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Abbreviations: pp, percentage points; SES, socioeconomic status; SSB, sugar-sweetened beverage. https://doi.org/10.1371/journal.pmed.1002664.t003
Source publication
Background
Several strategies have been proposed to reduce the intake of added sugars in the population. In Mexico, a 10% sugar-sweetened beverages (SSBs) tax was implemented in 2014, and the implementation of other nutritional policies, such as product reformulation to reduce added sugars, is under discussion. WHO recommends that all individuals c...
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The World Health Organization (WHO) recommends reducing free sugars to less than 10% of total energy intake (TEI) due to their potential implications in weight gain and dental caries. Our objectives were to (1) estimate the intake of total, added, and free sugars, (2) define the main sugar sources, and (3) evaluate the adherence to sugar guidelines...
Citations
... In general, lower-income households and individuals are more likely to reduce their purchases in response to a tax, and therefore stand to gain more long-term health and monetary benefits (Barrientos-Gutierrez et al., 2017;Basto-Abreu et al., 2018;Sánchez-Romero et al., 2016;Torres-Álvarez et al., 2020). This was the case in evaluations of the Mexican nonessential food and SSB taxes (Batis et al., 2016;Colchero et al., 2016;Hernández-F et al., 2019;Ng et al., 2019;Sánchez-Romero et al., 2016) as well as South ...
... Previous modeling studies estimating the impact of interventions to reduce sugary drinks intake have assumed that a part of the reduced energy will be substituted. 26,27 If policies induce similar changes to the ones observed here, then simulation studies may have underestimated the total impact on total energy intake and obesity. ...
Background:
Processed discretionary foods and drinks (industrialized sugary drinks, sweet and savory snacks, and grain-based sweets) are often target of policies aimed at regulating the food environment. We aimed to understand if a lower intake of processed foods or drinks is associated with substitution or complementation patterns and overall intake.
Methods:
We analyzed a subsample with two 24-hr dietary recalls of the Mexican National Health and Nutrition Survey 2012 (358 children, 253 adolescents, and 278 adults). We compared within-person, energy and added sugar intakes between days with and without consumption of each food group with fixed-effects regressions. We estimated the relative change (change in intake when not consumed/average intake when consumed *100) RESULTS: Processed discretionary foods were not fully substituted, as total energy was 200 to 400 kcal/d lower when these foods were not consumed. The change in total intake was larger than the intake when consumed (i.e., complemented) for industrialized sugary drinks in adolescents (-136%) and adults (-215%), and sweet, savory snacks for children (-141%). The change was lower (i.e., partially substituted) for grain-based sweets among children (-78%) and adolescents (-73%). For added sugars, most processed discretionary groups were complemented.
Conclusions:
Days without intake of processed discretionary foods were associated with lower total energy and added sugar intake compared to days when those discretionary foods were consumed. This suggests that regulatory policies to reduce the intake of processed foods could have a meaningful impact on improving overall diet. This article is protected by copyright. All rights reserved.
... Despite the World Health Organization having recommended reducing free sugars and added sugars to <5% of daily caloric intake to lower the risk of unhealthy outcomes [5], consumption of sugars remains at a high level in developed countries, such as the US and UK [47,48], and keeps increasing in some developing counties, such as China and Mexico [49,50]. We are the first meta-analysis to explore the associations of total sugar and fructose and allcause mortality, CVD mortality, and cancer mortality and found a higher intake of total sugar and fructose increased risk of all-cause and CVD mortality. ...
Objectives:
We performed a systematic review and dose-response meta-analysis to assess the association of total sugars, added sugars, fructose, and sucrose with all-cause, cardiovascular disease (CVD), and cancer mortality.
Methods:
We searched PubMed, Embase, and Web of Science for prospective cohort studies up to May 10, 2022. Pooled relative risks and 95% CIs were calculated by random effect models, and the linear and non-linear dose-response associations were explored by restricted cubic splines.
