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Projected impact of the Portuguese sugar-sweetened beverage tax on obesity incidence across different age groups: A modelling study

2020-03-12Journal article Open access
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dc.contributor.authorGoiana-da-Silva, Francisco
dc.contributor.authorSevero, Milton
dc.contributor.authorCruz e Silva, David
dc.contributor.authorGregório, Maria João
dc.contributor.authorAllen, Luke N.
dc.contributor.authorMuc, Magdalena
dc.contributor.authorMorais Nunes, Alexandre
dc.contributor.authorTorres, Duarte
dc.contributor.authorMiraldo, Marisa
dc.contributor.authorAshrafian, Hutan
dc.contributor.authorRito, Ana
dc.contributor.authorWickramasinghe, Kremlin
dc.contributor.authorBreda, João
dc.contributor.authorDarzi, Ara
dc.contributor.authorAraújo, Fernando
dc.contributor.authorLopes, Carla
dc.date.accessioned2021-03-15T15:28:32Z
dc.date.available2021-03-15T15:28:32Z
dc.date.issued2020-03-12
dc.descriptionComparative Studypt_PT
dc.description.abstractBackground: Excessive consumption of sugar has a well-established link with obesity. Preliminary results show that a tax levied on sugar-sweetened beverages (SSBs) by the Portuguese government in 2017 led to a drop in sales and reformulation of these products. This study models the impact the market changes triggered by the tax levied on SSBs had on obesity incidence across various age groups in Portugal. Methods and findings: We performed a national market analysis and population-wide modelling study using market data for the years 2014-2018 from the Portuguese Association of Non-Alcoholic Drinks (GlobalData and Nielsen Consumer Panel), dietary data from a national survey (IAN-AF 2015-2016), and obesity incidence data from several cohort studies. Dietary energy density from SSBs was calculated by dividing the energy content (kcal/gram) of all SSBs by the total food consumption (in grams). We used the potential impact fraction (PIF) equation to model the projected impact of the tax-triggered change in sugar consumption on obesity incidence, through both volume reduction and reformulation. Results showed a reduction of 6.6 million litres of SSBs sold per year. Product reformulation led to a decrease in the average energy density of SSBs by 3.1 kcal/100 ml. This is estimated to have prevented around 40-78 cases of obesity per year between 2016 and 2018, with the biggest projected impact observed in adolescents 10 to <18 years old. The model shows that the implementation of this tax allowed for a 4 to 8 times larger projected impact against obesity than would be achieved though reformulation alone. The main limitation of this study is that the model we used includes data from various sources, which can result in biases-despite our efforts to mitigate them-related to the methodological differences between these sources. Conclusions: The tax triggered both a reduction in demand and product reformulation. These, together, can reduce obesity levels among frequent consumers of SSBs. Such taxation is an effective population-wide intervention. Reformulation alone, without the decrease in sales, would have had a far smaller effect on obesity incidence in the Portuguese population.pt_PT
dc.description.sponsorshipInfrastructure support for this research was provided by the NIHR Imperial Biomedical Research Centre (BRC).pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationPLoS Med. 2020 Mar 12;17(3):e1003036. doi: 10.1371/journal.pmed.1003036. eCollection 2020 Mar.pt_PT
dc.identifier.doi10.1371/journal.pmed.1003036pt_PT
dc.identifier.issn1549-1277
dc.identifier.urihttp://hdl.handle.net/10400.18/7494
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.relation.publisherversionhttps://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003036pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectAdolescentpt_PT
dc.subjectAdultpt_PT
dc.subjectAge Distributionpt_PT
dc.subjectAgedpt_PT
dc.subjectAged, 80 and overpt_PT
dc.subjectChildpt_PT
dc.subjectChild, Preschoolpt_PT
dc.subjectEnergy Intakept_PT
dc.subjectHumanspt_PT
dc.subjectIncidencept_PT
dc.subjectInfantpt_PT
dc.subjectInfant, Newbornpt_PT
dc.subjectMiddle Agedpt_PT
dc.subjectModels, Theoreticalpt_PT
dc.subjectNutritive Valuept_PT
dc.subjectPediatric Obesitypt_PT
dc.subjectPortugalpt_PT
dc.subjectProtective Factorspt_PT
dc.subjectRisk Factorspt_PT
dc.subjectSugar-Sweetened Beveragespt_PT
dc.subjectTime Factorspt_PT
dc.subjectYoung Adultpt_PT
dc.subjectCommercept_PT
dc.subjectConsumer Behaviorpt_PT
dc.subjectTaxespt_PT
dc.subjectEstilos de Vida e Impacto na Saúdept_PT
dc.subjectPortugalpt_PT
dc.titleProjected impact of the Portuguese sugar-sweetened beverage tax on obesity incidence across different age groups: A modelling studypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue3pt_PT
oaire.citation.startPagee1003036pt_PT
oaire.citation.titlePLoS Medicinept_PT
oaire.citation.volume17pt_PT
rcaap.embargofctAcesso de acordo com política editorial da revista.pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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