Sugar-sweetened beverage taxes may prevent CVD, diabetes
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All sugar-sweetened beverage tax designs, including volume, tiered and absolute sugar content taxes, have potential to generate substantial health gains with regard to CVD and diabetes in addition to cost savings, a study found.
“Our investigation builds upon and greatly extends prior studies by evaluating and comparing the health and economic benefits of volume, tiered and absolute sugar content sugar-sweetened beverage taxes in the United States,” Yujin Lee, PhD, postdoctoral fellow of the Friedman School of Nutrition Science and Policy at Tufts University, told Healio. “All three sugar-sweetened beverage taxes would generate substantial economic and health benefits. Health gains and savings would be approximately doubled for the tiered and absolute sugar content taxes compared to the volume tax.”
Simulating tax benefits
In this microsimulation study published in Circulation, Lee and colleagues used the CVD-PREDICT model to develop baseline cardiometabolic risk factors, sociodemographics and lifestyle habits using data from the 2009-2014 National Health and Nutrition Examination Survey. Sugar-sweetened beverage intake and added sugar contents were obtained from two 24-hour dietary recalls per participant.
Three sugar-sweetened beverage national excise tax scenarios were models, which were based on tiers, volume and absolute sugar content. These were then assessed for estimated incremental changes in CVD and diabetes, in addition to quality-adjusted life-years, cost-effectiveness and costs.
Participants in this study were aged 35 to 80 years (mean age, 55 years), 53% of whom were women, 72% were white adults and 29% were low income.
Throughout a lifetime, the generated tax revenue would be $142 billion for tiered taxes, $80.4 billion for volume taxes and $41.7 billion for absolute sugar content taxes.
During a mean simulated follow-up of 28.7 years, the volume tax would prevent 269,000 cases of diabetes (95% CI, 265,000-274,000) and 850,000 cases of CVD (95% CI, 836,000-864,000). In addition, it would save $53.2 billion in net costs (95% CI, 52.3-54.1) and gain 2.44 million QALYs (95% CI, 2.4-2.48).
Savings and gains were nearly doubled for the absolute sugar content and tiered taxes. Absolute sugar content tax would prevent 1,852,000 total CVD events (95% CI, 1,831,000-1,874,000) and 555,000 cases of diabetes (95% CI, 544,000-557,000), in addition to saving $105 billion in net costs (95% CI, 103-106) and gaining 5.02 million QALYs (95% CI, 4.96-5.09). A tiered tax would prevent 1,673,000 total CVD events (95% CI, 1,650,000-1,696,000) and 531,000 cases of diabetes (95% CI, 524,000-539,000). This tax would also save $105 billion in net costs (95% CI, 103-106) and save 4.85 million QALYs (95% CI, 4.78-4.92).
Greatest gains from tax
Gains per million individuals were greatest in black and Hispanic individuals, younger adults and lower-income Americans. The volume tax could prevent 7,486 CVD events per 1 million black adults compared with 4,568 CVD events per 1 million white adults.
“We did not estimate improved health outcomes or cost savings from reductions in other diseases that may be influenced by reduction in sugar-sweetened beverages (eg, dental [cavities], other obesity-related conditions, gallstones), which can be assessed in future studies,” Lee said in an interview.
For more information:
Yujin Lee, PhD, can be reached at yujin.lee2@tufts.edu.
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