Ford C N, Poti J M, Ng S W, Popkin B M
Department of Epidemiology MD Anderson Cancer Center, The University of Texas, Houston, Texas, (USA), 77030.
Department of Nutrition and Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Pediatr Obes. 2017 Apr;12(2):146-154. doi: 10.1111/ijpo.12121. Epub 2016 Apr 5.
Taxing sugar-sweetened beverages (SSBs) has been proposed as a strategy to combat child obesity. Yet it is unclear how a tax on SSBs might influence the overall quality of diet in preschool children. Thus, we use simulated price increases and the 2010 Healthy Eating Index (HEI-2010) to explore the relationship between SSB taxes and diet quality in preschool children.
Price and purchase data from the 2009-2012 Nielsen Homescan Panel and a two-part marginal effects model were used to estimate relative changes in purchases with a 20% increase in the price of SSBs. Demand elasticities were applied to dietary intake data for children ages 2-5 years from the National Health and Nutrition Examination Survey (2009-2010 and 2011-2012) to estimate the impact of a 20% SSB tax on dietary intake and quality (HEI-2010).
A 20% increase in the price of SSBs was associated with lower total caloric intake (-28 kcal d , p < 0.01), caloric intake from juice drinks (-20 kcal d , p < 0.01), added sugars (-4.1 servings d , p = 0.03), refined grains (-0.63 servings d , p < 0.01) and total meat (-0.56 servings d , p < 0.01). Beneficial decreases in empty calories and refined grains were offset by unfavourable changes in fatty acid profile, total protein, vegetables and fruit, such that total HEI scores (0-100 range) were not meaningfully changed with a 20% increase in SSB price (difference: -0.85, p < 0.01).
A 20% tax on SSBs could decrease caloric intake, and intakes of added sugars and SSBs, but may not improve diet quality as an isolated intervention among US preschool children.
对含糖饮料征税已被提议作为应对儿童肥胖的一项策略。然而，对含糖饮料征税如何影响学龄前儿童的整体饮食质量尚不清楚。因此，我们利用模拟价格上涨和2010年健康饮食指数（HEI - 2010）来探究对含糖饮料征税与学龄前儿童饮食质量之间的关系。
使用2009 - 2012年尼尔森家庭扫描面板的价格和购买数据以及两部分边际效应模型，来估计含糖饮料价格上涨20%时购买量的相对变化。将需求弹性应用于国家健康与营养检查调查（2009 - 2010年和2011 - 2012年）中2至5岁儿童的饮食摄入数据，以估计含糖饮料征税20%对饮食摄入和质量（HEI - 2010）的影响。
含糖饮料价格上涨20%与总热量摄入降低（-28千卡/天，p < 0.01）、果汁饮料热量摄入降低（-20千卡/天，p < 0.01）、添加糖摄入降低（-4.1份/天，p = 0.03）、精制谷物摄入降低（-0.63份/天，p < 0.01）以及总肉类摄入降低（-0.56份/天，p < 0.01）相关。空热量和精制谷物的有益减少被脂肪酸谱、总蛋白质、蔬菜和水果的不利变化所抵消，以至于含糖饮料价格上涨20%时，总HEI得分（0 - 100分范围）没有显著变化（差异：-0.85，p < 0.01）。
对含糖饮料征收20%的税可能会降低热量摄入、添加糖和含糖饮料的摄入量，但作为一项单独干预措施，在美国学龄前儿童中可能无法改善饮食质量。
