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Using nutritional survey data to inform the design of sugar-sweetened beverage taxes in low-resource contexts: a cross-sectional analysis based on data from an adult Caribbean population

Published version
Peer-reviewed

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Abstract

Objective: Sugar-sweetened beverage (SSB) taxes have been implemented widely. We aimed to use a pre-existing nutritional survey data to inform SSB tax design by assessing: (1) baseline consumption of SSBs and SSB-derived free sugars, (2) the percentage of SSB-derived free sugars that would be covered by a tax and (3) the extent to which a tax would differentiate between high-sugar SSBs and low-sugar SSBs. We evaluated these three considerations using pre-existing nutritional survey data in a developing economy setting. Methods: We used data from a nationally representative cross-sectional survey in Barbados (2012–2013, prior to SSB tax implementation). Data were available on 334 adults (25–64 years) who completed two non-consecutive 24-hour dietary recalls. We estimated the prevalence of SSB consumption and its contribution to total energy intake, overall and stratified by taxable status. We assessed the percentage of SSB-derived free sugars subject to the tax and identified the consumption-weighted sugar concentration of SSBs, stratified by taxable status. Findings: Accounting for sampling probability, 88.8% of adults (95% CI 85.1 to 92.5) reported SSB consumption, with a geometric mean of 2.4 servings/day (±2 SD, 0.6, 9.2) among SSB consumers. Sixty percent (95% CI 54.6 to 65.4) of SSB-derived free sugars would be subject to the tax. The tax did not clearly differentiate between high-sugar beverages and low-sugar beverages. Conclusion: Given high SSB consumption, targeting SSBs was a sensible strategy in this setting. A substantial percentage of free sugars from SSBs were not covered by the tax, reducing possible health benefits. The considerations proposed here may help policymakers to design more effective SSB taxes.

Description

Funder: Robinson College, University of Cambridge


Funder: Medical Research Council; FundRef: http://dx.doi.org/10.13039/501100000265


Funder: British Heart Foundation; FundRef: http://dx.doi.org/10.13039/501100000274


Funder: UKCRC Public Health Research Centre of Excellence


Funder: Economic and Social Research Council; FundRef: http://dx.doi.org/10.13039/501100000269


Funder: Cancer Research UK; FundRef: http://dx.doi.org/10.13039/501100000289


Funder: Wellcome Trust; FundRef: http://dx.doi.org/10.13039/100004440


Funder: Yates Unilever Fund


Funder: The Ministry of Health of the Government of Barbados


Funder: National Institute for Health Research; FundRef: http://dx.doi.org/10.13039/501100000272


Funder: Gates Cambridge PhD Scholarship


Funder: Smuts Memorial Fund, University of Cambridge; FundRef: http://dx.doi.org/10.13039/501100000710


Funder: Global Food Security Fund


Funder: Luca D’Agliano Scholarship

Keywords

Public health, 1506, 1724, health policy, nutrition, epidemiology, public health

Journal Title

BMJ Open

Conference Name

Journal ISSN

2044-6055

Volume Title

10

Publisher

BMJ Publishing Group
Sponsorship
Medical Research Council Epidemiology Unit Core Support (MC_UU_12015/5)
US Center for Disease Control and Prevention (TEPHINET)
Canadian International Development Research Centre (107604-001)