scholarly journals Taxed and untaxed beverage intake by South African young adults after a national sugar-sweetened beverage tax: A before-and-after study

PLoS Medicine ◽  
2021 ◽  
Vol 18 (5) ◽  
pp. e1003574
Author(s):  
Michael Essman ◽  
Lindsey Smith Taillie ◽  
Tamryn Frank ◽  
Shu Wen Ng ◽  
Barry M. Popkin ◽  
...  
Keyword(s):  
South Africa ◽  
South African ◽  
Energy Intake ◽  
Behavioral Change ◽  
Cross Sectional ◽  
Sugar Sweetened Beverage ◽  
Sugar Intake ◽  
Sweetened Beverage ◽  
Before And After ◽  
Before And After Study

Background In an effort to prevent and reduce the prevalence rate of people with obesity and diabetes, South Africa implemented a sugar-content-based tax called the Health Promotion Levy in April 2018, one of the first sugar-sweetened beverage (SSB) taxes to be based on each gram of sugar (beyond 4 g/100 ml). This before-and-after study estimated changes in taxed and untaxed beverage intake 1 year after the tax, examining separately, to our knowledge for the first time, the role of reformulation distinct from behavioral changes in SSB intake. Methods and findings We collected single-day 24-hour dietary recalls from repeat cross-sectional surveys of adults aged 18–39 years in Langa, South Africa. Participants were recruited in February–March 2018 (pre-tax, n = 2,459) and February–March 2019 (post-tax, n = 2,489) using door-to-door sampling. We developed time-specific food composition tables (FCTs) for South African beverages before and after the tax, linked with the diet recalls. By linking pre-tax FCTs only to dietary intake data collected in the pre-tax and post-tax periods, we calculated changes in beverage intake due to behavioral change, assuming no reformulation. Next, we repeated the analysis using an updated FCT in the post-tax period to capture the marginal effect of reformulation. We estimated beverage intake using a 2-part model that takes into consideration the biases in using ordinary least squares or other continuous variable approaches with many individuals with zero intake. First, a probit model was used to estimate the probability of consuming the specific beverage category. Then, conditional on a positive outcome, a generalized linear model with a log-link was used to estimate the continuous amount of beverage consumed. Among taxed beverages, sugar intake decreased significantly (p < 0.0001) from 28.8 g/capita/day (95% CI 27.3–30.4) pre-tax to 19.8 (95% CI 18.5–21.1) post-tax. Energy intake decreased (p < 0.0001) from 121 kcal/capita/day (95% CI 114–127) pre-tax to 82 (95% CI 76–87) post-tax. Volume intake decreased (p < 0.0001) from 315 ml/capita/day (95% CI 297–332) pre-tax to 198 (95% CI 185–211) post-tax. Among untaxed beverages, sugar intake increased (p < 0.0001) by 5.3 g/capita/day (95% CI 3.7 to 6.9), and energy intake increased (p < 0.0001) by 29 kcal/capita/day (95% CI 19 to 39). Among total beverages, sugar intake decreased significantly (p = 0.004) by 3.7 (95% CI −6.2 to −1.2) g/capita/day. Behavioral change accounted for reductions of 24% in energy, 22% in sugar, and 23% in volume, while reformulation accounted for additional reductions of 8% in energy, 9% in sugar, and 14% in volume from taxed beverages. The key limitations of this study are an inability to make causal claims due to repeat cross-sectional data collection, and that the magnitude of reduction in taxed beverage intake may not be generalizable to higher income populations. Conclusions Using a large sample of a high-consuming, low-income population, we found large reductions in taxed beverage intake, separating the components of behavioral change from reformulation. This reduction was partially compensated by an increase in sugar and energy from untaxed beverages. Because policies such as taxes can incentivize reformulation, our use of an up-to-date FCT that reflects a rapidly changing food supply is novel and important for evaluating policy effects on intake.

Assessing sugar-sweetened beverage intakes, added sugar intakes and BMI before and after the implementation of a sugar-sweetened beverage tax in South Africa

2020 ◽  
pp. 1-11
Author(s):  
Stephanie V Wrottesley ◽  
Nicholas Stacey ◽  
Gudani Mukoma ◽  
Karen J Hofman ◽  
Shane A Norris
Keyword(s):  
South Africa ◽  
South African ◽  
Sugar Consumption ◽  
Added Sugar ◽  
Sugar Sweetened Beverage ◽  
Sweetened Beverage ◽  
High Consumption ◽  
Before And After ◽  
Middle Aged Adults ◽  
Insight Into