Results:
Comparing the highest with the lowest categories of total sugars, the summary RR was 1.09 (95% CI, 1.02-1.15; I2 = 71.9%) for all-cause mortality, 1.10 (1.02-1.18; I2 = 12.7%) for CVD mortality, and 1.00 (0.94-1.05; I2 = 0) for cancer mortality. For fructose, the summary relative risk was 1.09 (1.03-1.16; I2 = 58.4%) for all-cause mortality, 1.11 (1.03-1.20; I2 = 37.4%) for CVD mortality, and 1.00 (0.95-1.06; I2 = 0) for cancer mortality. Restricted cubic splines found non-linear associations of total sugars and fructose with all-cause and CVD mortality (P for non-linearity < 0.001). A significant increment in risk of all-cause and CVD mortality was observed with >10% energy intake to 20% energy intake for total sugars and fructose. No association was found for the added sugars and sucrose with all-cause, CVD, and cancer mortality.
Conclusions:
Increased intake of total sugars and fructose is associated with all-cause and CVD mortality but not associated with cancer mortality, which could have implications for guideline recommendations regarding the risk of mortality related to sugar intake.
... Although Argentina has recently approved the labeling law, it is essential to start implementing the policy of healthy taxes in Argentina and other countries in the region to decrease consumption [38]. There is evidence that increasing taxes can significantly benefit to the public, and Mexico was the first country to successfully promote this type of change in the region [39]. In Brazil, Claro et al. found that increases in the price of SSBs were associated with a reduction in consumption. ...
... Furthermore, reformulating SSBs to reduce sugar content is a debt for several countries and could result in measurable reductions in consumption in Latin America [39]. ...
Background:
Approximately two-thirds of Argentine adults are overweight or obese, and 11% have diabetes. Over the last two decades, all population groups have increased their consumption of ultra-processed foods and sugar-sweetened beverages (SSB). We aimed to estimate the disease burden-deaths, events, and costs to the health system-attributed to SSB consumption in Argentina.
Methods:
We used a comparative risk assessment framework to estimate the health and economic impacts that would be avoided in a scenario without sugar-sweetened beverage (SSB) consumption. We calculated the direct effects on diabetes, cardiovascular disease, and BMI, and then estimated the effects of BMI on disease incidence. Finally, we applied the population attributable factor to calculate the health and economic burden avoided in Argentina in 2020.
Results:
Our model estimated that about 4,425 deaths, 110,000 healthy life years lost to premature death and disability, more than 520,000 cases of overweight and obesity in adults, and 774,000 in children and adolescents would be attributed to SSB Consumption in Argentina. This disease burden corresponds to 23% of type-2 diabetes cases and other significant proportions of cardiovascular disease and cancer. The overweight and obesity costs attributable to SSB totaled approximately $47 million in adults and $15 million in children and adolescents.
Conclusion:
A significant number of disease cases, deaths, and health care costs could be attributed to SSB consumption in Argentina. Implementing measures to reduce the sugar content in beverages is a pending debt for the country and could lead to measurable improvements in population health, especially among children and adolescents.
... Likewise, reformulation of SSBs to reduce sugar content could produce measurable reductions in consumption for populations in LAC countries. 32 Furthermore, the beneficial effect that warning labels could have on public health and in effectively reducing obesity and its associated costs was studied in Mexico. The expected impact of beverage labelling could lead to a 10.5% reduction in calories consumed. ...
Objective
Overweight and obesity are important contributors to the non-communicable disease burden. The consumption of sugar-sweetened beverages (SSBs) has been associated with an increased risk of type 2 diabetes mellitus (T2DM), cardiovascular disease, cancer and other conditions. The objective of this study was to estimate the burden of disease attributable to the consumption of SSBs and the costs to the healthcare systems in Argentina, Brazil, El Salvador, and Trinidad and Tobago.
Design
Following a systematic review of models, a comparative risk assessment framework was developed to estimate the health and economic impact associated with the consumption of SSBs.
Setting
Argentina, Brazil, El Salvador, and Trinidad and Tobago.
Participants
Overall population.
Primary and secondary outcome measures
The model estimated the effects of SSB consumption on health through two causal pathways: one mediated by body mass index (BMI) and health conditions associated with BMI and another that reflected the independent effects of SSB consumption on T2DM and cardiovascular diseases.
