Overconsumption Of Sugar-sweetened Beverages Research Articles

The distributional implications of health taxes: A case study on the Italian sugar tax

As over-consumption of sugar-sweetened beverages (SSBs) is considered a major contributor to the rising prevalence of obesity and associated diseases, public authorities from different countries are considering the introduction of SSBs taxation. In this study, we evaluate the potential impact of the upcoming Italian sugar tax on SSBs and sugar consumption, also accounting for differences across socio-economic groups. We also analyze alternative SSBs tax designs (i.e., excise tax on sugar and two-tier tax based on sugar content) to compare their effectiveness and provide a more general analysis about the outcomes of SSBs taxation. In our empirical analysis, we first estimate consumers’ demand for SSBs using the random coefficient logit demand model (Berry, Levinsohn, and Pakes, 1995) and Nielsen Household Panel data of SSBs purchases for the period 2019–2020. Then, the estimated demand parameters and marginal costs for SSBs are employed to conduct counterfactual simulations to derive the new market equilibria under the simulated SSBs tax scheme scenarios. Our results show that the Italian sugar tax is the most effective in reducing SSBs and sugar consumption (on average, by 18% and 24% respectively) among all the simulated tax scenarios. This is also due to the strategic reactions of SSBs manufacturers who over-shift the change in marginal cost (i.e., tax rate) to final prices. Moreover, despite being financially regressive, taxes on SSBs may be progressive from a health perspective, as low-income groups experience the greatest fall in SSBs and sugar consumption. Reinvesting tax revenues in health-related programs targeting the most vulnerable socio-economic groups (i.e., low-income households with children) may minimize the regressivity of SSBs taxes.

Situating commercial determinants of health in their historical context: a qualitative study of sugar-sweetened beverages in Jamaica

BackgroundNon-communicable diseases (NCDs) are the leading cause of mortality across the Caribbean and similar regions. Structural determinants include a marked increase in the dependency on food imports, and the proliferation of processed foods, including sugar-sweetened beverages (SSBs). We focused on Jamaica as a case study and the health challenge of SSBs, and situated contemporary actions, experiences and policies within their historical context to investigate underlying drivers of commercial determinants of health and attempts to counter them. We asked: how can a historical perspective of the drivers of high level SSB consumption in Jamaica contribute to an enhanced understanding of the context of public health policies aimed at reducing their intake?MethodsAn ethnographic approach with remote data collection included online semi-structured interviews and workshops with 22 local experts and practitioners of health, agriculture and nutrition in Jamaica and attending relevant regional public webinars on SSBs and NCD action in the Caribbean. Our analysis was situated within a review of historical studies of Caribbean food economies with focus on the twentieth century. Jamaican and UK-based researchers collected and ethnographically analysed the data, and discussed findings with the wider transdisciplinary team.ResultsWe emphasise three key areas in which historical events have shaped contextual factors of SSB consumption. Trade privileged sugar as a cash crop over food production during Jamaica’s long colonial history, and trade deregulation since the 1980s through structural adjustment opened markets to transnational companies. These changes increased Jamaican receptiveness to the mass advertisement and marketing of these companies, whilst long-standing power imbalances hampered taxation and regulation in contemporary public health actions. Civil society efforts were important for promoting structural changes to curb overconsumption of SSBs and decentring such entrenched power relations.ConclusionThe contemporary challenge of SSBs in Jamaica is a poignant case study of commercial determinants of health and the important context of global market-driven economies and the involvement of private sector interests in public health policies and governance. Historically contextualising these determinants is paramount to making sense of the sugar ecology in Jamaica today and can help elucidate entrenched power dynamics and their key actors.

The impact of sugar tax on carbonated soft drinks in Nigeria

A sugar tax is a fiscal intervention levied on sugar-sweetened beverages (SSBs) to discourage consumption and improve population health. The over-consumption of SSBs is linked with the prevalence of obesity and diet-related non-communicable diseases (NCDs). Nigeria in the year 2022 introduces a 10 naira per litre excise tax on all non-alcoholic SSBs. This study assessed the impact of a sugar tax on the consumption of carbonated soft drinks in Nigeria. The study explored a mathematical model to estimate the effect of the sugar tax on the consumption of SSBs, three tax scenarios were assessed using Monte-Carlo Simulation. Historical consumption data from the 2018/2019 Nigeria Living Standard Survey was utilised. The outcome of the tax simulation revealed that a 10-naira excise tax on soft drinks is predicted to have a small effect on the price and quantity demanded of SSBs. The overall reduction in quantity demanded of SSB could be negligible if the tax rate does not increase the price by at least 20%. A 50-naira excise tax on soft drinks is anticipated to comply with the World Health Organization's recommendation, which calls for an increase in retail prices by at least 20%.

