Abstract
BACKGROUND: Excess added sugars, particularly from sugar-sweetened
beverages, are a major risk factor for cardiometabolic diseases including
cardiovascular disease and type 2 diabetes mellitus. In 2016, the US Food and
Drug Administration mandated the labeling of added sugar content on all
packaged foods and beverages. Yet, the potential health impacts and costeffectiveness of this policy remain unclear.
METHODS: A validated microsimulation model (US IMPACT Food
Policy model ) was used to estimate cardiovascular disease and type 2
diabetes mellitus cases averted, quality-adjusted life-years, policy costs,
health care, informal care, and lost productivity (health-related) savings
and cost-effectiveness of 2 policy scenarios: (1) implementation of the US
Food and Drug Administration added sugar labeling policy (sugar label),
and (2) further accounting for corresponding industry reformulation (sugar
label+reformulation). The model used nationally representative demographic
and dietary intake data from the National Health and Nutrition Examination
Survey, disease data from the Centers for Disease Control and Prevention
Wonder Database, policy effects and diet-disease effects from meta-analyses,
and policy and health-related costs from established sources. Probabilistic
sensitivity analysis accounted for model parameter uncertainties and
population heterogeneity.
RESULTS: Between 2018 and 2037, the sugar label would prevent 354400
cardiovascular disease (95% uncertainty interval, 167000–673500) and
599300 (302400–957400) diabetes mellitus cases, gain 727000 (401300–
1138000) quality-adjusted life-years, and save $31 billion (15.7–54.5) in net
healthcare costs or $61.9 billion (33.1–103.3) societal costs (incorporating
reduced lost productivity and informal care costs). For the sugar
label+reformulation scenario, corresponding gains were 708800 (369200–
1252000) cardiovascular disease cases, 1.2 million (0.7–1.7) diabetes mellitus
cases, 1.3 million (0.8–1.9) quality-adjusted life-years, and $57.6 billion
(31.9–92.4) and $113.2 billion (67.3–175.2), respectively. Both scenarios
were estimated with >80% probability to be cost saving by 2023.
CONCLUSIONS: Implementing the US Food and Drug Administration added
sugar labeling policy could generate substantial health gains and cost savings
for the US population
A new Nutrition Facts label that highlights the amount of added sugars in food could prevent nearly 1 million cases of heart disease and type 2 diabetes, suggests a new study published in the journal Circulation. If consumers had access to this new label, their food choices could prevent more than 350,000 cases of heart disease and nearly 600,000 cases of type 2 diabetes over the next two decades, researchers predicted using a computer model.
The new label, first proposed by the U.S. Food and Drug Administration (FDA) in May 2016, adds a new line under the “total carbohydrate” category that details the amount of sugar that has been added on top of the sugars already contained in a food product. Added sugars account for more than 15% of Americans' total daily calories, exceeding the recommended level of less than 10%, the researchers said in background notes.
The researchers used an already validated model that considers a variety of information—including demographics, risk factors, dietary habits, and diseases—to project the impact of the revised Nutrition Facts label on consumers’ food choices, their long-term health, and the economic cost of heart disease and type 2 diabetes.
According to the researchers, the most striking finding from the study came when they predicted what might happen if the food industry responded to the new label by reducing the amount of added sugars in products. Even a partial industry response could result in about 700,000 fewer cases of heart disease and 1.2 million fewer cases of type 2 diabetes over the next 20 years, the model shows.
“The industry should be part of the solution,” said Renata Micha, associate research professor at the Tufts University School of Nutrition Science and Policy. “We saw when we did account for even a modest industry reformulation, maximum health and economic gain can be achieved.”
The FDA has delayed implementation of the label until 2020.
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