Results
The model results indicated that for all four countries, in 1 year, SSB consumption was associated with 18 000 deaths (3.2% of the total disease-related deaths), seven million disease events (3.3% of the total disease-related events), a half-million DALYs and US$2 billion in direct medical costs. This included 1.5 million cases of overweight and obesity in children/adolescents (12% of the excess weight cases) and 2.8 million cases in adults (2.8%); 2.2 million cases of type 2 diabetes (19%); 200 000 cases of heart disease (3.8%); 124 000 strokes (3.9%); 116 000 cases of musculoskeletal disease (0.2%); 102 000 cases of kidney disease (0.9%); and 45 000 episodes of asthma (0.4%). The Trinidad and Tobago population were the most affected by disease events.
Conclusions
The study results indicate that the consumption of SSBs is associated with a significant burden of disease and death in Latin America and the Caribbean.
... WHO estimated in 2017 that obesity has reached the proportions of a worldwide pandemic, resulting in the deaths of 2.8 million people yearly. The relationship Sesamin Lignan between exposure to highly processed foods and obesity-related outcomes in adults has been demonstrated by five cross-sectional and longitudinal studies (Holdsworth et al. 2013;Popkin et al. 2018;Monteiro et al. 2019). Nevertheless, Adams and White (2015) explain that obesity results from the consumption of ultra-processed foods, which has been proven in well-controlled trials. ...
In food processing industries, thermal processing is a traditional method to kill the microorganisms and provision of safe food for human consumption. This develops some desirable characteristics in a final product, like caramelization and browning. On the other hand, it also develops some undesirable changes in color, flavor, natural freshness, and losses of micronutrients such as vitamins and phenolic contents. These days consumers are aware and conscious about their health, hence and demand safe and nutrients rich food products is increasing day by day. Minimum or mild heat treatment is the best solution for meeting consumer expectations because it minimizes the losses of beneficial properties of the final product and retains maximum natural color, flavor, texture, and freshness attributes of the final products. No significant effect was reported in phenolic contents, ascorbic acid, and other heat-sensitive nutrients during non-thermal processing. This chapter discussed the nonthermal processing techniques in detail and its effects on micronutrients, texture, and microbial load of processed foods.KeywordsHigh-pressurePhenolic contentsIrradiationNatural freshnessPathogenic bacteriaElectromagnetic spectrumUV light
... WHO estimated in 2017 that obesity has reached the proportions of a worldwide pandemic, resulting in the deaths of 2.8 million people yearly. The relationship Sesamin Lignan between exposure to highly processed foods and obesity-related outcomes in adults has been demonstrated by five cross-sectional and longitudinal studies (Holdsworth et al. 2013;Popkin et al. 2018;Monteiro et al. 2019). Nevertheless, Adams and White (2015) explain that obesity results from the consumption of ultra-processed foods, which has been proven in well-controlled trials. ...
Food safety is ensured when everyone has access to sufficient, healthy, and nutritious food that is adequate to their needs and food preferences for healthy and effective life. It is seen as a causal and related pathway from production through distribution, processing, and consumption. In most instances, the underlying causes of food-related illness are infectious or toxic and are caused by bacteria, viruses, parasites, or chemicals that enter the body through food or contaminated water. Chemical transformation of food constituents can result in either acute poisoning or extended illness like cancer, obesity, cardiovascular disease, and mental health disorder. Raw foods of animal origin, fruit, and vegetables, as well as raw shellfish containing marine biotoxins, are examples of unhealthy foods intake. However, creating and exploring data that summarize nutritional intake and its relationship with disease as highly important task in developing disease prevention and curing disease as well. Thus, this chapter highlights recent advances on diseases prevention through food. Also, it describes the association between food safety and contamination during the food preparation process. Developing scientifically sound, innovative, and efficient nutrition involvements is both rewarding and challenging.KeywordsNutritionDisease preventionFood safetyFood contamination
... Given our still limited understanding of the relationship between these and other risk factors with the time dynamics of atherosclerosis, MI, and heart disease development, this work is an important contribution to the literature. As highlighted by the authors, their approach builds on and brings to cardiovascular disease the ideas and perspectives of earlier mechanistic and biologically based models for the epidemiology of cancer, diabetes, and other chronic diseases (13,15,23,(45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57)(58). ...