Impact of dietary sucralose and sucrose-sweetened water intake on lipid and glucose metabolism in male mice.

Overconsumption of sugar-sweetened beverages (SSBs) is associated with an increased risk of metabolic disorders, including obesity and diabetes. However, accumulating evidence also suggests the potential negative impact of consuming nonnutritive sweeteners (NNSs) on weight and glycaemic control. The metabolic effects of sucralose, the most widely used NNS, remain controversial. This study aimed to compare the impact of intake of dietary sucralose (acceptable daily intake dose, ADI dose) and sucrose-sweetened water (at the same sweetness level) on lipid and glucose metabolism in male mice. Sucralose (0.1mg/mL) or sucrose (60mg/mL) was added to the drinking water of 8-week-old male C57BL/6 mice for 16weeks, followed by oral glucose and intraperitoneal insulin tolerance tests, and measurements of bone mineral density, plasma lipids, and hormones. After the mice were sacrificed, the duodenum and ileum were used for examination of sweet taste receptors (STRs) and glucose transporters. A significant increase in fat mass was observed in the sucrose group of mice after 16weeks of sweetened water drinking. Sucrose consumption also led to increased levels of plasma LDL, insulin, lipid deposition in the liver, and increased glucose intolerance in mice. Compared with the sucrose group, mice consuming sucralose showed much lower fat accumulation, hyperlipidaemia, liver steatosis, and glucose intolerance. In addition, the daily dose of sucralose only had a moderate effect on T1R2/3 in the intestine, without affecting glucose transporters and plasma insulin levels. Compared with mice consuming sucrose-sweetened water, daily drinking of sucralose within the ADI dose had a much lower impact on glucose and lipid homeostasis.

Barriers to, and facilitators of, the adoption of a sugar sweetened beverage tax to prevent non-communicable diseases in Uganda: a policy landscape analysis

ABSTRACT Background Uganda is experiencing an increase in nutrition-related non-communicable diseases. Risk factors include overconsumption of sugar-sweetened beverages. Fiscal and taxation policies aim to make the consumption of healthier foods easier. However, the adoption and implementation of fiscal policies by countries are constrained by political and economic challenges. Objective We investigated the policy and political landscape related to the prevention of nutrition-related non-communicable diseases in Uganda to identify barriers to and facilitators of the adoption of sugar-sweetened beverage taxation in Uganda. Methods A desk-based policy analysis of policies related to nutrition-related non-communicable diseases and sugar-sweetened beverage taxation was conducted. Four key informant consultations (n = 4) were conducted to verify the policy review and to gain further insight into the policy and stakeholder contexts. Analysis was framed by Kingdon’s theory of agenda setting and policy change. Results Nutrition-related non-communicable diseases were recognised as an emerging problem in Uganda. The Government has adopted a comprehensive approach to improve diets, but implementation is slow. There is limited recognition of the consumption of sugar and sugar-sweetened beverages as a contributor to the nutrition-related non-communicable disease burden in policy documents. Existing taxes on soft drinks are lower than the World Health Organization’s recommended rate of 20% and do not target sugar content. The soft drink industry has been influential in framing the taxation debate, and the Ministry of Finance previously reduced taxation of sugar-sweetened beverages. Maintaining competitiveness in a regional market is an important business strategy. However, the Ministry of Health and other public health actors in civil society have been successful (albeit marginally) in countering reductions in taxation, which are supported by industry. Conclusions An established platform for sugar-sweetened beverage taxation advocacy exists in Uganda. Compelling local research that explicitly links soft drink taxes to health goals is essential to advance sugar-sweetened beverage taxation.

Are Sugar-Sweetened Beverage Taxes Effective? Reviewing the Evidence Through a Marketing Systems Lens

The overconsumption of sugar-sweetened beverages (SSBs) is associated with noncommunicable diseases such as obesity, type 2 diabetes, and cancer. Voluntary industry codes have largely failed to curb the overconsumption of sugar, and governments globally are increasingly willing to impose taxes on SSBs. However, the effectiveness of SSB taxation varies significantly. Drawing on a systematic review of the most recent literature (N = 79), the authors find that heterogeneity in outcomes is likely to result from idiosyncratic conditions within marketing systems. Building on marketing systems theory, they identify and critically evaluate (omitted) factors within the marketing environment that have an impact on the effectiveness of SSB taxation. Findings reveal that most studies to date focus on demand-side issues, often omitting supply-side responses such as reformulation or pass-through rates. Furthermore, studies largely disregard evidence from marketing and behavioral sciences, which show that taxation works through psychological mechanisms other than price. Finally, the authors find that few studies have systematically evaluated the complementary effects of SSB taxation and other health-promoting policies. By highlighting these blind spots in the current SSB taxation knowledge, the authors provide fruitful avenues for future research at the nexus of marketing and public policy.

