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新西兰垃圾食品和含糖饮料税对人口健康、卫生系统成本及温室气体排放的潜在影响:一项建模研究

Potential effect of real-world junk food and sugar-sweetened beverage taxes on population health, health system costs and greenhouse gas emissions in New Zealand: a modelling study.

作者信息

Grout Leah, Mizdrak Anja, Nghiem Nhung, Jones Amanda C, Blakely Tony, Ni Mhurchu Cliona, Cleghorn Christine

机构信息

Burden of Disease Epidemiology, Equity and Cost-Effectiveness Program, University of Otago, Wellington, New Zealand.

Population Interventions, Centre for Epidemiology and Biostatistics, The University of Melbourne School of Population and Global Health, Melbourne, Victoria, Australia.

出版信息

BMJ Nutr Prev Health. 2022 Feb 7;5(1):19-35. doi: 10.1136/bmjnph-2021-000376. eCollection 2022.

Abstract

Poor diet is a major risk factor for excess weight gain and obesity-related diseases, including cardiovascular diseases, type 2 diabetes mellitus, osteoarthritis and several cancers. This paper aims to assess the potential impacts of real-world food and beverage taxes on change in dietary risk factors, health gains (in quality-adjusted life years (QALYs)), health system costs and greenhouse gas (GHG) emissions as if they had all been implemented in New Zealand (NZ). Ten taxes or tax packages were modelled. A proportional multistate life table model was used to predict resultant QALYs and costs over the remaining lifespan of the NZ population alive in 2011, as well as GHG emissions. QALYs ranged from 12.5 (95% uncertainty interval (UI) 10.2 to 15.0; 3% discount rate) per 1000 population for the import tax on sugar-sweetened beverages (SSB) in Palau to 143 (95% UI 118 to 171) per 1000 population for the excise duties on saturated fat, chocolate and sweets in Denmark, while health expenditure savings ranged from 2011 NZ$245 (95% UI 188 to 310; 2020 US$185) per capita to NZ$2770 (95% UI 2140 to 3480; US$2100) per capita, respectively. The modelled taxes resulted in decreases in GHG emissions from baseline diets, ranging from -0.2% for the tax on SSB in Barbados to -2.8% for Denmark's tax package. There is strong evidence for the implementation of food and beverage tax packages in NZ or similar high-income settings.

摘要

不良饮食是体重过度增加以及肥胖相关疾病的主要风险因素,这些疾病包括心血管疾病、2型糖尿病、骨关节炎和几种癌症。本文旨在评估现实世界中食品和饮料税对饮食风险因素变化、健康收益(以质量调整生命年(QALYs)衡量)、卫生系统成本和温室气体(GHG)排放的潜在影响,就好像这些税收在新西兰(NZ)全部实施了一样。对十种税收或税收组合进行了建模。使用比例多状态生命表模型来预测2011年新西兰存活人口剩余寿命期间的QALYs和成本,以及温室气体排放。QALYs范围从帕劳对含糖饮料(SSB)征收的进口税每千人口12.5(95%不确定区间(UI)10.2至15.0;3%贴现率)到丹麦对饱和脂肪、巧克力和糖果征收的消费税每千人口143(95% UI 118至171),而卫生支出节省分别从人均2011新西兰元245(95% UI 188至310;2020美元185)到人均2770新西兰元(95% UI 2140至3480;2100美元)。建模的税收导致基线饮食的温室气体排放减少,范围从巴巴多斯对SSB征收的税减少-0.2%到丹麦的税收组合减少-2.8%。有强有力的证据支持在新西兰或类似的高收入环境中实施食品和饮料税组合。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/863d/9237873/edd168f83a2e/bmjnph-2021-000376f01.jpg

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