Mechanistic and biologically based mathematical models of chronic and behavioral disease processes aim to capture the main mechanistic or biological features of the disease development, and to connect these with epidemiological outcomes. These approaches have a long history in epidemiological research and are complementary to traditional epidemiological or statistical approaches to investigate the role of risk factor exposures on disease risk.
In the article by Simonetto et al. (Am J Epidemiol. XXXX;XXX(XX):XXXX–XXXX)), the authors present a mechanistic, process-oriented, model to investigate the role of smoking, hypertension and dyslipidemia on the development of atherosclerotic lesions and their progression to myocardial infarction (MI). Their approach builds on and brings to cardiovascular disease the ideas and perspectives of earlier mechanistic and biologically based models for the epidemiology of cancer and other chronic diseases, providing important insights into the mechanisms and epidemiology of smoking related MI.
We argue that although mechanistic modeling approaches have demonstrated their value and place in epidemiology, they are highly underutilized. We call for efforts to grow mechanistic and biologically based modeling research, expertise and awareness in epidemiology, including the development of training and collaboration opportunities to attract more students and researchers from STEM areas into the epidemiology field.
... Likewise, reformulation of SSBs to reduce sugar content could produce measurable reductions in consumption for populations in LAC countries. 32 Furthermore, the beneficial effect that warning labels could have on public health and in effectively reducing obesity and its associated costs was studied in Mexico. The expected impact of beverage labelling could lead to a 10.5% reduction in calories consumed. ...
Objective: Overweight and obesity are important contributors to the non-communicable disease burden. The consumption of sugar-sweetened beverages (SSBs) has been associated with an increased risk of type 2 diabetes mellitus (T2DM), cardiovascular disease, cancer and other conditions. The objective of this study was to estimate the burden of disease attributable to the consumption of SSBs and the costs to the healthcare systems in Argentina, Brazil, El Salvador, and Trinidad and Tobago.
Design: Following a systematic review of models, a comparative risk assessment framework was developed to estimate the health and economic impact associated with the consumption of SSBs.
Setting: Argentina, Brazil, El Salvador, and Trinidad and Tobago.
Participants: Overall population.
Primary and secondary outcome measures: The model estimated the effects of SSB consumption on health through two causal pathways: one mediated by body mass index (BMI) and health conditions associated with BMI and another that reflected the independent effects of SSB consumption on T2DM and cardiovascular diseases.
Results: The model results indicated that for all four countries, in 1 year, SSB consumption was associated with 18 000 deaths (3.2% of the total disease-related deaths), seven million disease events (3.3% of the total disease-related events), a half-million DALYs and US$2billion in direct medical costs. This included 1.5 million cases of overweight and obesity in children/adolescents(12% of the excess weight cases) and 2.8 million cases in adults (2.8%); 2.2 million cases of type 2 diabetes(19%); 200 000 cases of heart disease (3.8%); 124000 strokes (3.9%); 116 000 cases of musculoskeletal disease (0.2%); 102 000 cases of kidney disease (0.9%); and 45 000 episodes of asthma (0.4%). The Trinidad and Tobago population were the most affected by disease events.
Conclusions: The study results indicate that the consumption of SSBs is associated with a significant burden of disease and death in Latin America and the Caribbean.
... Modeling studies find excise taxes on unhealthy foods and beverages to be cost-saving. Andreyeva, Chaloupka, and Brownell 2011;Basto-Abreu et al. 2018;Briggs et al. 2013a;Briggs et al. 2013b;Gortmaker et al. 2015;Lal et al. 2017;Long et al. 2015a;Manyema et al. 2014;Sacks et al. 2011;Saxena et al. 2019a;Saxena et al. 2019b;Veerman et al. 2016;Wang et al. 2012;Wilde et al. 2019 FOP warning labels FOP warning labels are both effective and cost-saving. FOP traffic light labeling appears to be cost saving. ...
