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      Changes in Population-Level Consumption of Taxed and Non-Taxed Sugar-Sweetened Beverages (SSB) after Implementation of SSB Excise Tax in Thailand: A Prospective Cohort Study

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          Abstract

          Background: Thailand has implemented a sugar-sweetened beverage (SSB) excise tax since September 2017, but questions remain about changes in individual-level SSB consumption after tax implementation. This study aimed to analyze the change in taxed and non-taxed SSB consumption in the Thai population. Method: This cohort study was carried out in 2018 and 2019. A total of 5594 persons who participated in both years were included in the analysis. Descriptive and t-test analyses were carried out in order to identify the significance of the difference between taxed and non-taxed SSB consumption in 2018 and 2019. Results: A lower mean ratio of average taxed SSBs consumed to average non-taxed SSBs consumed was found to be statistically significant ( p = 0.001). That is, the decline in taxed SSB consumption is significantly greater than that of the non-taxed consumption. The greater reduction in taxed SSB consumption than the non-taxed SSB consumption was found to be significant among males, older persons, the lower-income population, and the unemployed. Conclusions: Overall, the current SSB tax has the capacity to successfully discourage consumption of SSBs with high sugar level. The decline in SSB consumption is, however, not found across all socioeconomic groups. Thresholds for SSB-tiered tax structure may have to be reviewed.

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          Sugar-Sweetened Beverages and Risk of Metabolic Syndrome and Type 2 Diabetes

          Vasanti Malik, Barry M. Popkin, George Bray … (2010)
          OBJECTIVE Consumption of sugar-sweetened beverages (SSBs), which include soft drinks, fruit drinks, iced tea, and energy and vitamin water drinks has risen across the globe. Regular consumption of SSBs has been associated with weight gain and risk of overweight and obesity, but the role of SSBs in the development of related chronic metabolic diseases, such as metabolic syndrome and type 2 diabetes, has not been quantitatively reviewed. RESEARCH DESIGN AND METHODS We searched the MEDLINE database up to May 2010 for prospective cohort studies of SSB intake and risk of metabolic syndrome and type 2 diabetes. We identified 11 studies (three for metabolic syndrome and eight for type 2 diabetes) for inclusion in a random-effects meta-analysis comparing SSB intake in the highest to lowest quantiles in relation to risk of metabolic syndrome and type 2 diabetes. RESULTS Based on data from these studies, including 310,819 participants and 15,043 cases of type 2 diabetes, individuals in the highest quantile of SSB intake (most often 1–2 servings/day) had a 26% greater risk of developing type 2 diabetes than those in the lowest quantile (none or <1 serving/month) (relative risk [RR] 1.26 [95% CI 1.12–1.41]). Among studies evaluating metabolic syndrome, including 19,431 participants and 5,803 cases, the pooled RR was 1.20 [1.02–1.42]. CONCLUSIONS In addition to weight gain, higher consumption of SSBs is associated with development of metabolic syndrome and type 2 diabetes. These data provide empirical evidence that intake of SSBs should be limited to reduce obesity-related risk of chronic metabolic diseases.
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            Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies

            L. Te Morenga, S. Mallard, J. Mann (2013)
            To summarise evidence on the association between intake of dietary sugars and body weight in adults and children.
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              Intake of sugar-sweetened beverages and weight gain: a systematic review.

              Vasanti Malik, Matthias B. Schulze, Frank Hu (2006)
              Consumption of sugar-sweetened beverages (SSBs), particularly carbonated soft drinks, may be a key contributor to the epidemic of overweight and obesity, by virtue of these beverages' high added sugar content, low satiety, and incomplete compensation for total energy. Whether an association exists between SSB intake and weight gain is unclear. We searched English-language MEDLINE publications from 1966 through May 2005 for cross-sectional, prospective cohort, and experimental studies of the relation between SSBs and the risk of weight gain (ie, overweight, obesity, or both). Thirty publications (15 cross-sectional, 10 prospective, and 5 experimental) were selected on the basis of relevance and quality of design and methods. Findings from large cross-sectional studies, in conjunction with those from well-powered prospective cohort studies with long periods of follow-up, show a positive association between greater intakes of SSBs and weight gain and obesity in both children and adults. Findings from short-term feeding trials in adults also support an induction of positive energy balance and weight gain by intake of sugar-sweetened sodas, but these trials are few. A school-based intervention found significantly less soft-drink consumption and prevalence of obese and overweight children in the intervention group than in control subjects after 12 mo, and a recent 25-week randomized controlled trial in adolescents found further evidence linking SSB intake to body weight. The weight of epidemiologic and experimental evidence indicates that a greater consumption of SSBs is associated with weight gain and obesity. Although more research is needed, sufficient evidence exists for public health strategies to discourage consumption of sugary drinks as part of a healthy lifestyle.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Nutrients
                Journal ID (iso-abbrev): Nutrients
                Journal ID (publisher-id): nutrients
                Title: Nutrients
                Publisher: MDPI
                ISSN (Electronic): 2072-6643
                Publication date (Electronic): 27 October 2020
                Publication date Collection: November 2020
                Volume: 12
                Issue: 11
                Electronic Location Identifier: 3294
                Affiliations
                [1 ]Institute for Population and Social Research, Mahidol University, Nakhon Pathom 73170, Thailand; birt_redmachine@ 123456hotmail.com (N.T.); aphichat.cha@ 123456mahidol.ac.th (A.C.); rossarin.gra@ 123456mahidol.ac.th (R.S.G.)
                [2 ]Bureau of Dental Health, Department of Health, Ministry of Public Health, Nonthaburi 11000, Thailand; pprasertsom@ 123456gmail.com
                Author notes
                Article
                Publisher ID: nutrients-12-03294
                DOI: 10.3390/nu12113294
                PMC ID: 7692763
                PubMed ID: 33121147
                SO-VID: 5f71a460-57ba-43d4-b313-8ef33ff4b01a
                Copyright © © 2020 by the authors.
                License:

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                Date received : 04 October 2020
                Date accepted : 23 October 2020
                Categories
                Subject: Article

                ScienceOpen disciplines: Nutrition & Dietetics
                Keywords: sugar-sweetened beverage,excise tax,fiscal policy,thailand,obesity,non-communicable diseases
                Data availability:
                ScienceOpen disciplines: Nutrition & Dietetics
                Keywords: sugar-sweetened beverage, excise tax, fiscal policy, thailand, obesity, non-communicable diseases

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