Adelaide Dental School, The University of Adelaide, Adelaide, Australia.
Department of Dentistry - Quality and Safety of Oral Health Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Netherlands.
BMC Public Health. 2023 May 27;23(1):986. doi: 10.1186/s12889-023-15884-5.
As part of the Global Strategy on Oral health, the World Health Organization (WHO) is exploring cost-effective interventions for oral health, including taxation on sugar-sweetened beverages (SSBs). To inform this process, this umbrella review aimed to identify the best available estimates pertaining to the impact of SSB taxation on the reduction of sugars intake, and the sugars-caries dose-response, such that estimates of the impact of SSB taxation on averting dental caries in both high (HIC) and low and middle (LMIC) countries be available.
The questions addressed were: (1) what are the effects of SSB taxation on consumption of SSBs and (2) sugars? (3) What is the effect on caries of decreasing sugars? and (4) what is the likely impact of a 20% volumetric SSB tax on the number of active caries prevented over 10 years? Data sources included PubMed, Embase, Web of Science, Scopus, CINAHL, Dentistry and Oral Sciences Source, Cochrane Library, Joanna Briggs Institute (JBI) Systematic Review Register, and PROSPERO. The review was conducted with reference to JBI guidelines. The quality of included systematic reviews was assessed using AMSTAR to identify best evidence.
From 419 systematic reviews identified for questions 1 & 2, and 103 for question 3, 48 (Questions 1 & 2) and 21 (Question 3) underwent full text screening, yielding 14 and five included reviews respectively. Best available data indicated a 10% tax would reduce SSB intake by 10.0% (95% CI: -5.0, 14.7%) in HIC and by 9% (range -6.0 to 12.0%) in LMIC, and that a 20% tax would reduce free sugars intake on average by 4.0 g/d in LMIC and 4.4 g/d in HIC. Based on best available dose response data, this could reduce the number of teeth with caries per adults (HIC and LMIC) by 0.03 and caries occurrence in children by 2.7% (LMIC) and 2.9% (HIC), over a 10-year period.
Best available data suggest a 20% volumetric SSB tax would have a modest impact on prevalence and severity of dental caries in both HIC and LMIC.
作为全球口腔健康战略的一部分，世界卫生组织（WHO）正在探索针对口腔健康的具有成本效益的干预措施，包括对含糖饮料（SSB）征税。为了为这一过程提供信息，本伞式审查旨在确定有关 SSB 征税对减少糖摄入量和糖龋齿剂量反应影响的最佳现有估计数，以便在高收入国家（HIC）和低收入和中等收入国家（LMIC）中获得 SSB 征税对预防龋齿的影响的估计数。
所提出的问题是：（1）SSB 征税对 SSB 和（2）糖的消费有何影响？（3）减少糖对龋齿有何影响？（4）20％容积 SSB 税对预防 10 年内龋齿活跃数的可能影响是什么？数据来源包括 PubMed、Embase、Web of Science、Scopus、CINAHL、Dentistry and Oral Sciences Source、Cochrane 图书馆、 Joanna Briggs 研究所（JBI）系统评价登记处和 PROSPERO。该审查是根据 JBI 指南进行的。使用 AMSTAR 评估纳入的系统评价的质量，以确定最佳证据。
针对问题 1 和 2 确定了 419 项系统评价，针对问题 3 确定了 103 项系统评价，对 48 项（问题 1 和 2）和 21 项（问题 3）进行了全文筛选，分别得出 14 项和 5 项纳入的评价。最佳现有数据表明，10％的税收将使 HIC 中 SSB 的摄入量减少 10.0％（95％CI：-5.0，14.7％），而 LMIC 中 SSB 的摄入量减少 9％（范围为-6.0 至 12.0％），20％的税收将使 LMIC 中平均每天减少 4.0 克游离糖，HIC 中每天减少 4.4 克游离糖。根据最佳可用剂量反应数据，这可以使成年人（HIC 和 LMIC）每颗牙齿的龋齿数量减少 0.03，使儿童的龋齿发生率降低 2.7％（LMIC）和 2.9％（HIC），持续 10 年。
最佳现有数据表明，20％容积 SSB 税将对 HIC 和 LMIC 中龋齿的流行率和严重程度产生适度影响。
