Health benefits of reducing sugar-sweetened beverage intake in high risk populations of California: results from the cardiovascular disease (CVD) policy model

• Published in: PloS one 2013-12, Vol.8 (12), p.e81723
• Main Authors: Mekonnen, Tekeshe A, Odden, Michelle C, Coxson, Pamela G, Guzman, David, Lightwood, James, Wang, Y Claire, Bibbins-Domingo, Kirsten
• Format: Article
• Language: English
• Subjects: African Americans; Beverages; Beverages - adverse effects; Blood Pressure; Body mass; Body Mass Index; Body size; California; Cardiovascular disease; Cardiovascular diseases; Computer simulation; Consumption; Coronary artery disease; Coronary heart disease; Cost engineering; Cost reduction; Cost-Benefit Analysis - statistics & numerical data; Diabetes mellitus; Diabetes Mellitus, Type 2 - economics; Diabetes Mellitus, Type 2 - etiology; Diabetes Mellitus, Type 2 - prevention & control; Forecasts and trends; Health care; Health care costs; Health risk assessment; Health risks; Heart diseases; Hispanic Americans; Humans; Hypertension; Income; Minority & ethnic groups; Models, Statistical; Myocardial Infarction - economics; Myocardial Infarction - etiology; Myocardial Infarction - prevention & control; Obesity; Obesity - economics; Obesity - etiology; Obesity - prevention & control; Risk; Risk Factors; Subgroups; Subpopulations; Sugar; Sweetening Agents - adverse effects; Taxation
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0081723

Consumption of sugar-sweetened beverage (SSB) has risen over the past two decades, with over 10 million Californians drinking one or more SSB per day. High SSB intake is associated with risk of type 2 diabetes, obesity, hypertension, and coronary heart disease (CHD). Reduction of SSB intake and the potential impact on health outcomes in California and among racial, ethnic, and low-income sub-groups has not been quantified. We projected the impact of reduced SSB consumption on health outcomes among all Californians and California subpopulations from 2013 to 2022. We used the CVD Policy Model - CA, an established computer simulation of diabetes and heart disease adapted to California. We modeled a reduction in SSB intake by 10-20% as has been projected to result from proposed penny-per-ounce excise tax on SSB and modeled varying effects of this reduction on health parameters including body mass index, blood pressure, and diabetes risk. We projected avoided cases of diabetes and CHD, and associated health care cost savings in 2012 US dollars. Over the next decade, a 10-20% SSB consumption reduction is projected to result in a 1.8-3.4% decline in the new cases of diabetes and an additional drop of 0.5-1% in incident CHD cases and 0.5-0.9% in total myocardial infarctions. The greatest reductions are expected in African Americans, Mexican Americans, and those with limited income regardless of race and ethnicity. This reduction in SSB consumption is projected to yield $320-620 million in medical cost savings associated with diabetes cases averted and an additional savings of $14-27 million in diabetes-related CHD costs avoided. A reduction of SSB consumption could yield substantial population health benefits and cost savings for California. In particular, racial, ethnic, and low-income subgroups of California could reap the greatest health benefits.