Sugar-sweetened beverage tax could reduce obesity and type 2 diabetes in India

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Sugar-sweetened beverage tax could reduce obesity and type 2 diabetes in India A sugar-sweetened beverage (SSB) tax could help mitigate the rise in obesity and type 2 diabetes rates in India among both urban and rural populations, according to a study published this week in PLOS Medicine. Sanjay Basu and colleagues, from Stanford University, USA, estimated that a 20% SSB tax across India could avert 11.2 million cases of overweight/obesity and 400,000 cases of type 2 diabetes between 2014 and 2023, based on the current rate of increases in SSB sales. If SSB sales were to increase more steeply than the current rate, as predicted by drinks industry marketing models, the researchers estimate that the tax would avert 15.8 million cases of overweight/obesity and 600,000 cases of diabetes.

The researchers combined data on how price changes affect the demand for SSBs with historical data on SSB sales trends, BMIs, and new cases of diabetes, to estimate the effect that a 20% SSB tax would have on energy consumption, the prevalence of overweight/obesity, and the number of new cases (incidence) of diabetes among Indian subpopulations. The researchers observed that the largest relative effect of the SSB tax was likely to be among young men in rural areas.

Like all studies that use mathematical models to calculate outcomes, the numbers here are only estimates and dependent on the underlying assumptions (for example, that future consumer behaviour will reflect historical data) and the validity of the input data (for example, that consumers report SSB consumption accurately).

Nonetheless, acknowledging that the numbers are not exact predictions, the authors conclude that "Sustained SSB taxation at a high tax rate could mitigate rising obesity and type 2 diabetes in India among both urban and rural subpopulations."

They continue: "Future research should replicate the findings observed here in other rapidly developing middle-income countries where SSB consumption is increasing at a rapid rate."

In a linked Perspective, Tony Blakely and colleagues discuss the real-world implications of this type of mathematical modeling study.

### Research Article

Funding: Funded by the National Institute on Aging (P30 AG017253, SB), the International Development Research Center (SB, SV, DS, SE), Wellcome Trust (SE), and the Stanford University Department of Medicine (SB). DS is funded by an ERC investigator award 313590-HRES. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing Interests: BP spoke on hydration at a symposium sponsored by Danome Water at The Nutrition Society (British), assisted colleagues at the National Institute of Public Health in Mexico with a grant on SSBs vs. water funded by Danome Water, and was a coinvestigator on another RCT of water vs. diet beverages vs. SSB funded by Nestle´ . DS is a member of the Editorial Board of PLOS Medicine.

Citation: Basu S, Vellakkal S, Agrawal S, Stuckler D, Popkin B, et al. (2014) Averting Obesity and Type 2 Diabetes in India through Sugar-Sweetened Beverage Taxation: An Economic-Epidemiologic Modeling Study. PLoS Med 11(1): e1001582. doi:10.1371/journal.pmed.1001582

IN YOUR COVERAGE PLEASE USE THIS URL TO PROVIDE ACCESS TO THE FREELY AVAILABLE PAPER:

http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001582

Contact:

Sanjay Basu
Stanford University
UNITED STATES
basus@stanford.edu

Perspective Article

Funding: TB and NW are funded under the Burden of Disease Epidemiology, Equity and Cost Effectiveness Programme (BODE3), funded by the Health Research Council of New Zealand (10/248). BKB received funding for this work under SPEND: Strategic Pricing: Effects on Nutrition & Disease. This study is funded by the Health Research Council of New Zealand (10/077). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing Interests: The authors have declared that no competing interests exist.

Citation: Blakely T, Wilson N, Kaye-Blake B (2014) Taxes on Sugar-Sweetened Beverages to Curb Future Obesity and Diabetes Epidemics. PLoS Med 11(1): e1001583. doi:10.1371/journal.pmed.1001583

IN YOUR COVERAGE PLEASE USE THIS URL TO PROVIDE ACCESS TO THE FREELY AVAILABLE PAPER:

http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001583

Contact:

Tony Blakely
University of Otago
NEW ZEALAND
+ 64 21 918608
tony.blakely@otago.ac.nz