA1c; so that's a measure of how well diabetes is controlled, how bad really the sugar is; was absolutely out of this world. You know, 12-13%; so really, really bad and the person was very symptomatic with their diabetes. Where realistically, the only intervention I did for them was just to note to them that they drank an absolutely extraordinary amount of sugary drinks. Unfortunately for a few people, they’d actually gone to a bit of a sort of feedback cycle because the diabetes led them to pass a lot of urine, that's one of the symptoms of diabetes. So, they felt very thirsty and they would drink something to alleviate their thirst, but they would almost always drink more Coca Cola, or more Fanta, or more Sprite. And of course, that pushes up their glucose even higher, drives more polyuria (so more passing urine). So, it was this unvirtuous cycle!
And there was a lady I'm thinking of. I initially asked her to start some medication, but not at a very high dose. But she recognised, “okay, maybe the sugary drinks is a problem”, and she really did stop it all. Three months later, HbA1c dropped below 6%. I could barely believe it!
And it wasn't just one patient. In the last 12 months, I've had three people. A month ago, I was speaking to a young chap in his 20s, he'd put on 60 kg (132 lb) in the last two years. And I've calculated separate to his food; he was having around 2 kg (4.4 lb) of sugar per week just in the form of sugary drinks. For someone at that level of caloric intake from sugar, yeah probably cutting that out will actually in fact alleviate most of the reason why they continue to put on weight and why they’re feeling unwell.
Dr Michael Bonning
I still vividly remember, and it's now more than 10 years ago, an 8-year-old child who weighted 80 kg (200 lb) and coming to an understanding with his parents about this same problem. That there is just free or excess sugar in his diet through the former. And he’s eight; he doesn't go to the store on his own, he doesn't do the family shop. He’s within an environment where we can control these things.
Now, when we come out of that environment, so when we're an adult and what we can make our own choices, we do end up in a situation where one of the most useful signals is price. And, we can say price means quality. We can say price means you know price means… something that’s
being worked on. Or you know, if you're buying a car or if you're buying a house or something. But also, we can recognise that price in amongst food is very much a sign of what people will make choices on.
I always start with this. People aren't necessarily always rational when it comes to decision making, and that's fine because food isn't just calories in and what powers us to get through the day. It is cultural. We have things that we find more appetising. I'm already finding this out… I've got a fourteen-month-old son, and his likelihood of eating broccoli is lower than some of the other things that we might put in front of him! People do act in ways that may not always be in their best interest, and you and I can say that to people as doctors.
Sometimes we need different forms of the message. When I worked, in a community down your way down, in Airds, what we found was we often needed five or six different messages. We needed the healthy alternative. We talked about water, but in some places, we also had to work out that the water pipes needed to be fixed, or that access to water that tasted good wasn't necessarily easy. What we talked about is the very low-cost alternative, but it wasn't necessarily available to everyone.
That always has to be a bit of a starting point. Which is, we can say, “just drink water”, or “don't drink this”, but if this is the cheapest thing and the most available thing in your community, the gradient is that it drives you towards using it. I used to take the medical students that I taught around the local supermarkets in this community and I would show them that the soft drink aisle was an entire aisle, whereas the fresh food stand was maybe, the size of four of these tables. It was the commercial realities following the following community behaviour and informing a feedback loop as well. So that aisle was growing and would always had more products, and those products always sold, and they could stay on the shelf as long as they needed to because they lasted forever. And then, you had this section here that was very underutilised.
Part of what we had to then was to re-teach people how to how to think about fresh food, how to think about options that were better for them, even if those options were predominantly water or were beverages that might be fizzy drinks, but didn't necessarily have sugar in them. And just like in lots of areas, food science, and in this matter drink science, has come a long way in the last 10-15 years. We know that products formulated with no sugar are becoming more and more palatable to people, whereas original versions of soft drinks without sugar in them often had quite a hard metallic taste. And that's because of some of the original artificial sweeteners we used.
There's things going on that makes the transition easier, but there's also still commercial vested interest at the moment. Because exactly as you describe, that person, who… because they drank more drink, they pass more urine, and it creates this vicious cycle. That vicious cycle is making someone, a corporation, a lot of money. And that vicious cycle doesn't necessarily exist, or it doesn't exist as strongly, when drinks don't have significant amounts of sugar in them.
Dr Michael Tam
It is challenging, because I'm also so very mindful that for a lot of people, sweet drinks, it's just deeply pleasurable. It's enjoyable.
Dr Michael Bonning
Our bodies are hard-wired for it.
Dr Michael Tam
Wired for it. That's right. And they live a hard life and this is a simple pleasure. One could take a certain philosophical stance, “so who am I to, you know, stand in the way of someone's simple pleasures”, especially if they don't seem like they are having any obvious immediate harm. But as we know from an aggregate population perspective, there is in fact quite substantial harm.
