Taxing sugar-sweetened beverages in China:By volume or sugar content? A consumer welfare approach

Using scanner data on the consumption of packaged liquid beverages by Chinese urban households,we estimated the price elasticity of various beverages and compared the effects of volume-based versus sugar-content-based taxation strategies on consumer welfare.Compared to the volume-based tax,the sugar-content-based beverage tax was predicted to cost less in compensating variation under the same amount of sugar reduced,indicating that taxation based on sugar content may be more efficient in preserving consumer welfare.Further comparison across different socioeconomic groups reveals that,given current beverage consumption status in China,the efficiency advantage of the sugar-content-based taxation strategy is more pronounced than that of the volume-based taxation.Our conclusions can provide insights for the food industry and the government to reduce the sugar content in beverages.

Report on Childhood Obesity in China (9): Sugar-sweetened Beverages Consumption and Obesity

Objective To explore the associations between sugar-sweetened beverage （SSB） consumption and obesity as well as obesity-related cardiometabolic disorders among children in China. Methods A total of 6974 （boys 3558, girls 3412） children aged 6-13 years participated in the study. Each participant’s height, weight, waist circumference, fasting glucose, triglycerides, total cholesterol, high- density lipoprotein cholesterol, and low-density lipoprotein cholesterol were measured. The type of beverage consumption was determined using a self-administered questionnaire. Results SSBs were consumed regularly by 46.1% of the children. The prevalence [adjusted odds ratio （95% confidence internal （CI）] of obesity was 7.6% [as the reference group （ref.）], 10.1% [1.36（1.07, 1.74）], and 11.6% [1.46（1.21, 1.75）], among children who regularly drank milk, other beverages and SSBs, respectively. Regularly drinking SSBs elevated the likelihood of abdominal obesity [adjusted odds ratio （95% CI）： 1.36 （1.17, 1.59）]. The prevalence [adjusted odds ratio （95% CI）] of obesity among children who regularly drank sports/caloric beverages, carbonated beverages, sweet tea, and plant protein beverages was 16.8% [2.00（1.31, 3.07）], 12.7% [1.52（1.23, 1.88）], 11.5% [1.52（1.18, 1.95）], and 10.4% [1.41（1.03, 1.94）], respectively, which was higher than that of regular milk drinkers [7.6 % （ref.）]. The prevalence [adjusted odds ratio （95% CI）] of abdominal obesity among children who regularly drank sweet tea, fruit/vegetable juices, and carbonated beverages was 17.7% [1.55（1.26, 1.90）], 16.2% [1.36（1.09, 1.70）], and 15.3% [1.24（1.03, 1.50）], respectively, which was much higher than that of regular milk drinkers [12.8% （ref.）]. Conclusions Regular SSB consumption was positively related to obesity and abdominal obesity. This relationship should be investigated further using a longitudinal study design.

Sugar intake from sweetened beverages and diabetes:A narrative review

Type 2 diabetes mellitus(T2DM)is one of the fastest growing public health concerns around the world.Sugar-sweetened beverage(SSB)consumption has been proven to be associated with adverse health consequences in the diabetic population.Reducing SSB consumption,body weight control,healthy diets,and increased physical activity have been suggested as strategies to improve diabetes prevention and management.This literature review provides an overview of:(1)The association between SSB consumption and the risk of T2DM;(2)Types of SSB consumption and T2DM;(3)The effect of obesity and inflammation on the association between SSB consum-ption and risk of T2DM;and(4)SSB consumption in T2DM patients.There is still work to be done to determine how SSB consumption is related to T2DM,but the current research on identifying the association between SSB consumption and T2DM is promising,with the most promising studies confirming the connection between SSBs,T2DM risk,and diabetes management.Future studies should explore more effective SSB related diabetes prevention and management interventions.

Improved Interpretive Accuracy of Sugar Content on Beverage Labels Following an Educational Intervention for Children

To address childhood obesity, it is important to help children make better choices with regards to intake of sugary drinks and snacks. The purpose of this study was to evaluate the validity of a novel educational intervention designed to convert grams of sugar into teaspoons on labeled beverages. A convenience sample of children （n = 21） at a charter elementary school in Washington, D. C was studied. A pre-test required an estimation of teaspoons of sugar on labels, followed by a practice demonstration and song. A post-test was given requiring estimation of teaspoons of sugar in on the same labels. Two weeks later, a retention test as well as qualitative questions assessed participant learning and information usage. Test scores revealed increased accuracy from pre-test （26.2%） to post-test （79.8%）. Estimations were more accurate after the demonstration, as evidenced by the decreased range in average variation of responses （＋25.6 tsp to ＋1.8 tsp）. Two-week recall maintained accuracy （66.7%）, with an average variance of ＋3.8 teaspoons. Qualitative responses revealed participants had learned and used the conversion concepts. These results suggest that the educational intervention was effective. Qualitative data suggest behavior change, increased awareness, and the potential for change extending to caregivers.

