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Nakhimovsky SS, Feigl AB, Avila C, et al. Taxes on Sugar-Sweetened Beverages to Reduce Overweight and Obesity in Middle-Income Countries: A Systematic Review. PLoS One. 2016;11(9):e0163358doi: 10.1371/journal.pone.0163358.
Nakhimovsky, S. S., Feigl, A. B., Avila, C., O'Sullivan, G., Macgregor-Skinner, E., & Spranca, M. (2016). Taxes on Sugar-Sweetened Beverages to Reduce Overweight and Obesity in Middle-Income Countries: A Systematic Review. PloS one, 11(9), e0163358. https://doi.org/10.1371/journal.pone.0163358
Nakhimovsky, Sharon S, et al. "Taxes on Sugar-Sweetened Beverages to Reduce Overweight and Obesity in Middle-Income Countries: A Systematic Review." PloS one vol. 11,9 (2016): e0163358. doi: https://doi.org/10.1371/journal.pone.0163358
Nakhimovsky SS, Feigl AB, Avila C, O'Sullivan G, Macgregor-Skinner E, Spranca M. Taxes on Sugar-Sweetened Beverages to Reduce Overweight and Obesity in Middle-Income Countries: A Systematic Review. PLoS One. 2016 Sep 26;11(9):e0163358. doi: 10.1371/journal.pone.0163358. eCollection 2016. PMID: 27669014; PMCID: PMC5036809.
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PLoS One. 2016 Sep 26;11(9):e0163358. doi: 10.1371/journal.pone.0163358. eCollection 2016.

Taxes on Sugar-Sweetened Beverages to Reduce Overweight and Obesity in Middle-Income Countries: A Systematic Review.

PloS one

Sharon S Nakhimovsky, Andrea B Feigl, Carlos Avila, Gael O'Sullivan, Elizabeth Macgregor-Skinner, Mark Spranca

Affiliations

  1. International Health Division, Abt Associates, Bethesda, Maryland, United States of America.
  2. Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America.
  3. Office of Reputational Capital, Abt Associates, Cambridge, Massachusetts, United States of America.

PMID: 27669014 PMCID: PMC5036809 DOI: 10.1371/journal.pone.0163358

Abstract

BACKGROUND: 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).

METHODS AND FINDINGS: 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.

CONCLUSIONS: 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.

Conflict of interest statement

The authors have declared that no competing interests exist and that the commercial affiliation does not alter our adherence to PLOS ONE policies on sharing data and materials.

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