Sugar, Sugar

With increasing rates of obesity across the globe, governments are beginning to take more and more action to reduce the consumption of unhealthy dietary products. In 2014, Mexico took a step in this direction by implementing a 1 peso per liter tax on all sugar-sweetened beverages. Since then, researchers both for and against this kind of health policy have been performing studies in order to determine whether it truly has the intended effect of reducing the consumption of sugar-sweetened beverages.

One study published in Health Affairs claims to have reached such a conclusion. Using data from Nielsen’s Mexico Consumer Panel Services across four years, including two years before and two years after the tax was introduced, the study examined household purchases of sugar-sweetened beverages stratified by socioeconomic level and determined that there was a significant decrease in purchases across the board. The article not only demonstrated thorough and reasonable methods of data collection and analysis, but also that its results can likely be extrapolated to apply to other populations across the globe.

A study like this begs the question: how should other governments respond? While similar attempts have been made in the United States to deter sugar consumption through policy, they are typically met with heavy resistance and are unlikely to pass into law in certain jurisdictions. Despite having the most overweight population the world, the United States has historically struggled with any kind of policy in which people feel their decisions are being taken out of their hands.

Yet even without these laws in place, is it truly the people who make the decisions? With food distribution dominated by massive corporations that are left loosely regulated by the government, access to excessively sugary food continues to overpower other choices, and in some areas – such as food deserts – might even be the only option.

As physician-advocates, we are in relative positions of authority to educate policymakers on the necessity of reducing consumption of unhealthy foods to improve health outcomes and reduce overall health care expenses. As this study shows, taxing sugar-sweetened beverages may be just the right way to do it.

This Policy Prescriptions® review is written by Amit Narawane as part of our collaboration with the Health Policy Journal Club at Baylor College of Medicine. Mr. Narawane is a first year medical student.

Abstract

Mexico implemented a 1 peso per liter excise tax on sugar-sweetened beverages on January 1, 2014, and a previous study found a 6 percent reduction in purchases of taxed beverages in 2014. In this study we estimated changes in beverage purchases for 2014 and 2015. We used store purchase data for 6,645 households from January 2012 to December 2015. Changes in purchases of taxed and untaxed beverages in the study period were estimated using two models, which compared 2014 and 2015 purchases with predicted (counterfactual) purchases based on trends in 2012-13. Purchases of taxed beverages decreased 5.5 percent in 2014 and 9.7 percent in 2015, yielding an average reduction of 7.6 percent over the study period. Households at the lowest socioeconomic level had the largest decreases in purchases of taxed beverages in both years. Purchases of untaxed beverage increased 2.1 percent in the study period. Findings from Mexico may encourage other countries to use fiscal policies to reduce consumption of unhealthy beverages along with other interventions to reduce the burden of chronic disease.

PMID: 28228484

Colchero, MA, et al. Health Affairs. 2017;36 (3): 564-571.