Using nutritional survey data to inform the design of sugar-sweetened beverage taxes in low-resource contexts: a cross-sectional analysis based on data from an adult Caribbean population
Creators: name: Alvarado, Miriam
name: Harris, Rachel
name: Rose, Angela
name: Unwin, Nigel
name: Hambleton, Ian
name: Imamura, Fumiaki
name: Adams, Jean
Publisher: name: Apollo - University of Cambridge Repository
Year: 2020
Subjects: Public health
1506
1724
health policy
nutrition
epidemiology
public health

description: Funder: Robinson College, University of Cambridge
description: Funder: Medical Research Council; FundRef: http://dx.doi.org/10.13039/501100000265
description: Funder: British Heart Foundation; FundRef: http://dx.doi.org/10.13039/501100000274
description: Funder: UKCRC Public Health Research Centre of Excellence
description: Funder: Economic and Social Research Council; FundRef: http://dx.doi.org/10.13039/501100000269
description: Funder: Cancer Research UK; FundRef: http://dx.doi.org/10.13039/501100000289
description: Funder: Wellcome Trust; FundRef: http://dx.doi.org/10.13039/100004440
description: Funder: Yates Unilever Fund
description: Funder: The Ministry of Health of the Government of Barbados
description: Funder: National Institute for Health Research; FundRef: http://dx.doi.org/10.13039/501100000272
description: Funder: Gates Cambridge PhD Scholarship
description: Funder: Smuts Memorial Fund, University of Cambridge; FundRef: http://dx.doi.org/10.13039/501100000710
description: Funder: Global Food Security Fund
description: Funder: Luca D’Agliano Scholarship
description: Objective: Sugar-sweetened beverage (SSB) taxes have been implemented widely. We aimed to use a pre-existing nutritional survey data to inform SSB tax design by assessing: (1) baseline consumption of SSBs and SSB-derived free sugars, (2) the percentage of SSB-derived free sugars that would be covered by a tax and (3) the extent to which a tax would differentiate between high-sugar SSBs and low-sugar SSBs. We evaluated these three considerations using pre-existing nutritional survey data in a developing economy setting. Methods: We used data from a nationally representative cross-sectional survey in Barbados (2012–2013, prior to SSB tax implementation). Data were available on 334 adults (25–64 years) who completed two non-consecutive 24-hour dietary recalls. We estimated the prevalence of SSB consumption and its contribution to total energy intake, overall and stratified by taxable status. We assessed the percentage of SSB-derived free sugars subject to the tax and identified the consumption-weighted sugar concentration of SSBs, stratified by taxable status. Findings: Accounting for sampling probability, 88.8% of adults (95% CI 85.1 to 92.5) reported SSB consumption, with a geometric mean of 2.4 servings/day (±2 SD, 0.6, 9.2) among SSB consumers. Sixty percent (95% CI 54.6 to 65.4) of SSB-derived free sugars would be subject to the tax. The tax did not clearly differentiate between high-sugar beverages and low-sugar beverages. Conclusion: Given high SSB consumption, targeting SSBs was a sensible strategy in this setting. A substantial percentage of free sugars from SSBs were not covered by the tax, reducing possible health benefits. The considerations proposed here may help policymakers to design more effective SSB taxes.