小学生主观不健康饮食态度和行为对其含糖饮料消费频率的影响

目的:探讨与小学生含糖饮料消费相关的自身主观危险因素,为更有效地控制小学生含糖饮料消费提供依据。方法:对江西省南昌市和山西省晋中市5所小学共1172名小学生的含糖饮料消费频率和消费相关态度、行为及动因进行问卷调查。结果:含糖饮料消费频率“<3次/周”“≥3次/周”的小学生分别占84.1%、15.9%;4.6%的小学生认为饮用含糖饮料不会影响健康、10.2%的小学生表示“不清楚”;18.7%的小学生会将含糖饮料当水喝;41.3%的小学生会因“就是想喝”而喝含糖饮料。单因素分析显示,“认为饮用含糖饮料不影响健康”、“把含糖饮料当水喝”、“就是想喝”都是含糖饮料消费频率较高的影响因素(P<0.05)。调整相关因素后Logistic回归分析结果显示,具有“认为饮用含糖饮料不影响健康”者、“把含糖饮料当水喝”者、“因就是想喝而喝”者含糖饮料消费频率≥3次/周的风险分别是不具有这些特征者的2.179倍(95%CI:1.132~4.192,P<0.05)、2.249倍(95%CI:1.530~3.304,P<0.05)、1.366倍(95%CI:0.968~1.926,P=0.076)。由上述3个主观因素构建的组合危险分数越高的小学生,含糖饮料消费频率越高(P_(趋势)<0.05)。结论:小学生含糖饮料消费频率与其自身主观不健康态度行为有关,应据此采取针对性的干预措施,从根本上控制儿童青少年含糖饮料的消费。

Mediterranean dietary components are inversely associated with advanced colorectal polyps:A case-control study

AIM To evaluate the association between the Mediterranean diet(MD) pattern and its components, and advanced colorectal polyps(adenoma and serrated adenoma).METHODS A case-control study among patients undergoing screening, diagnostic or surveillance colonoscopies during 2010-2015 at the Tel-Aviv Medical Center, Gastroenterology Department. Cases with advanced polyps were defined as: Advanced adenoma [> 10 mm, with features of high grade dysplasia(HGD) or villous histology], advanced serrated adenoma(> 10 mm or with dysplasia) or multiple(≥ 3) non-advanced adenomas or serrated adenomas. Cases of non-advanced adenomas were defined as adenomas < 10 mm, without features of HGD or villous histology. Controls were defined as those without polyps at the current colonoscopy and without a history of colorectal polyps. Data collection included: anthropometrics measured according to a standardized protocol, fasting blood tests performed at the same lab, medical history recorded by a structured interview and dietary intake evaluated by a 116-item food frequency questionnaire. Adherence to the MD components was evaluated according to intake above/below the sample median, for potentially beneficial/detrimental components respectively, as accepted. RESULTS We recruited 206 cases with advanced polyps, 192 cases with non-advanced adenoma and 385 controls. The number of adhered MD components was inversely associated with a diagnosis of advanced polyps in a dose-response manner(OR = 0.34, 95%CI: 0.17-0.65; OR = 0.22, 95%CI: 0.11-0.43; and OR = 0.18, 95%CI: 0.07-0.47 for 3-4, 5-7 and 8-10 components, respectively), but not with non-advanced adenomas(OR = 0.54, 95%CI: 0.25-1.13; OR = 0.48, 95%CI: 0.23-0.99; and OR = 0.43, 95%CI: 0.16-1.12 for 3-4, 5-7 and 8-10 components, respectively). Low intake of sugar-sweetened beverages and red meat, as well as high intake of fish, were inversely associated with advanced polyps(OR = 0.56, 95%CI: 0.36-0.87; OR = 0.63, 95%CI: 0.42-0.95; and OR = 0.66, 95%CI: 0.44-0.99, respectively), while only low intake of red meat was inversely associated with non-advanced adenomas(OR = 0.71, 95%CI: 0.49-0.97). CONCLUSION A better adherence to the MD, specifically low intake of sugar-sweetened beverages and red meat as well as high intake of fish, is related to lower odds for advanced polyps.

含糖饮料消费和抑郁风险:前瞻性队列研究的Meta分析

目的已发表的研究对含糖饮料(SSBs)消费与抑郁风险增加之间的关系得出了不一致的结论,为此,本Meta分析拟进一步评估SSBs摄入与抑郁风险之间的关系。方法检索PubMed、Web of Science、Embase、Cochrane、中国期刊全文数据库(CNKI)、万方数据库,搜集有关SSBs消费与抑郁风险的前瞻性队列研究,检索时间为建库至2023年3月1日。采用DerSimonian-Laird法进行异质性检验。采用随机效应模型进行效应量的合并,并通过亚组分析和敏感性分析寻找异质性的来源。通过漏斗图和Egger检验是否存在发表偏倚,并采用剪补法(Duval and Tweedie nonparametric trimandfillmethod)探究发表偏倚对结论的影响。结果本Meta分析纳入了7项队列研究,共294910名参与者。Meta分析结果显示,与SSBs摄入量最低组相比,摄入量最高组发生抑郁的综合风险为1.28(95%CI:1.08-1.51)。亚组分析结果显示,SSBs消费与抑郁风险的关联存在性别、年龄、地区和随访时间的差异。敏感性分析显示,本次所纳入的研究对SSBs摄入与抑郁风险的合并效应均没有过度影响。结论过量摄入SSBs有增加抑郁风险的可能,但仍需进一步证实。

中国九省成人含糖饮料消费及添加糖摄入量的趋势分析

目的了解中国九省2004-2009年成人含糖饮料中添加糖的消费现状。方法利用美国农业部添加糖数据库中含糖饮料的添加糖数据和"中国居民健康与营养调查"的"软饮料和含糖果汁饮料的消费"数据估算中国含糖饮料消费添加糖的摄入量。结果含糖饮料消费基本呈上升趋势。我国成人居民来自含糖饮料的添加糖摄入量平均每人每日为13.4 g。男性明显高于女性,城市居民高于农村地区。来自软饮料的添加糖摄入量高于含糖果汁。结论中国添加糖摄入量相对于其他发达国家还较低,也未超过世界卫生组织和美国心脏协会的建议值,但总体消费率呈上升趋势继续上升。