Targeting Overconsumption of Sugar-Sweetened Beverages vs. Overall Poor Diet Quality for Cardiometabolic Diseases Risk Prevention: Place Your Bets!

Chronic overconsumption of sugar-sweetened beverages (SSBs) is amongst the dietary factors most consistently found to be associated with obesity, type 2 diabetes (T2D) and cardiovascular disease (CVD) risk in large epidemiological studies. Intervention studies have shown that SSB overconsumption increases intra-abdominal obesity and ectopic lipid deposition in the liver, and also exacerbates cardiometabolic risk. Similar to the prevalence of obesity and T2D, national surveys of food consumption have shown that chronic overconsumption of SSBs is skyrocketing in many parts of the world, yet with marked heterogeneity across countries. SSB overconsumption is also particularly worrisome among children and adolescents. Although the relationships between SSB overconsumption and obesity, T2D, and CVD are rather consistent in epidemiological studies, it has also been shown that SSB overconsumption is part of an overall poor dietary pattern and is particularly prevalent among subgroups of the population with low socioeconomic status, thereby questioning the major focus on SSBs to target/prevent cardiometabolic diseases. Public health initiatives aimed specifically at decreasing SSB overconsumption will most likely be successful in influencing SSB consumption per se. However, comprehensive strategies targeting poor dietary patterns and aiming at improving global dietary quality are likely to have much more impact in addressing the unprecedented public health challenges that we are currently facing.

Long-term consumption of sugar-sweetened beverage during the growth period promotes social aggression in adult mice with proinflammatory responses in the brain

Overconsumption of sugar-sweetened beverages (SSBs) is known to be a key contributor to the obesity epidemic; however, its effects on behavioral changes are yet to be fully studied. In the present study, we examined the long-term effects of SSB on social aggression in mice. Three-week-old weaned mice started to drink either a 30 w/v% sucrose solution (S30), plain water (CT), or an aspartame solution with sweetness equivalent to the sucrose solution (A30) and continued to drink until they were 11-week-old adults. Aggressive behaviors were assessed by the resident-intruder test. We found that SSB significantly promoted social aggression, accompanied by heightened serum corticosterone and reduced body weight. To understand the underlying mechanism, we performed transcriptome analyses of brain. The profiles of mice on S30 were dramatically different from those on CT or A30. Transcriptional networks related to immunological function were significantly dysregulated by SSB. FACS analysis of mice on S30 revealed increased numbers of inflammatory cells in peripheral blood. Interestingly, the artificial sweetener failed to mimic the effects of sugar on social aggression and inflammatory responses. These results demonstrate that SSB promotes aggressive behaviors and provide evidence that sugar reduction strategies may be useful in efforts to prevent social aggression.

Evaluation of healthy and sensory indexes of sweetened beverages using an electronic tongue

Overconsumption of sugar-sweetened beverages may increase the risk of health problems and so, the evaluation of their glycemic load and fructose-intolerance level is essential since it may allow establishing possible relations between physiologic effects of sugar-rich beverages and health. In this work, an electronic tongue was used to accurately classify beverages according to glycemic load (low, medium or high load) as well to their adequacy for people suffering from fructose malabsorption syndrome (tolerable or not): 100% of correct classifications (leave-one-out cross-validation) using linear discriminant models based on potentiomentric signals selected by a meta-heuristic simulated annealing algorithm. These results may be partially explained by the electronic tongue’s capability to mimic the human sweetness perception and total acid flavor of beverages, which can be related with glycemic load and fructose-intolerance index. Finally, the E-tongue was also applied to quantify, accurately, healthy and sensory indexes using multiple linear regression models (leave-one-out cross-validation: Radj>0.99) in the following dynamic ranges: 4.7<glycemic load≤30; 0.4<fructose intolerance index≤1.5; 32<sweetness perception<155; 1.3<total acid flavor, gL−1<8.3; and, 5.8<well-balanced flavor≤74. So, the proposed electronic tongue could be used as a practical, fast, low-cost and green tool for beverage’s healthy and sensory evaluation.

