Abstract
Study questionWhat effect on body mass index, obesity and diabetes can we expect from the 1-peso-per-litre tax to sugar sweetened beverages in Mexico?MethodsUsing recently published estimates of the reductions in beverage purchases due to the tax, we modelled its expected long-term impacts on body mass index (BMI), obesity and diabetes. Microsimulations based on a nationally representative dataset were used to estimate the impact of the tax on BMI and obesity. A Markov population model, built upon an age-period-cohort model of diabetes incidence, was used to estimate the impact on diagnosed diabetes in Mexico. To analyse the potential of tax increases we also modelled a 2-peso-per-litre tax scenario.Study answer and limitationsTen years after the implementation of the tax, we expect an average reduction of 0.15 kg/m2 per person, which translates into a 2.54% reduction in obesity prevalence. People in the lowest level of socioeconomic status and those between 20 and 35 years of age showed the largest reductions in BMI and overweight and obesity prevalence. Simulations show that by 2030, under the current implementation of 1-peso-per-litre, the tax would prevent 86 to 134 thousand cases of diabetes. Overall, the 2-peso-per-litre scenario is expected to produce twice as much of a reduction. These estimates assume the tax effect on consumption remains stable over time. Sensitivity analyses were conducted to assess the robustness of findings; similar results were obtained with various parameter assumptions and alternative modelling approaches.What this study addsThe sugar-sweetened beverages tax in Mexico is expected to produce sizable and sustained reductions in obesity and diabetes. Increasing the tax could produce larger benefits. While encouraging, estimates will need to be updated once data on direct changes in consumption becomes available.
Highlights
Changes in dietary patterns and physical activity have led to a historical increase in body weight and metabolic diseases
Excess body weight is linked to major chronic diseases such as diabetes, cardiovascular disease, and cancer.[2]
Obesity prevalence was higher among individuals in the third (36.43%) and fourth (36.94%) quartiles
Summary
Changes in dietary patterns and physical activity have led to a historical increase in body weight and metabolic diseases. The proportion of adults with a body mass index (BMI) of 25 kg/m2 or higher increased between 1980 and 2013 from 28.8% to 36.9% in men, and from 29.8% to 38.0% in women.[1] Excess body weight is linked to major chronic diseases such as diabetes, cardiovascular disease, and cancer.[2] Currently, achieving population weight reduction is considered the single most important public health goal after tobacco control.[3]. [5] High fasting plasma glucose, excessive BMI, and dietary risks account for more than 30% of disability-adjusted life years and over 50% of the deaths in the country.[6] In 2008 the total cost of obesity-related diseases (type 2 diabetes, cardiovascular disease, breast cancer and osteoarthritis) was 4 billion USD per year.[7] Considering the large toll of excess weight and diabetes, calls to implement nationwide efforts to reduce obesity and diabetes in the country have been made.[7,8]
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