Abstract Objective: To provide insight into the context and public health implications of the South African sugar-sweetened beverage (SSB) tax (Health Promotion Levy; HPL) by describing SSB and added sugar intakes, as well as BMI, 1 year prior to, at the time of and 1 year after implementation of the HPL. Design: Longitudinal dietary intake was assessed using a quantitative food frequency questionnaire (QFFQ) and BMI was measured via anthropometry. Setting: Soweto, Johannesburg, South Africa. Participants: Adolescents, young adults and middle-aged adults (n 617). Results: At baseline, median SSB intakes were 36 ml/d, 214 ml/d and 750 ml/d for those in low, medium and high consumption tertiles, respectively. SSB intake decreased by two times/week in medium consumers and seven times/week in high consumers between baseline and 12 months, equivalent to 107 ml/d and 536 ml/d reductions, respectively. These reduced levels were maintained in the following year (i.e. to 24 months). There was an overall decrease in the amount of energy consumed as added sugar in the low (−48 kJ/d), medium (−153 kJ/d) and high (−106 kJ/d) SSB consumption groups between baseline and 24 months; however, the percentage of total energy consumed as added sugar remained relatively consistent (between 10 and 11 %). There were small overall increases in BMI across low (0·6 kg/m2), medium (0·9 kg/m2) and high (1·0 kg/m2) SSB tertiles between baseline and 24 months. Conclusions: These findings suggest reductions in SSB and added sugar consumption contemporaneous to the introduction of the HPL – particularly for those with higher baseline intakes.

scholarly journals Sugar-sweetened beverage consumption and association with weight status in Irish children: a cross-sectional study prior to the introduction of a government tax on sugar-sweetened beverages

2020 ◽  
Vol 23 (12) ◽  
pp. 2234-2244
Author(s):  
Janas M Harrington ◽  
Catherine Perry ◽  
Eimear Keane ◽  
Ivan J Perry
Keyword(s):  
Energy Intake ◽  
Weight Status ◽  
Cross Sectional Study ◽  
Normal Weight ◽  
Sectional Study ◽  
Daily Energy Intake ◽  
Cross Sectional ◽  
Sugar Sweetened Beverage ◽  
Sweetened Beverage ◽  
Daily Energy

AbstractObjective:To provide baseline evidence of sugar-sweetened beverage (SSB) consumption in a sample of Irish children prior to the introduction of the SSB tax; to identify the energy contribution of SSB to daily energy intake; and to explore the association between SSB consumption and overweight/obesity.Design:Cross-sectional study.Setting:Primary schools in Cork, Ireland in 2012.Participants:1075 boys and girls aged 8–11 years. SSB consumption was assessed from 3-d food diaries. BMI was used to define obesity (International Obesity Taskforce definitions). Plausible energy reporters (n 724, 68 % of total sample) were classified using Schofield equation.Results:Eighty-two per cent of children with plausible energy intake consumed SSB. Mean energy intake from SSB was 485 kJ (6 % of total kJ). Mean kilojoules from SSB increased with weight status from 443 kJ for normal-weight children to 648 kJ for children with overweight/obesity (5·8 and 7·6 % of total kJ, respectively). Mean SSB intake was significantly higher in children with overweight/obesity than normal-weight children (383 and 315 ml/d). In adjusted analyses, children consuming >200 ml/d had an 80 % increased odds of overweight/obesity compared to those consuming <200 ml/d (OR 1·8, 95 % CI 1·0, 3·5). Family socioeconomic status and lifestyle determinants, including frequency of takeaway consumption and TV viewing, were also significantly associated with SSB consumption.Conclusions:SSB account for a substantial proportion of daily energy intake and are significantly associated with child overweight/obesity. This study provides baseline data from a sample of children from which the impact of the SSB tax can be benchmarked.

scholarly journals Cost of inaction on sugar-sweetened beverage consumption: implications for obesity in South Africa

2015 ◽  
Vol 19 (13) ◽  
pp. 2296-2304 ◽  
Author(s):  
Aviva Tugendhaft ◽  
Mercy Manyema ◽  
Lennert J Veerman ◽  
Lumbwe Chola ◽  
Demetre Labadarios ◽  
...  
Keyword(s):  
South Africa ◽  
South African ◽  
Preventive Measures ◽  
Population Distribution ◽  
National Income ◽  
Communicable Diseases ◽  
Obesity Prevalence ◽  
Non Communicable Diseases ◽  
Sugar Sweetened Beverage ◽  
Sweetened Beverage

