Taxes on Sugar-Sweetened Beverages to Reduce Overweight and Obesity in Middle-Income Countries: A Systematic Review.
Taxes on Sugar-Sweetened Beverages to Reduce Overweight and Obesity in Middle-Income Countries: A Systematic Review.
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DOI：
10.1371/journal.pone.0163358
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Spranca M
中科院分区：
文献类型：
--
作者：
Nakhimovsky SS;Feigl AB;Avila C;O'Sullivan G;Macgregor-Skinner E;Spranca M
在中等收入国家，可能导致体重增加的含糖饮料（SSB）的消费量正在上升。对SSBs征税可能有助于应对这一挑战。以高收入国家为重点的系统审查表明，对SSB征税可能会减少SSB的消费。中等收入国家对价格变化的反应可能不同，这些国家的政府正在考虑征税。为了帮助他们的政策决定，本审查汇编了来自中等收入国家的证据，评估税后价格上涨（目标1），总体和按社会经济群体对SSB和其他产品的需求变化（目标2），以及对超重和肥胖流行率的影响（目标3）。我们对中等收入国家（1990-2016年）SSB征税的有效性进行了系统性审查，并确定了来自巴西、厄瓜多尔、印度、墨西哥、秘鲁和南非的9项研究。估计自有价格弹性在-0.6至-1.2之间，如果SSB价格上涨10%，SSB消费量的减少在每人每天5至39千焦之间。该综述发现，牛奶可能是替代品，离家准备的食物，零食和糖果可能是SSB的补充。一项准实验研究和两项建模研究也发现，在考虑替代效应后，SSB价格与肥胖结果之间存在负相关关系。尽管在研究的国家中，基线肥胖患病率和每人每天的SSB消费量存在差异，但估计值是一致的。审查表明，对SSB征税将提高SSB的价格，特别是在生产商很少的市场上的含糖苏打。对SSB征税也将减少净能量摄入，足以防止肥胖患病率的进一步增长，但不能永久性地降低人口体重。需要使用更好的调查数据和更强的研究设计进行更多的研究，以确定SSB税对中等收入国家肥胖患病率的长期有效性。
The consumption of sugar-sweetened beverages (SSBs), which can lead to weight gain, is rising in middle-income countries (MICs). Taxing SSBs may help address this challenge. Systematic reviews focused on high-income countries indicate that taxing SSBs may reduce SSB consumption. Responsiveness to price changes may differ in MICs, where governments are considering the tax. To help inform their policy decisions, this review compiles evidence from MICs, assessing post-tax price increases (objective 1), changes in demand for SSBs and other products, overall and by socio-economic groups (objective 2), and effects on overweight and obesity prevalence (objective 3). We conducted a systematic review on the effectiveness of SSB taxation in MICs (1990–2016) and identified nine studies from Brazil, Ecuador, India, Mexico, Peru, and South Africa. Estimates for own-price elasticity ranged from -0.6 to -1.2, and decreases in SSB consumption ranged from 5 to 39 kilojoules per person per day given a 10% increase in SSB prices. The review found that milk is a likely substitute, and foods prepared away from home, snacks, and candy are likely complements to SSBs. A quasi-experimental study and two modeling studies also found a negative relationship between SSB prices and obesity outcomes after accounting for substitution effects. Estimates are consistent despite variation in baseline obesity prevalence and per person per day consumption of SSBs across countries studied. The review indicates that taxing SSBs will increase the prices of SSBs, especially sugary soda, in markets with few producers. Taxing SSBs will also reduce net energy intake by enough to prevent further growth in obesity prevalence, but not to reduce population weight permanently. Additional research using better survey data and stronger study designs is needed to ascertain the long-term effectiveness of an SSB tax on obesity prevalence in MICs.
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