Flow diagram for study selection.

<p>FSTA, Food Science and Technology Abstracts.</p

Posterior median standardised mortality rates (95% CIs) and standardised rate ratios (95% CIs) by DoR and cause of death.

1<p>Chinese reference (same DoR).</p>2<p>DoR (25+) reference.</p

Posterior median standardised mortality rates (95% CIs) and standardised rate ratios (95% CIs) by natality and cause of death.

1<p>Chinese reference (same natality).</p

Food Pricing Strategies, Population Diets, and Non-Communicable Disease: A Systematic Review of Simulation Studies

<div><h3>Background</h3><p>Food pricing strategies have been proposed to encourage healthy eating habits, which may in turn help stem global increases in non-communicable diseases. This systematic review of simulation studies investigates the estimated association between food pricing strategies and changes in food purchases or intakes (consumption) (objective 1); Health and disease outcomes (objective 2), and whether there are any differences in these outcomes by socio-economic group (objective 3).</p> <h3>Methods and Findings</h3><p>Electronic databases, Internet search engines, and bibliographies of included studies were searched for articles published in English between 1 January 1990 and 24 October 2011 for countries in the Organisation for Economic Co-operation and Development. Where ≥3 studies examined the same pricing strategy and consumption (purchases or intake) or health outcome, results were pooled, and a mean own-price elasticity (own-PE) estimated (the own-PE represents the change in demand with a 1% change in price of that good). Objective 1: pooled estimates were possible for the following: (1) taxes on carbonated soft drinks: own-PE (<em>n = </em>4 studies), −0.93 (range, −0.06, −2.43), and a modelled −0.02% (−0.01%, −0.04%) reduction in energy (calorie) intake for each 1% price increase (<em>n = </em>3 studies); (2) taxes on saturated fat: −0.02% (−0.01%, −0.04%) reduction in energy intake from saturated fat per 1% price increase (<em>n = </em>5 studies); and (3) subsidies on fruits and vegetables: own-PE (<em>n = </em>3 studies), −0.35 (−0.21, −0.77). Objectives 2 and 3: variability of food pricing strategies and outcomes prevented pooled analyses, although higher quality studies suggested unintended compensatory purchasing that could result in overall effects being counter to health. Eleven of 14 studies evaluating lower socio-economic groups estimated that food pricing strategies would be associated with pro-health outcomes. Food pricing strategies also have the potential to reduce disparities.</p> <h3>Conclusions</h3><p>Based on modelling studies, taxes on carbonated drinks and saturated fat and subsidies on fruits and vegetables would be associated with beneficial dietary change, with the potential for improved health. Additional research into possible compensatory purchasing and population health outcomes is needed.</p> <p> <em>Please see later in the article for the Editors' Summary</em></p> </div

Scenario analyses: cost-effectiveness plane for the age group 50–54 y.

<p>GDP, gross domestic product.</p

Health states in the Markov model.

<p>CHF, congestive heart failure.</p

One-way sensitivity analysis: tornado plot for pooled subtypes for the age group 50–54 y.

<p>One-way sensitivity analysis: tornado plot for pooled subtypes for the age group 50–54 y.</p

Cost-effectiveness acceptability curves.

<p>Cost-effectiveness acceptability curves.</p

Scenario analysis: cost of trastuzumab decreases by 30%.

<p>Scenario analysis: cost of trastuzumab decreases by 30%.</p

Person time and deaths by sex by age and DoR, 2001<b>–</b>2004 cohort, ‘total’ definition of ethnicity, aggregated over the three Asian groups.

<p>All counts are random rounded to a near multiple of three with a minimum cell size of 6, as per Statistics New Zealand protocols. Person years are weighted person years.</p>1<p>Weighted deaths.</p