Abstract MP42: Intakes of Sugar-Sweetened Beverages and Total Sugars are Associated with Higher Triglycerides in a Multi-Ethnic Sample of Children

Background: Intakes of sugar-sweetened beverages (SSB) and added sugars have been targeted in efforts to reduce childhood obesity and cardiovascular disease risk factors in children. Although evidence is sparse in children, overconsumption of SSB and added sugars has been linked to greater dyslipidemia in adults. Objectives: To examine the association between intakes of SSB, added sugars, and total sugars, with blood lipids in a multi-ethnic sample of children with prevalent obesity. Methods: In this cross-sectional study, we examined associations between intakes of SSB, added sugars, and total sugars with high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG) in a sample of 276 children aged 8-15 y (mean age 11.8 y; 39% white, 14% black, 16% Hispanic/Latino, 12% Asian, and 19% multi-racial/other) with prevalent overweight/obesity (45% with ≥85 th BMI percentile and 25% with ≥95 th ). Percentage of daily calories from SSB, as well as intakes of added sugars (tsp) and total sugars (g), were estimated using the 2004 Block Food Frequency Questionnaire for Children. HDL-C and TG were obtained from a fasting blood sample. Percentage of calories from SSB, added sugars, and energy-adjusted total sugars were dichotomized at their upper tertile cut-points, specifically, at 7%, 13 tsp, and 116 g, respectively, creating two intake categories for each dietary exposure. ANCOVA was used to analyze the data; covariates were age, sex, race/ethnicity, obesity, total calories, and intakes of saturated fat and dietary fiber. TG was log-transformed prior to analysis; low HDL-C was defined as ≤45 mg/dL and borderline/high TG, as ≥75 (aged ≤9 y) or ≥90 mg/dL (≥10 y). Results: Median daily intake of total sugars was 94.2 g, 47% of which was derived from added sugars (median: 9.9 tsp, range: 1-76 tsp). Only 12% of children followed the American Heart Association calorie-specific recommendations for intake of added sugars. Median contribution of SSB to total calories was 4.4% (range: 0 to 51%), and SSB calories contributed 36% (range: 0 to 100%) of calories from added sugars. Both low HDL-C and borderline/high TG were prevalent (26-27% overall) and were more common in children classified as obese (61% and 53%, respectively) than in those who were not obese (16% and 17%, respectively, P&lt;0.0001 for each); however, intakes of SSB, added sugars, and total sugars did not differ with obesity. In multivariate-adjusted models, higher TG was associated with high intakes of SSB (75.3 vs. 67.6 mg/dL, P=0.04) and total sugars (76.5 vs. 67.0 mg/dL, P=0.01), while the association with added sugars was not significant. There were no associations with HDL-C. Conclusions: Among children with prevalent obesity, higher intakes of SSB and total sugars were associated with higher TG concentrations, but not with lower HDL-C. Further research is needed on the health implications of lower SSB and sugar intakes in diverse samples.

Reducing Sugar-Sweetened Beverage Consumption: Evidence, Policies, and Economics

Sugar-sweetened beverages (SSBs) are the largest source of added sugar in the US diet and have contributed to the obesity and diabetes epidemics. This review article describes the health consequences of overconsumption of SSB over the past decades, and its potential implications on economic costs and population health. Policy-based strategies to discourage SSB consumption are discussed, with particular emphasis on their economic rationales. Though there is evidence of the need to curb SSB consumption at the population level, several important evidence gaps remain regarding potential unintended consequences, and the comparative and cost effectiveness of policy interventions.

Overconsumption of Sugar-Sweetened Beverages: A Powerful Marketing Unveiled, a Multi Level Range of Actions to Explore

Overconsumption of Sugar-Sweetened Beverages: A Powerful Marketing Unveiled, a Multi Level Range of Actions to Explore

Metabolic and behavioural effects of sucrose and fructose/glucose drinks in the rat

Overconsumption of sugar-sweetened beverages, in particular carbonated soft drinks, promotes the development of overweight and obesity and is associated with metabolic disturbances, including intrahepatic fat accumulation and metabolic syndrome. One theory proposes that drinks sweetened with high-fructose corn syrup are particularly detrimental to health, as they contain fructose in its 'free' monosaccharide form. This experiment tested whether consuming 'free' fructose had a greater impact on body weight and metabolic abnormalities than when consumed 'bound' within the disaccharide sucrose. Male Hooded Wistar rats were given free access for 56 days to 10% sucrose (Group Suc), 10%, 50/50 fructose/glucose (Group FrucGluc) or water control drinks (Group Control), plus chow. Caloric intake and body weights were measured throughout the protocol, and the following metabolic indices were determined between days 54 and 56: serum triglycerides, liver triglycerides, retroperitoneal fat and oral glucose tolerance. Animals with access to sugar beverages consumed 20% more calories, but did not show greater weight gain than controls. Nevertheless, they developed larger abdominal fat pads, higher triglyceride levels and exhibited impaired insulin/glucose homeostasis. Comparison of the two sugars revealed increased fasting glycaemia in the FrucGluc group, but not in Suc group, whereas the Suc group was more active in an open field. A metabolic profile indicating increased risk of diabetes mellitus and cardiovascular disease was observed in animals given access to sugar-sweetened beverages. Notably, 'free' fructose disrupted glucose homeostasis more than did 'bound' fructose, thus posing a greater risk of progression to type 2 diabetes.