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Dogbe W, Akaichi F, Rungapamestry V, Revoredo-Giha C. Effectiveness of implemented global dietary interventions: a scoping review of fiscal policies. BMC Public Health 2024; 24:2552. [PMID: 39300446 DOI: 10.1186/s12889-024-19988-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 09/04/2024] [Indexed: 09/22/2024] Open
Abstract
BACKGROUND Although the World Health Organisation (WHO) has proposed the use of fiscal policies to mitigate consumption externalities such as overweight and obesity-related diseases, very little is known about the impacts of the different types and framing of national and/or regional fiscal policies that have been implemented over the years. There is the need to provide up-to-date evidence on the impact of fiscal policies that have been enacted and implemented across the globe. METHODS We conducted a scoping review of all implemented government fiscal policies in the food and drinks sector to identify the different types of fiscal policies that exist and the scope of their impact on consumers as well as the food environment. Electronic databases such as the Web of Science and Google Scholar were used to search for appropriate literature on the topic. A total of 4,191 articles were retrieved and 127 were synthesized and charted for emerging themes. RESULTS The results from this review were synthesized in MS Excel following Arksey & O'Malley (2005). Emerging themes were identified across different countries/settings for synthesis. The results confirms that fiscal policies improve consumers' health; increase the prices of foods that are high in fats, sugar, and salt; increase government revenue; and shift consumption and purchases towards healthier and untaxed foods. CONCLUSION Governments already have the optimum tool required to effect changes in consumer behaviour and the food environment.
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Affiliation(s)
- Wisdom Dogbe
- The Rowett Institute, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, UK.
| | - Faical Akaichi
- Scotland's Rural College (SRUC), Peter Wilson Building, King's Buildings, West Mains Road, Edinburgh, EH9 3JG, UK
| | | | - Cesar Revoredo-Giha
- Scotland's Rural College (SRUC), Peter Wilson Building, King's Buildings, West Mains Road, Edinburgh, EH9 3JG, UK
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Valizadeh P, Ng SW. Promoting Healthier Purchases: Ultraprocessed Food Taxes and Minimally Processed Foods Subsidies for the Low Income. Am J Prev Med 2024; 67:3-14. [PMID: 38573260 DOI: 10.1016/j.amepre.2024.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 02/24/2024] [Accepted: 02/26/2024] [Indexed: 04/05/2024]
Abstract
INTRODUCTION Fiscal policies can shift relative food prices to encourage the purchase and consumption of minimally processed foods while discouraging the purchase and consumption of unhealthy ultraprocessed foods, high in calories and nutrients of concern (sodium, sugar, and saturated fats), especially for low-income households. METHODS The 2017-2018 packaged food purchase data among U.S. households were used to derive household income- and composition-specific demand elasticities across 22 food and beverage categories. Policy simulations, conducted in 2022-2023, assessed the impact of national taxes on unhealthy ultraprocessed food and beverage purchases, both separately and alongside subsidies for minimally processed foods and beverages targeted to low-income households. Resultant nutritional implications are reported on the basis of changes in purchased calories and nutrients of concern. In addition, financial implications for both households and the federal government are projected. RESULTS A sugar-based tax on sugar-sweetened beverages would lower both volume and calories purchased with the largest impact on low-income households without children. Meanwhile, targeted subsidies would increase fruit, vegetable, and healthier drink purchases without substantially increasing calories. Under tax simulations, low-income households would make larger reductions in their absolute volume and calorie purchases of taxed foods and beverages than their higher-income counterparts, suggesting that these policies, if implemented, could help narrow nutritional disparities. CONCLUSIONS Levying national taxes on unhealthy ultraprocessed foods/beverages and offering targeted subsidies for minimally processed foods/beverages could promote healthier food choices among low-income households. Such policies have the potential to benefit low-income households financially and at a relatively low cost for the federal government annually.
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Affiliation(s)
- Pourya Valizadeh
- Department of Agricultural Economics, Texas A&M University, College Station, Texas
| | - Shu Wen Ng
- Department of Nutrition, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
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Riediger ND, Neufeld T, Tait M, Turnbull L, Mann K, Waugh A, Bombak A. An examination of sugar-sweetened beverage tax regulations in six jurisdictions: Applying a social justice perspective to beverage taxation and exemptions. Glob Public Health 2024; 19:2394806. [PMID: 39183469 DOI: 10.1080/17441692.2024.2394806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 08/14/2024] [Indexed: 08/27/2024]
Abstract
Taxes, legislation and politics are social determinants of health, which can impact health through multiple pathways. The purpose of this study was to review regulations regarding sugar-sweetened beverage (SSB) taxation and describe taxation/exemption of various beverage categories. We reviewed SSB taxation regulations from Mexico, the United Kingdom, Berkeley, Philadelphia, San Francisco and South Africa. Supplementary government documents and academic publications were also reviewed to further discern beverage taxation/exemption and zero-rating. There were a number of beverage types that fell clearly into typically taxed or exempt/zero-rated categories across all six jurisdictions (e.g. pop/soda as taxed and water as zero-rated). Exemptions and ambiguities within the six regulations can generally be grouped as a lack of clarity regarding the meaning and use of milk; the meaning of 'medical purposes' and 'supplemental'; the point at which a beverage is prepared; the form of concentrate (i.e. liquid/frozen/powder) or medium used (e.g. water, coffee); and location of preparation or business size of retailer. SSB tax regulations are complex, unclear, vary across jurisdiction and leave several beverage types with added sugar exempt from taxation or at risk of a legal challenge. Lastly, tax exemptions generally reflect and perpetuate existing sociopolitical dynamics within the food system.