AbstractObjectiveTo estimate the effect of increased sugar-sweetened beverage (SSB) consumption on future adult obesity prevalence in South Africa in the absence of preventive measures.DesignA model was constructed to simulate the effect of a 2·4 % annual increase in SSB consumption on obesity prevalence. The model computed the change in energy intake assuming a compounding increase in SSB consumption. The population distribution of BMI by age and sex was modelled by fitting measured data from the 2012 South African National Income Dynamics Survey to the log-normal distribution and shifting the mean values.SettingOver the past decade the prevalence of obesity and related non-communicable diseases has increased in South Africa, as have the sales and availability of SSB. Soft drink sales in South Africa are projected to grow between 2012 and 2017 at an annual compounded growth rate of 2·4 % in the absence of preventive measures to curb consumption.ResultsA 2·4 % annual growth in SSB sales alongside population growth and ageing will result in an additional 1 287 000 obese adults in South Africa by 2017, 22 % of which will be due to increased SSB consumption.ConclusionsIn order to meet the South African target of reducing the number of people who are obese and/or overweight by 10 % by 2020, the country cannot afford to delay implementing effective population-wide interventions. In the face of plans to increase growth of SSB, the country will soon face even greater challenges in overcoming obesity and related non-communicable diseases.

Effectiveness of tax reform on entrepreneurship

2019 ◽  
Vol 9 (1) ◽  
pp. 94-111
Author(s):  
Chigozie Andy Ngwaba ◽  
SeyedSoroosh Azizi
Keyword(s):  
South Africa ◽  
South African ◽  
Tax Reform ◽  
Cross Sectional ◽  
Content Type ◽  
Individual Level ◽  
Self Employment ◽  
The World Bank ◽  
Level Data ◽  
Before And After

Purpose The purpose of this paper is to investigate the effects of tax reform on entrepreneurship in South Africa using repeated cross-sectional data from the World Bank. Design/methodology/approach The paper adopts a difference-in-difference estimation technique as well as contrasting periods before and after the tax reform. This contrast is achieved by examining individuals in the formal and informal sector and measuring the effectiveness of the reform on self-employment. Findings The results indicate that the tax reform had a positive and significant effect on the probability of becoming self-employed in South Africa and is robust across different econometric specifications. Originality/value The authors use individual-level data to measure the effectiveness of a tax reform policy on entrepreneurship. Utilizing the South African post-Apartheid tax reform as a natural experiment allows the authors to identify the effects of taxes on the choice of becoming self-employed.

scholarly journals An evaluation of Chile’s Law of Food Labeling and Advertising on sugar-sweetened beverage purchases from 2015 to 2017: A before-and-after study

PLoS Medicine ◽  
2020 ◽  
Vol 17 (2) ◽  
pp. e1003015 ◽  
Author(s):  
Lindsey Smith Taillie ◽  
Marcela Reyes ◽  
M. Arantxa Colchero ◽  
Barry Popkin ◽  
Camila Corvalán
Keyword(s):  
Food Labeling ◽  
Sugar Sweetened Beverage ◽  
Sweetened Beverage ◽  
Before And After ◽  
Before And After Study

scholarly journals Missed Opportunities: The Need to Promote Public Knowledge and Awareness of Sugar-Sweetened Beverage Taxes

2021 ◽  
Vol 18 (9) ◽  
pp. 4607
Author(s):  
Emily A. Altman ◽  
Kristine A. Madsen ◽  
Laura A. Schmidt
Keyword(s):  
San Francisco ◽  
Correct Recall ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Missed Opportunities ◽  
Sugar Sweetened Beverage ◽  
Sweetened Beverage ◽  
Before And After ◽  
Education Levels ◽  
Missed Opportunity

Despite a growing body of evidence showing that sugar-sweetened beverage (SSB) taxes nudge consumers away from SSBs, we lack an understanding of people’s awareness and perceptions of SSB taxes and whether tax awareness and perceptions differ based on sociodemographic characteristics. We used serial cross-sectional study intercept surveys (n = 2715) in demographically diverse neighborhoods of Berkeley and Oakland in 2015 and 2017, and San Francisco and Richmond in 2017. In the year following successful SSB tax ballot measures, 45% of respondents correctly recalled that an SSB tax had passed in their city. In untaxed cities, 14% of respondents incorrectly thought that a tax had passed. Perceived benefits of SSB taxes to the community and to children’s health were moderate and, like correct recall of an SSB tax, were higher among respondents with higher education levels. Awareness of SSB taxes was low overall, and perceptions about taxes’ benefits varied by educational attainment, reflecting a missed opportunity to educate citizens about how SSB taxes work and their importance. Public health efforts should invest in campaigns that explain the benefits of SSB taxes and provide information about how tax revenues will be invested, both before and after a tax proposal has passed.

scholarly journals Projected effects on salt purchases following implementation of a national salt reduction policy in South Africa

2020 ◽  
pp. 1-18
Author(s):  
Rhoda N. Ndanuko ◽  
Maria Shahid ◽  
Alexandra Jones ◽  
Terry Harris ◽  
Joel Maboreke ◽  
...  
Keyword(s):  
South Africa ◽  
South African ◽  
Salt Content ◽  
Meat Products ◽  
Food Product ◽  
Food Groups ◽  
Food Category ◽  
Cross Sectional ◽  
Salt Reduction ◽  
Sectional Analysis

