Taxing sugar-sweetened beverages as a policy to reduce overweight and obesity in countries of different income classifications: a systematic review

Abstract

Objective: To evaluate the potential impact of sugar-sweetened beverage (SSB) taxes on overweight and obesity prevalence in countries of different income classifications. Design: Systematic review following PRISMA guidelines (PROSPERO number CRD42020161612). Five databases (Cochrane Library, Embase, LILACS (via Virtual Health Library) and MEDLINE (via PubMed), and Web of Science were searched, from January 2009 up to December 2019. Articles that reported changes in purchases, sales, intake, body weight, BMI, overweight and/or obesity prevalence due to a tax on, or price change in SSBs were included. Setting: Studies conducted in countries of different income classifications. Participants: The search yielded 8,349 articles of which twenty-one met inclusion criteria. Results: Among the 16 studies selected, only 2 did not show that consumption, sales and purchase decreased as the price of SSBs increased. In 8 of the 13 studies selected, a positive effect of an SSB tax on decreasing overweight and obesity prevalence was expected. It is estimated that a 20% taxation on SSBs would result in a greater decrease in the prevalence of overweight and obesity compared to a 10% rate. Studies with no significant effect of taxing on sales, purchases, consumption and prevalence of obesity were from high-income countries, while significant effects of taxing on reducing purchase, consumption and/or obesity prevalence were found in studies from upper-middle and middle-income countries. Conclusion: A high SSB tax might be an effective fiscal policy to decrease purchase and consumption of SSBs and reduce overweight/obesity prevalence, especially if the tax were specific for beverage volume.

Using GRADE Evidence to Decision frameworks to support the process of health policy-making: an example application regarding taxation of sugar-sweetened beverages

“…in education, infrastructure), to be maximally effective in the reduction of poor health outcomes. 18 However, the evidence presented in this article suggests that a tax on SSBs may be an effective component in future public health policies.…”

“… 17 SSB taxation appears to be particularly effective in decreasing sales and consumptions, and the prevalence of overweight and obesity, when the tax is high, specific for beverage volume and applied to a broad definition of SSBs. 18 …”

The Potential Impact of Different Taxation Scenarios towards Sugar-Sweetened Beverages on Overweight and Obesity in Brazil: A Modeling Study

“…In India, an estimated reduction of 3% was found for overweight and obesity prevalence [ 18 ]. A recently published systematic review showed that taxation of SSBs had a positive effect on decreasing the prevalence of overweight and obesity in most studies, and that this impact was greater with higher taxation [ 23 ]. The same study showed that non-significant effects on sales, purchases, consumption, and obesity prevalence were observed in high-income countries, showing the differences in this impact between countries with different income classifications.…”

“…The adoption of fiscal policies based on the specific taxation of SSBs has been recommended by national and international health agencies, as they are measures that can potentially reduce consumption of this group of beverages. Evidence from modeling studies, systematic reviews, and meta-analyses conducted in the United Kingdom, Ireland, South Africa, Germany, Thailand, and Colombia, respectively, show that the taxation of these beverages may reduce their consumption, leading to a reduction in body weight [ 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ].…”

The Impact of Sugar-Sweetened Beverage Taxes by Household Income: A Multi-City Comparison of Nielsen Purchasing Data

“…Fiscal policies to reduce the consumption of SSBs have been recommended by the WHO since 2015; such policies have already been adopted by more than 50 countries and territories around the world [ 8 ]. Studies have shown these initiatives to be effective in doing so [ 9 , 10 , 11 , 12 ], and much evidence links improvement in diet quality in general [ 13 , 14 , 15 ], through shifting away from energy-dense foods toward nutrient-dense foods to reduce obesity and diabetes prevalence. Some studies examine actual purchasing data at the aggregate or household level, usually for one taxed location at a time, while many others take a simulation approach.…”