Like as you mentioned, I think some of the newer of artificial sweeteners have made it easier. You know, I usually tell people water is best, but the reality is I think a lot of people do find if they are a heavy consumer of sweet drinks that moving to a no sugar formulation is definitely easier. Most people say that it's not the same. But it's adequate. And for some people, that's enough for them to make a transition.
Dr Michael Bonning
The same as we move people off smoking to nicotine replacement. They need something. And that something can be an artificially sweetened beverage. The other part is yes, in the individual case, one drink here, one drink there. But as you know, it started out that a sweet drink was a treat. Now, for many people it forms a staple in their diet. It's an everyday or multiple times a day event and that has been the change.
Talking about food science, we have made almost everything that is processed more palatable and in doing so, the technology behind it is often adding two things. It's, adding more sugar or it's making the otherwise tastier, so that we consume more. And that has become really problematic with our diets, including sugar sweetened beverages; all of this is on top of a caloric base, what we eat day-to-day, that is already well above probably what most of us need. And so as we live lives that often have less activity in them than generations prior to us and more calories, those two things always when they're out of alignment results in our bodies doing what anthropologically, or genetically and historically, our bodies were always trained to do. Which is when there is food around we layer up with fat, fat around our bodies, because our bodies are designed to prepare for the hard times.
Dr Michael Tam
To prepare for famines which we don’t have anymore in the Western world.
Dr Michael Bonning
Well, that's it. And there's just no environment where we have… We're fighting biology and unfortunately commercial interests have hijacked biology to make these drinks and food as well, so palatable that we just want to eat more and more of it. And that's hard to overcome. You have to create some other signals to, you know, help do that.
Dr Michael Tam
Yeah. Yeah. I think some time ago, I can't quite remember where I read it… it might have been from the Freakonomics people… talking about sin taxes. So, taxes on alcohol, tobacco excises, including potentially sugar. I can't remember if the article was specifically about sugar. And it was making an interesting economic argument that in a civil democracy we have to tax something. There is a role for government, despite what some people say! Minimally we need someone to enforce contracts, you know, and pay for policing and military and the like. There is some role for government, even if you're a libertarian.
Dr Michael Bonning
And maybe pay for the healthcare system!
Dr Michael Tam
That’s right!
Dr Michael Bonning
Which we both work in.
Dr Michael Tam
There is some role for government and that has to come from a collectivist approach to getting revenue. And, if you're going to have to tax something, then surely having a tax on behaviours that we as a democratic society that choose to say that we actually want less of this, is probably better than taxing things we actually want more of. So, this country, like many countries, a large proportion of our tax base is through income tax. We actually want people to work more for the most part, so if it means that we can broaden the tax base by taxing these other things, there's a side effect of potentially improving health outcomes and reducing harms from certain behaviours. That is still arguably less intrusive from the civil liberties perspective than just outright banning things, setting hard limits on corporations. You can make perhaps a qualified justification why this is actually potential better policies than other things.
Dr Michael Bonning
And so that's how I've certainly thought about it in formulating this over years with the AMA has been twofold. The first one is we shouldn't outright ban this. Unlike something like illicit drugs, it's very clear that in small doses this is a quite reasonable thing that someone could enjoy from time to time. We can make an argument that people can make their own choices, but that society shouldn't necessarily subsidise those choices. And I say subsidise those choices because of all the healthcare and other things that we have to do, if your diet happens to contain lots of sugar means that across the course of your life, you're going to see someone like me a lot more than maybe if you didn’t.
Now, that's not the whole story. Obviously, there's complex genetics and social environments, and you know all kinds of other things that play into it. But we can at least do that. We can at least help change some decision-making and on aggregate, even if it means that you just drink some less, then that's probably across the course of a lifetime and across the course of the society, that’s going to work out better for all of us.
The second part is that we have called this what we call a hypothecated tax. It means that for the revenue you raise through taxing sugar, you push that money back into subsidising the cost of healthier alternatives. And you can target that to communities where water is less accessible, you know, clean, water that's doesn't have bad taste to it. And you might put it into those communities where their bottled water or other services become cheaper. Or the second is that you make all fresh fruit, you know, fruit and vegetables cheaper so that people can spend more of their money on that. Or get more for their money. So, that we're pushing forward with better alternatives.
Dr Michael Bonning
And that's harder for government to because government doesn't like being told with hard limits about how they should spend their money. They like the freedom to operate…
Dr Michael Tam
Put it into general revenue, make decisions afterwards!
Dr Michael Bonning
Yeah, that's right! But you know, our approach has been that if we really want to use this to drive public health outcomes, and you can't just say, use a sin tax. You must also support better outcomes. When I worked in a community in southwest Sydney, we put money from many of our programs where people paid a small amount to attend something, into fruit and vegetable boxes. And we ran cooking classes. So those two things put together, we're trying to undo that cycle, that vicious cycle where people didn't have much access to fresh fruit and vegetables, but also because of that, they generationally had lost the art of cooking.
Dr Michael Tam
It can’t be all stick.
