4 research outputs found
Body weight impact of the sugar- sweetened beverages tax in Mexican children: A modeling study
Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/156213/3/ijpo12636_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156213/2/ijpo12636-sup-0001-supinfo.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156213/1/ijpo12636.pd
Correction: Expected changes in obesity after reformulation to reduce added sugars in beverages: A modeling study.
[This corrects the article DOI: 10.1371/journal.pmed.1002664.]
Nonparametric Estimation of the Potential Impact Fraction and Population Attributable Fraction with Individual-Level and Aggregated Data
The estimation of the potential impact fraction (including the population
attributable fraction) with continuous exposure data frequently relies on
strong distributional assumptions. However, these assumptions are often
violated if the underlying exposure distribution is unknown or if the same
distribution is assumed across time or space. Nonparametric methods to estimate
the potential impact fraction are available for cohort data, but no
alternatives exist for cross-sectional data. In this article, we discuss the
impact of distributional assumptions in the estimation of the population impact
fraction, showing that under an infinite set of possibilities, distributional
violations lead to biased estimates. We propose nonparametric methods to
estimate the potential impact fraction for aggregated (mean and standard
deviation) or individual data (e.g. observations from a cross-sectional
population survey), and develop simulation scenarios to compare their
performance against standard parametric procedures. We illustrate our
methodology on an application of sugar-sweetened beverage consumption on
incidence of type 2 diabetes. We also present an R package pifpaf to implement
these methods
Expected changes in obesity after reformulation to reduce added sugars in beverages: A modeling study.
BACKGROUND:Several strategies have been proposed to reduce the intake of added sugars in the population. In Mexico, a 10% sugar-sweetened beverages (SSBs) tax was implemented in 2014, and the implementation of other nutritional policies, such as product reformulation to reduce added sugars, is under discussion. WHO recommends that all individuals consume less than 10% of their total energy intake (TEI) from added sugars. We propose gradually reducing added sugars in SSBs to achieve an average 10% consumption of added sugars in the Mexican population over 10 years and to estimate the expected impact of reformulation in adult body weight and obesity. METHODS AND FINDINGS:Baseline consumption for added sugars and SSBs, sex, age, socioeconomic status (SES), height, and weight for Mexican adults were obtained from the 2012 Mexico National Health and Nutrition Survey (ENSANUT). On average, 12.6% of the TEI was contributed by added sugars; we defined a 50% reduction in added sugars in SSBs over 10 years as a reformulation target. Using a dynamic weight change model, sugar reductions were translated into individual expected changes in body weight assuming a 43% caloric compensation and a 2-year lag for the full effect of reformulation to occur. Results were stratified by sex, age, and SES. Twelve years after reformulation, the TEI from added sugars is expected to decrease to 10%, assuming no compensation from added sugars; 44% of the population would still be above WHO recommendations, requiring further sugar reductions to food. Body weight could be reduced by 1.3 kg (95% CI -1.4 to -1.2) in the adult population, and obesity could decrease 3.9 percentage points (pp; -12.5% relative to baseline). Our sensitivity analyses suggest that the impact of the intervention could vary from 0.12 kg after 6 months to 1.52 kg in the long term. CONCLUSIONS:Reformulation to reduce added sugars in SSBs could produce large reductions in sugar consumption and obesity in the Mexican adult population. This study is limited by the use of a single dietary recall and by data collected in all seasons except summer; still, these limitations should lead to conservative estimates of the reformulation effect. Reformulation success could depend on government enforcement and industry and consumer response, for which further research and evidence are needed