Sugar-Sweetened Beverages Tax and childhood obesity in US

Written by: Katherine Wang

Can tax on Sugar-sweetened beverage lower children’s weight?



Since children are the future of the nation, it is very important to make sure the children can grow in a healthy way. In the United States, there is increased concern about obesity epidemic among children. Because many researches show the childhood obesity is linked to the consumption of sugar-sweetened drinks, some strategies are aimed at decreasing obesity prevalence rate by raising the tax on sugar-sweetened beverages. Until now, about forty states already have taxes on sugared beverages to tackle the childhood obesity issue. As the public policy for taxes on sugared beverages has been widely taken in the United States, we need to take a closer look at the potential effect of this policy.

Epidemiology behind the policy

I searched the Internet and found many papers regarding childhood obesity and consumption of sugar-sweetened beverages (SSBs). Growing epidemiologic studies were conducted to reveal the relationship between consuming SSBs (exposure) and childhood obesity (disease). Lots of researchers used epidemiologic method to design the study and draw a conclusion about SSBs and obesity.

For instance, three researchers of children’s hospital at Boston carried on a prospective, observational analysis to examine the link between consumption of sugar-sweetened drinks and childhood obesity. In this study, investigators enrolled 548 schoolchildren from public schools in four Massachusetts communities, and followed them for 19 months. The participants’ SSBs consumption and obesity status were measured and recorded. Afterward, investigators used linear and logistic regression analyses adjusted for potentially confounders to interpret the data. This study concluded that the consumption of sugar-sweetened drinks is related to obesity in children.

Similarly, there are many researches targeted on this topic. In order to give you a summary of related study, I cite the study synopses here.
( http://www.yaleruddcenter.org/resources/upload/docs/what/policy/SSBtaxes/SSBStudiesChildhoodObesity8.09.pdf )
 As the study synopses shown, most researches demonstrate significant association between SSBs consumption and childhood obesity.

What did these epidemiologic studies prove?

Among those articles that indicated significant association, they built a connection between SSBs consumption and childhood obesity. Particularly, some studies revealed the casual relationship, which proved consuming SSBs could lead to children obesity. So, I used a brief picture below to show the main finding of these epidemic studies.

From tax to weight loss--- not that simple.

Let us think about our final goal. What we want to achieve by taking the policy? Yes, we want to decrease the obesity prevalence of children. And where do we start from? That is simple, just begin with raising tax of SSB.

Wow! It appears to be a very short distance between our start step and the goal. Next, I add more detail in this process. Ideally, raising tax on SSBs leads to decrease in SSBs consumption and lower calories intake, thus promote childhood obesity.

However, if we consider about the links between four components, some underlying issues show up.

       

First, does raising tax on SSBs necessarily cause less SSBs consumption? Increasing price may not impact on the rich families. For those people who have sufficient money or would like to buy favorite things regardless of price, tax increase could not reduce their love for SSBs. Moreover, it is possible that obese children are more addictive to sweet food and beverages, so, price control may only be effective for less obese children. While, the children who are severely obese may still experience difficulty in stop drinking SSBs.

Let us check the second link, which is between decreasing SSBs consumption and less calories intake. Assume an obese boy who loves sweet things very much, when he notices the SSBs is expensive, what will he do? We hope he could buy milk instead or buy nothing, however, for many children, that would be too disappointing. Because he is not satisfied by the SSRs, he may seek other sweet things to get psychological balance. Perhaps, this boy will buy some cheap candies or chocolates to still his appetite. The result is, the calories contained in candies and chocolates are not less than SSBs. Thus, the calories intake will not be lowered.

Because human’s behavior is often involved with many complex factors, we cannot simply conclude the people’s response to a public policy. In many cases, things do not progress as we expected. We should evaluate the exact benefit of implementing public policy. So, more epidemiologic studies are needed to show real effect of SSBs tax policy played on overall calories consumption and weight status of children.

I have seen similar study to test the influence of SSRs-control intervention among children. The study reveals such intervention could promote weight loss. However, we have to consider about the different settings between intervention program and daily life. In other words, children who successfully adhere to the diet rule of intervention may not able to control themselves in everyday life. It is necessary to examine the impact of policy in the life scene.

In general, we must make sure the links between components can be real, rather than imaginary. It is important to critically think about the effectiveness of public policy.

Some other ideas to promote the fitness of Children

In order to impulse people choose healthy food, decreasing the tax of vegetables and fruits may be helpful. When people are conscious of junk food tends to be more expensive and healthy food tends to be cheap, the chance of picking health food will be enhanced.

We could teach schoolchildren to make natural, healthy and tasty juice by themselves. Children may love healthy beverages if it brings fun. In addition, since parents’ decision can often influence children, parents’ participation may help children to build a healthy living habit.

References:

1.http://www.yaleruddcenter.org/resources/upload/docs/what/policy/SSBtaxes/SSBStudiesChildhoodObesity8.09.pdf
2.http://www.ncbi.nlm.nih.gov/pubmed/11229668