Predicting obesity reduction after implementing warning labels in Mexico: A modeling study

Basto-Abreu, Ana; Torres‐Álvarez, Rossana; Reyes-Sánchez, Francisco; González-Morales, Romina; Canto‐Osorio, Francisco; Colchero, M. Arantxa; Barquera, Sı́món; Rivera, Juan Á.; Barrientos‐Gutiérrez, Tonatiuh

doi:10.1371/journal.pmed.1003221

Cited by 53 publications

(54 citation statements)

References 26 publications

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“…In a time when some countries, states, and cities are implementing mandatory nutrition policies, including taxes on soft drinks [ 11 ] and front-of-package warning labels [ 12 , 13 ], there is much interest and debate around whether voluntary initiatives are effective. The success of PHE’s voluntary sugar reduction policy is heavily dependent on action by the entire food industry to reduce the sugar content of its products and to encourage changes in consumer behaviour towards purchasing lower sugar alternatives by launching new product lines or focussing marketing and advertising practices on lower sugar products.…”

Section: Introductionmentioning

confidence: 99%

The sugar content of foods in the UK by category and company: A repeated cross-sectional study, 2015-2018

et al. 2021

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Background Consumption of free sugars in the UK greatly exceeds dietary recommendations. Public Health England (PHE) has set voluntary targets for industry to reduce the sales-weighted mean sugar content of key food categories contributing to sugar intake by 5% by 2018 and 20% by 2020. The aim of this study was to assess changes in the sales-weighted mean sugar content and total volume sales of sugar in selected food categories among UK companies between 2015 and 2018. Methods and findings We used sales data from Euromonitor, which estimates total annual retail sales of packaged foods, for 5 categories—biscuits and cereal bars, breakfast cereals, chocolate confectionery, sugar confectionery, and yoghurts—for 4 consecutive years (2015–2018). This analysis includes 353 brands (groups of products with the same name) sold by 99 different companies. These data were linked with nutrient composition data collected online from supermarket websites over 2015–2018 by Edge by Ascential. The main outcome measures were sales volume, sales-weighted mean sugar content, and total volume of sugar sold by category and company. Our results show that between 2015 and 2018 the sales-weighted mean sugar content of all included foods fell by 5.2% (95% CI −9.4%, −1.4%), from 28.7 g/100 g (95% CI 27.2, 30.4) to 27.2 g/100 g (95% CI 25.8, 28.4). The greatest change seen was in yoghurts (−17.0% [95% CI −26.8%, −7.1%]) and breakfast cereals (−13.3% [95% CI −19.2%, −7.4%]), with only small reductions in sugar confectionery (−2.4% [95% CI −4.2%, −0.6%]) and chocolate confectionery (−1.0% [95% CI −3.1, 1.2]). Our results show that total volume of sugars sold per capita fell from 21.4 g/d (95% CI 20.3, 22.7) to 19.7 g/d (95% CI 18.8, 20.7), a reduction of 7.5% (95% CI −13.1%, −2.8%). Of the 50 companies representing the top 10 companies in each category, 24 met the 5% reduction target set by PHE for 2018. The key limitations of this study are that it does not encompass the whole food market and is limited by its use of brand-level sales data, rather than individual product sales data. Conclusions Our findings show there has been a small reduction in total volume sales of sugar in the included categories, primarily due to reductions in the sugar content of yoghurts and breakfast cereals. Additional policy measures may be needed to accelerate progress in categories such as sugar confectionery and chocolate confectionery if the 2020 PHE voluntary sugar reduction targets are to be met.

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Section: Introductionmentioning

confidence: 99%

The sugar content of foods in the UK by category and company: A repeated cross-sectional study, 2015-2018

et al. 2021

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“…First, the expected change in NEDF intake due to the tax was obtained from an observational study that estimated the impact of the tax in NEDF purchases (15); thus, we had to assume that the observed changes in household purchases translate into changes in individual-level intake. This assumption is common to prior studies that have estimated the impact of sugarsweetened beverages on body weight (52)(53)(54)(55). We used the 5.1% decrease in NEDF household purchases reported by Batis et al as a conservative estimate, although a subsequent evaluation observed a mean reduction in NEDF purchases of 6.0% in 2014-2015, which is related to a larger reduction in purchases in the second year of tax (27).…”

Section: Discussionmentioning

confidence: 99%

Potential Impact of the Nonessential Energy-Dense Foods Tax on the Prevalence of Overweight and Obesity in Children: A Modeling Study

