Abstract

Background/ObjectivesThe prevalence of obesity in South Africa has risen sharply, as has the consumption of sugar-sweetened beverages (SSBs). Research shows that consumption of SSBs leads to weight gain in both adults and children, and reducing SSBs will significantly impact the prevalence of obesity and its related diseases. We estimated the effect of a 20% tax on SSBs on the prevalence of and obesity among adults in South Africa.MethodsA mathematical simulation model was constructed to estimate the effect of a 20% SSB tax on the prevalence of obesity. We used consumption data from the 2012 SA National Health and Nutrition Examination Survey and a previous meta-analysis of studies on own- and cross-price elasticities of SSBs to estimate the shift in daily energy consumption expected of increased prices of SSBs, and energy balance equations to estimate shifts in body mass index. The population distribution of BMI by age and sex was modelled by fitting measured data from the SA National Income Dynamics Survey 2012 to the lognormal distribution and shifting the mean values. Uncertainty was assessed with Monte Carlo simulations.ResultsA 20% tax is predicted to reduce energy intake by about 36kJ per day (95% CI: 9-68kJ). Obesity is projected to reduce by 3.8% (95% CI: 0.6%–7.1%) in men and 2.4% (95% CI: 0.4%–4.4%) in women. The number of obese adults would decrease by over 220 000 (95% CI: 24 197–411 759).ConclusionsTaxing SSBs could impact the burden of obesity in South Africa particularly in young adults, as one component of a multi-faceted effort to prevent obesity.

Highlights

  • Overweight (25#BMI,30) and obesity (BMI$30) have reached epidemic proportions

  • The 2003 South Africa (SA) Demographic and Health Survey and the 2012 SA National Health and Nutrition Examination Survey (SANHANES-1) show that in less than a decade, obesity prevalence has increased from 8.8% to 10.6% in men and from 27.4% to 39.2% in women [4,5]

  • The association of obesity with hypertension and non-communicable diseases (NCDs) such as diabetes, stroke and cardiovascular disease (CVD) is well-established and the risk of these NCDs increases with increasing body mass [2,7,8]

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Summary

Introduction

Overweight (25#BMI,30) and obesity (BMI$30) have reached epidemic proportions. The 2003 SA Demographic and Health Survey and the 2012 SA National Health and Nutrition Examination Survey (SANHANES-1) show that in less than a decade, obesity prevalence has increased from 8.8% to 10.6% in men and from 27.4% to 39.2% in women [4,5]. The 2013 Global Burden of Disease (GBoD) Study reports that the prevalence increased to 13.5% and 42.0% for men and women respectively in 2013 [6]. The 2010 GBoD Study shows a substantial shift in the burden of disease from communicable disease to NCDs. In 1990, 47% of DALYs worldwide were from communicable, maternal, neonatal, and nutritional disorders, 43% from NCDs, and 10% from injuries. Analysis of the GBoD data for South Africa shows that in 2010 29.2% of all DALYs were attributable to NCDs

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