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Affiliation(s)
- Natalie D Riediger
- Department of Food and Human Nutritional Sciences, Faculty of Agricultural and Food Sciences, University of Manitoba, Winnipeg, Canada
| | - Tamara Neufeld
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Myra Tait
- Independent Scholar, Coleman, Canada
| | - Lorna Turnbull
- Faculty of Law, University of Manitoba, Winnipeg, Canada
| | - Kelsey Mann
- Department of Food and Human Nutritional Sciences, Faculty of Agricultural and Food Sciences, University of Manitoba, Winnipeg, Canada
| | - Anne Waugh
- Department of Food and Human Nutritional Sciences, Faculty of Agricultural and Food Sciences, University of Manitoba, Winnipeg, Canada
| | - Andrea Bombak
- Department of Sociology, University of New Brunswick, Fredericton, Canada
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Villaverde P, Tolentino-Mayo L, Cruz-Casarrubias C, Salgado JC, Aburto TC, Barquera S. Hypothetical impact of the Mexican front-of-pack labeling on intake of critical nutrients and energy. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:124. [PMID: 37941048 PMCID: PMC10631037 DOI: 10.1186/s41043-023-00462-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 10/27/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND Since 2020 in Mexico, front-of-pack warning labels (FOPWL) have been implemented in processed products. Evidence supports warning labels allow consumers to identify unhealthy products. We aimed to evaluate the hypothetical impact of the FOPWL regulation on the Mexican population's intake of critical nutrients and energy, based on the replacement of food and beverages using 4 hypothetical scenarios which represented the phases of the regulation. METHODS Dietary data were collected using a standardized 24-h dietary recall from the 2016 Mexican National Health and Nutrition Survey (n = 4184). To evaluate the hypothetical impact of FOPWL, the nutritional content of critical nutrients in processed products was evaluated according to the Mexican Official Standard 051 (NOM-051). Then, we replaced products with several warning labels (WL) with those with a fewer number of them or with non-processed food. For the replacement, 4 hypothetical scenarios were established: scenario 1: the current consumption of the Mexican Population, scenario 2: the replacement during the first phase of the norm, scenario 3: the replacement in the second phase and scenario 4: the replacement in the last phase. We estimated the means, confidence intervals (CI 95%), and the mean percentage change of energy, saturated fat, trans-fat, added sugars, and sodium intake during the second, third, and the fourth scenarios. RESULTS According to the norm, in the second scenario, the majority of the products presented a label for energy (52.6%) whereas in the third (56.4%) and fourth (61.2%) scenarios were for sodium. In contrast, trans-fat was the least labeled nutrient in all the scenarios (from 2.1 to 4.1%). In the fourth scenario, we observed a reduction of the intake of energy intake to 15.4% as well as saturated fat (- 20%, CI 95% - 18.4; - 21.6), trans-fat (- 8.2%, CI 95% - 6.4; - 10.1) and sodium (- 12.7%, CI 95% - 11.3; - 14.1). The most important reduction was observed for added sugars intake (until - 54.1%, CI 95% - 51; - 57.1). CONCLUSIONS FOPWL could be an effective strategy to decrease energy consumption and nutrients of concern. If consumers use the FOPWL, it would be an important change in critical nutrients intake. These results support that FOPWL might help the Mexican population to choose healthier nutrition alternatives.
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Affiliation(s)
- Paola Villaverde
- Center for Nutrition and Health Research, National Institute of Public Health, Avenida Universidad 655, Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico
| | - Lizbeth Tolentino-Mayo
- Center for Nutrition and Health Research, National Institute of Public Health, Avenida Universidad 655, Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico.