Abstract Objective: To assess the contribution of different food groups to total salt purchases and to evaluate the estimated reduction in salt purchases if mandatory maximum salt limits in South African legislation were being complied with. Design: This study conducted a cross-sectional analysis of purchasing data from Discovery Vitality members. Data were linked to the South African FoodSwitch database to determine the salt content of each food product purchased. Food category and total annual salt purchases were determined by summing salt content (kg) per each unit purchased across a whole year. Reductions in annual salt purchases were estimated by applying legislated maximum limits to product salt content. Setting: South Africa Participants: The study utilised purchasing data from 344,161 households, members of Discovery Vitality, collected for a whole year between January and December 2018. Results: Vitality members purchased R12.8 billion worth of food products in 2018, representing 9,562 products from which 264,583 kg of salt were purchased. The main contributors to salt purchases were bread and bakery products (23.3%); meat and meat products (19%); dairy (12.2%); sauces, dressings, spreads and dips (11.8%); and convenience foods (8.7%). The projected total quantity of salt that would be purchased after implementation of the salt legislation was 250,346 kg, a reduction of 5.4% from 2018 levels. Conclusions: A projected reduction in salt purchases of 5.4% from 2018 levels suggests that meeting the mandatory maximum salt limits in South Africa will make a meaningful contribution to reducing salt purchases.

scholarly journals Commitment and the emigration intentions of South African professional nurses

2013 ◽  
Vol 18 (1) ◽  
Author(s):  
Jeffrey J. Bagraim
Keyword(s):  
South Africa ◽  
South African ◽  
Employee Commitment ◽  
Western Cape ◽  
Public Health Services ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Tertiary Hospitals ◽  
Quantitative Design ◽  
The Relationship

The emigration of skilled nurses from South Africa exacerbates the crisis in the provision of public health services. A descriptive, quantitative design was applied to investigate the relationship between intention to emigrate and employee commitment. Over 400 registered nurses (N = 419), working within public sector tertiary hospitals in the Western Cape, responded to a cross-sectional survey questionnaire. Three foci of employee commitment (organisational, professional and national) were examined but only national commitment significantly helped predict intention to emigrate from South Africa in the regression model (beta = -0.0525, p < 0.0001). The implications of the results obtained in this study are discussed.Die emigrasie van verpleegkundiges uit Suid-Afrika vererger die krisis in die verskaffing van gesondheidsorgdienste in die land. ’n Beskrywende, kwantitatiewe ontwerp is gebruik om die verwantskap tussen werknemertoewyding en die voorneme om te emigreer te ondersoek. Meer as 400 verpleegsters (N = 419) wat in openbare tersiêre hospitale in die Wes-Kaap werk, het op die vraelys gereageer. Drie fokusareas van toewyding (organisatories, professioneel en nasionaal) is gemeet, maar net nasionale toewyding het daartoe bygedra om emigrasievoorneme te voorspel (beta = -0.0525, p < 0.0001). Die implikasies van hierdie resultate word bespreek.

scholarly journals The Relation Between Sugar Intake In Ultra Processed Beverages And Energy Intake Of Food And Beverage To Teenage Overweight

2020 ◽  
Vol 11 (2) ◽  
pp. 86-93
Author(s):  
Alvia Anggreini Setyaningrum ◽  
Sri Adiningsih
Keyword(s):  
Energy Intake ◽  
Sampling Technique ◽  
The Body ◽  
Nutrition Status ◽  
Observational Research ◽  
Chi Square ◽  
Cross Sectional ◽  
Sugar Intake ◽  
Food And Beverages ◽  
Food And Beverage

Overweight is an accumulation of excess adipose reserve within the body, resulting in an increase of bodyweight. Consumption of ultra-processed beverages, and energy intake from food and beverage are several fators that can cause the problem of overweight. This research aims to understand the relation between sugar intake in ultra-processed beverages and energy intake from food and beverages with overweight among teenage students of senior high school 6 Surabaya. The research is an observational research with cross-sectional design. Sampling is taken using proportional random sampling technique. The number of participants are 80 teenagers from 10th and 11th classes in June 2020. Participants are aged 15-18 years old. Energy intake from food and beverages are taken from 2x24 hour recall questionnaire, and sugar intake from ultra-processed beverages taken from seven-day beverages diary.. Statistical analysis are done using chi-square. The result shows relation between energy intake from food and beverages with overnutrition, with (p =< 0,001). In conclusion, excess energy intake from food and beverages relation with overweight problem to teenagers, thus requiring balanced nutritional guide education as well as annual nutrition status monitoring, from the school to its teenage students.  

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