Sugar Content in Sugar-Sweetened Beverages in the Aftermath of Thailand’s Sugar Tax: A Cross-Sectional Analysis

Abstract

Background: The high consumption of sugar-sweetened beverages (SSBs) has been linked to overweight and chronic disease. Since Thailand launched its sugar taxation policy, the sugar content of SSBs remains unknown. Objective: To assess product sugar content as g/100 mL and the number of products that meet the sugar tax criteria and to compare sugar content levels across various SSB categories. Materials and Methods: Between April and May 2020, a cross-sectional survey was conducted in Bangkok and five provinces in health region 2, which are Sukhothai, Phitsanulok, Phetchabun, Tak, and Uttaradit, using major supermarket retailers and local convenience stores. Data were collected from product packaging and nutrition information panels (NIP) of each SSB via photograph. Data were analyzed using descriptive statistics. The Kruskal-Wallis H test was used to compare sugar content across various SSB categories. Results: From 1,316 SSBs, the products without NIPs (n=79) were excluded, along with duplicate products in different packaging sizes (n=248). The remaining 989 items were included in the authors’ analyses. The median sugar content of all products was 7.5 (IQR 5.0 to 10.0) g/100 mL. The maximum sugar content was 24.0 g/100 mL in fermented milk and the minimum was 0.2 g/100 mL in herbal beverages. Flavored drinking yogurts had the highest median sugar content, at 11.7 (IQR 7.5 to 13.9) g/100 mL, while flavored water had the lowest median, at 4.5 (IQR 3.0 to 8.6) g/100 mL. There were statistically significant differences in sugar content between SSBs categories (p<0.001). Of all 989 products, 393 (39.7%) had a sugar content below 6 g/100 mL and were subjected to zero tax. Conclusion: Most of SSBs have low sugar content level with respect to excise sugar tax rate. However, the sugar content in drinkable dairy products and carbonated soft drink are of concern. Keywords: Sugar-sweetened beverages, Serving size, Sugar, Taxation