Dr Michael Bonning
It can’t be all stick; you've got to have some carrot to go with it. You've got to have a pathway forward that incentivises better behaviours. That was always how we've put forward this tax system would be to say this is a behaviour that has outsized cost to our society. So, you might think, “well, I'm the one who pays for the drink; you know, I pay my taxes”, but we spend huge amounts of money on treating diabetes and obesity in our community. So, we can put a tax upfront and then the second thing is that we should use that taxation revenue to fund better things that help alleviate those problems.
Dr Michael Tam
So, I like to think in policy making in government, maybe this is a vain hope, that decisions around policies are… based on purpose. You, know, “what are we trying to achieve?”. And I suppose we're not necessarily trying to achieve just a reduction in sugar consumption, but we actually want improved health for the population; that there's certain principles, we want to maintain civil liberties. But we actually do want a healthier community. And from a justice perspective, if you didn't know which exactly who you were going to be in the community, you would probably want to be healthier rather than having a significant risk of being potentially quite unhealthy but having more access to sugary drinks.
Dr Michael Bonning
That's it.
Dr Michael Tam
So, if we sort of focus on purpose of what we're trying to achieve… yeah, I think there are clearly risks of negative externalities when you introduce something like a tax. I think potentially we're seeing this in Australia with some of the tobacco excise possibly we're moving, we're getting some diminishing returns, I suspect in terms of counterfeit cigarettes and whatnot. Even though the policy is very effective. But yeah, we're having some policing issues now.
But, as long as we so focus on the purpose then, we've got something to aim for. Because, we have to ask yourself, is it actually meeting that purpose? And sometimes you don't know; you implement something that works great, but something weird happens and it doesn't work and you have to turn around.
Dr Michael Bonning
And that's something I'd like to see more of from government, which is to admit, even to themselves, when they're like, “this wasn't the best idea that we've ever had. We can own the fact that it was or wasn't a good idea”.
But good policy analysis, good evaluation of policy, which I think we don't see as much of here as we'd really like to and it is very hard politically to roll things back unless there's a change of government. Unless there's an ideological change in government. And then you can. But I'd like to see more of government… And I think that Australians would be very comfortable with that idea then say, “yeah, I make mistakes sometimes too”. It's nice to see when a government can own its faults. Because too often, I think they're worried about a focus on what's going to happen in the next election, “oh, you did this and then you pulled back from it”. As opposed to, we can try things knowing that democracy, government, everything else, it's an experiment. We're always in the idea that we're trying something to then work out, “well, what's the what's the effect?”.
And cigarette excise in Australia, which compared to overseas might double or triple the price of a packet of cigarettes, here has been very effective. However, we are now getting to the point where the undercurrent of cigarettes that come in from countries illegally with no excise, so they don't come through an Australian customs process to have an excise placed on them (you know, tax is essentially placed on them), are becoming so lucrative that they are now in a position where it's worthwhile for organised crime and others to bring them into the country. And you know, illicit tobacco now funds about $6.2 billion a year in the organised crime space.
Dr Michael Tam
Yeah. Is it that high, is it?
Dr Michael Bonning
Yeah. But against a whole industry of tobacco, which is, more than $100 billion, it's a very small part. But it's obviously growing compared to where it used to be. And so, thinking then about well, like anything else, what's the policy response going to be? Because do you say to federal police and customs and border protection that you should put importing illegal tobacco on the same level as importing methamphetamine or cocaine?
Well, that's a policy decision you got to make because that’s potentially being worth almost as much. You know it's worth billions of dollars. It funds all kinds of other illicit activity. Would it be easier to… would it be just as productive for police and border protection to go after cartons and cartons and cartons and, shipping containers of illegal cigarettes coming into the country.
It's very hard if you say… if you and I would just go and talk public policy and public health to a police officer or someone who works screening containers coming into the country and said it's just as bad overall that that these cigarettes are coming in versus…
Dr Michael Tam
The vibe is just wrong…
Dr Michael Bonning
Well, the vibe, and you’ve got to be able to work how that will work.
Dr Michael Tam
That the narrative has to make sense to individuals, even if in aggregate it makes sense.
Dr Michael Bonning
That's right. That's right. So, that I think remains the remains the challenge for all these kinds of public health challenges is how do you make the narrative work. Because, telling you can't or shouldn't have a sugary drink is actually easier once you've got diabetes. You can see the problem. Me trying to tell a 22-year-old who's just put on a little bit of weight and wants to know… well, that's a much harder personal narrative to square.
Dr Michael Tam
Thank you very much for all the game of chess and also the chat today it was very, very enlightening. Talking about some of these issues around policy approaches, rather than necessarily individual patient type approaches.
So, I want to give you something. So, as you might know, I wrote a book last year. This copy for you! I've written a message in it, and I signed it.
Dr Michael Bonning
Thank you very much.
Dr Michael Tam
Thank you and look best of luck. So, moving forward, I understand you looking at furthering your career in the policy space. I look forward to speaking to you again.
Dr Michael Bonning
Thank you very much, Michael, really appreciate it.
Dr Michael Tam
Good one. Thanks.
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