Projected impact of the Portuguese sugar-sweetened beverage tax on obesity incidence across different age groups: A modelling study.



Goiana-da-Silva, Francisco, Severo, Milton, Cruz E Silva, David, Gregório, Maria João, Allen, Luke N, Muc, Magdalena, Morais Nunes, Alexandre, Torres, Duarte, Miraldo, Marisa, Ashrafian, Hutan
et al (show 6 more authors) (2020) Projected impact of the Portuguese sugar-sweetened beverage tax on obesity incidence across different age groups: A modelling study. PLoS medicine, 17 (3). e1003036-.

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Abstract

BACKGROUND:Excessive consumption of sugar has a well-established link with obesity. Preliminary results show that a tax levied on sugar-sweetened beverages (SSBs) by the Portuguese government in 2017 led to a drop in sales and reformulation of these products. This study models the impact the market changes triggered by the tax levied on SSBs had on obesity incidence across various age groups in Portugal. METHODS AND FINDINGS:We performed a national market analysis and population-wide modelling study using market data for the years 2014-2018 from the Portuguese Association of Non-Alcoholic Drinks (GlobalData and Nielsen Consumer Panel), dietary data from a national survey (IAN-AF 2015-2016), and obesity incidence data from several cohort studies. Dietary energy density from SSBs was calculated by dividing the energy content (kcal/gram) of all SSBs by the total food consumption (in grams). We used the potential impact fraction (PIF) equation to model the projected impact of the tax-triggered change in sugar consumption on obesity incidence, through both volume reduction and reformulation. Results showed a reduction of 6.6 million litres of SSBs sold per year. Product reformulation led to a decrease in the average energy density of SSBs by 3.1 kcal/100 ml. This is estimated to have prevented around 40-78 cases of obesity per year between 2016 and 2018, with the biggest projected impact observed in adolescents 10 to <18 years old. The model shows that the implementation of this tax allowed for a 4 to 8 times larger projected impact against obesity than would be achieved though reformulation alone. The main limitation of this study is that the model we used includes data from various sources, which can result in biases-despite our efforts to mitigate them-related to the methodological differences between these sources. CONCLUSIONS:The tax triggered both a reduction in demand and product reformulation. These, together, can reduce obesity levels among frequent consumers of SSBs. Such taxation is an effective population-wide intervention. Reformulation alone, without the decrease in sales, would have had a far smaller effect on obesity incidence in the Portuguese population.

Item Type: Article
Uncontrolled Keywords: Humans, Incidence, Risk Factors, Age Distribution, Energy Intake, Nutritive Value, Models, Theoretical, Time Factors, Commerce, Adolescent, Adult, Aged, Aged, 80 and over, Middle Aged, Child, Child, Preschool, Infant, Infant, Newborn, Taxes, Portugal, Young Adult, Pediatric Obesity, Consumer Behavior, Protective Factors, Sugar-Sweetened Beverages
Depositing User: Symplectic Admin
Date Deposited: 27 Aug 2020 10:39
Last Modified: 18 Jan 2023 23:36
DOI: 10.1371/journal.pmed.1003036
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3098953