| | - Carlos Cruz-Casarrubias
- Center for Nutrition and Health Research, National Institute of Public Health, Avenida Universidad 655, Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico
| | - Juan C Salgado
- Center for Nutrition and Health Research, National Institute of Public Health, Avenida Universidad 655, Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico
- National Council of Humanities, Science and Technology, Mexico. Av. de los Insurgentes Sur 1582, Crédito Constructor, Benito Juárez, 03940, Mexico City, CDMX, Mexico
| | - Tania C Aburto
- Center for Nutrition and Health Research, National Institute of Public Health, Avenida Universidad 655, Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico
| | - Simón Barquera
- Center for Nutrition and Health Research, National Institute of Public Health, Avenida Universidad 655, Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico
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Buksh SM, Crookes A, de Wit JBF. Effectiveness of NCD-Related Fiscal Policies: Evidence from the Pacific. Nutrients 2023; 15:4669. [PMID: 37960321 PMCID: PMC10647377 DOI: 10.3390/nu15214669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/20/2023] [Accepted: 11/01/2023] [Indexed: 11/15/2023] Open
Abstract
Obesity in Pacific Island countries (PICs) has hit crisis levels, and the consequent high non-communicable disease (NCD) burden is devastating for their developing economies. Nutrition transitions from traditional, plant and seafood diets to a dependence on processed foods are at the core of the obesity and NCD epidemic in PICs. Fiscal policies are widely promoted as an effective mechanism to reduce consumption of unhealthy foods and increase consumption of fruits and vegetables. However, there are little data to evaluate the effectiveness of these policies as rates of NCDs and obesity in PICs continue to rise. This study used an online survey to recruit 4116 adults from six PICs: Fiji, Kiribati, Samoa, Solomon Islands, Tonga and Vanuatu. The study measured the consumption of and household access to sugar-sweetened beverages, ultra-processed packaged snacks, fruits and vegetables and attitudes on food prices and unhealthy eating. The study also assessed the relationship between consumption of these foods and drink and (1) household access, (2) price as a food choice motive, and (3) unhealthy eating attitudes. This study provides novel data on food-related behaviours in PICs, offers insights into the potential impact of NCD-related fiscal policies on food consumption and identifies other variables of interest.
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Affiliation(s)
- Shazna M. Buksh
- School of Law and Social Sciences, The University of the South Pacific, Suva 1168, Fiji; (S.M.B.); (A.C.)
- Translational Health Research Institute, Western Sydney University, Penrith, NSW 2751, Australia
- Department of Interdisciplinary Social Science, Faculty of Social and Behavioural Science, Utrecht University, 3584 CS Utrecht, The Netherlands
| | - Annie Crookes
- School of Law and Social Sciences, The University of the South Pacific, Suva 1168, Fiji; (S.M.B.); (A.C.)
| | - John B. F. de Wit
- Department of Interdisciplinary Social Science, Faculty of Social and Behavioural Science, Utrecht University, 3584 CS Utrecht, The Netherlands
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Rebolledo N, Bercholz M, Adair L, Corvalán C, Ng SW, Taillie LS. Sweetener Purchases in Chile before and after Implementing a Policy for Food Labeling, Marketing, and Sales in Schools. Curr Dev Nutr 2023; 7:100016. [PMID: 37180088 PMCID: PMC10111599 DOI: 10.1016/j.cdnut.2022.100016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 12/08/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Abstract
Background Chile's landmark food labeling and advertising policy led to major reductions in sugar purchases. However, it is unclear whether this led to increases in the purchases of nonnutritive sweeteners (NNS). Objectives The objective of this study was to assess the changes in NNS and caloric-sweetened (CS) products purchased after the law's first phase. Methods Longitudinal data on food and beverage purchases from 2,381 households collected from January 1, 2015 to December 31, 2017, were linked to nutritional information and categorized into added sweetener groups (unsweetened, NNS-only, CS-only, or NNS with CS). Logistic random-effects models and fixed-effects models were used to compare the percentage of households purchasing products and the mean volume purchased by sweetener category to a counterfactual based on pre-regulation trends. Results Compared with the counterfactual, the percentage of households purchasing any NNS beverages (NNS-only or NNS with CS) increased by 4.2 percentage points (pp) (95% CI: 2.8, 5.7; P < 0.01). This increase was driven by households purchasing NNS-only beverages (12.1 pp, 95% CI: 10.0, 14.2; P < 0.01). The purchased volume of beverages with any NNS increased by 25.4 mL/person/d (95% CI: 20.1, 30.7; P < 0.01) or 26.5%. Relative to the counterfactual, there were declines of -5.9 pp in households purchasing CS-only beverages (95% CI: -7.0, -4.7; P < 0.01). Regarding the types of sweeteners purchased, we found significant increases in the amounts of sucralose, aspartame, acesulfame K, and steviol glycosides purchased from beverages. Among foods, differences were minimal. Conclusions The first phase of Chile's law was associated with an increase in the purchases of beverages containing NNS and decreases in beverages containing CS, but virtually no changes in foods.
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Affiliation(s)
- Natalia Rebolledo
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Maxime Bercholz
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Linda Adair
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Camila Corvalán
- Institute of Nutrition and Food Technology (INTA), University of Chile, Macul, Chile
| | - Shu Wen Ng
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lindsey Smith Taillie
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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