Illescas-Zárate

Batis

Ramirez‐Silva

et al. 2021

Front. Public Health

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Background: Consumption of foods high in energy, sugar, fat, and salt contributes to the increase in body mass index and the prevalence of overweight and obesity in children. Mexico implemented an 8% tax to non-essential energy-dense foods (NEDF) in 2014 as part of a national strategy to reduce obesity.Objective: We modeled the potential effect of the NEDF tax on body mass index and overweight and obesity in Mexican children (6–17 years).Materials and Methods: We used the Dynamic Childhood Growth and Obesity Model calibrated to Mexican children to simulate the potential 1-year effect of the NEDF tax on body weight. Inputs for the model included NEDF consumption, weight, and height, obtained from the 2012 Mexican National Health and Nutrition Survey. To project the potential impact of the tax, we ran a first simulation without intervention and another reducing the caloric intake from NEDF in the proportion observed in the Mexican population after the tax (−5.1%). The tax effect was defined as the absolute difference in body mass index and prevalence of overweight and obesity between both models.Results: The tax on NEDF should lead to a mean reduction of 4.1 g or 17.4 kcal/day of NEDF at the population level. One year after the tax, mean body weight and body mass index should decrease 0.40 kg and 0.19 kg/m2; this translates into −1.7 and −0.4% points in overweight and obesity, respectively.Conclusions: The use of fiscal instruments to discourage the consumption of NEDF could help to reduce the prevalence of overweight and obesity in children.

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“…In our study, CHD excess mortality was mainly explained through increases in risk factors, mostly changes in diabetes, cholesterol and physical inactivity. These changes occurred along with rapid urbanization and changes in dietary patterns, leading to more physical inactivity and a transition from traditional to Westernised ultra-processed diet [41][42][43][44][45]. These changes in behavioral lifestyles have been associated with an increase in diabetes, obesity and hypercholesterolemia [16,23,45,46].…”

Section: Discussionmentioning

confidence: 99%

“…The fact that these risk factors share the same fundamental causes, points at the opportunities to implement population-based interventions to provide healthier contexts for diet and physical activity [ 22 ]. Over the past decade, Mexico has developed a clear agenda to reduce obesity and metabolic diseases, based on population interventions, such as taxes to unhealthy foods and food warning labels [ 41 , 42 ]. However, further population-based policies efforts will be needed to reduce obesity, diabetes and CHD deaths in Mexico.…”

Section: Discussionmentioning

confidence: 99%

Explaining the increment in coronary heart disease mortality in Mexico between 2000 and 2012

et al. 2020

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Background Mexico is still in the growing phase of the epidemic of coronary heart disease (CHD), with mortality increasing by 48% since 1980. However, no studies have analyzed the drivers of these trends. We aimed to model CHD deaths between 2000 and 2012 in Mexico and to quantify the proportion of the mortality change attributable to advances in medical treatments and to changes in population-wide cardiovascular risk factors. Methods We performed a retrospective analysis using the previously validated IMPACT model to explain observed changes in CHD mortality in Mexican adults. The model integrates nationwide data at two-time points (2000 and 2012) to quantify the effects on CHD mortality attributable to changes in risk factors and therapeutic trends. Results From 2000 to 2012, CHD mortality rates increased by 33.8% in men and by 22.8% in women. The IMPACT model explained 71% of the CHD mortality increase. Most of the mortality increases could be attributed to increases in population risk factors, such as diabetes (43%), physical inactivity (28%) and total cholesterol (24%). Improvements in medical and surgical treatments together prevented or postponed 40.3% of deaths; 10% was attributable to improvements in secondary prevention treatments following MI, while 5.3% to community heart failure treatments. Conclusions CHD mortality in Mexico is increasing due to adverse trends in major risk factors and suboptimal use of CHD treatments. Population-level interventions to reduce CHD risk factors are urgently needed, along with increased access and equitable distribution of therapies.

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Predicting obesity reduction after implementing warning labels in Mexico: A modeling study

Cited by 53 publications

References 26 publications

The sugar content of foods in the UK by category and company: A repeated cross-sectional study, 2015-2018

The sugar content of foods in the UK by category and company: A repeated cross-sectional study, 2015-2018

Potential Impact of the Nonessential Energy-Dense Foods Tax on the Prevalence of Overweight and Obesity in Children: A Modeling Study

Explaining the increment in coronary heart disease mortality in Mexico between 2000 and 2012

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