Study projections suggest that Mexico’s soda tax can substantially reduce consumption of sugar-sweetened drinks and reduce the prevalence of type 2 diabetes and cardiovascular disease.
In Mexico, approximately 70% of adults are overweight or obese, and 14% are diabetic. The prevalence of obesity and diabetes in Mexico is among the highest globally, and has been linked to the consumption of a large amount of sugar-sweetened beverages (SSBs) like soda. It is estimated that one-fifth of the total caloric intake of Mexican adults comes from SSBs, and is a major source of energy for both adults and children in areas without safe drinking water. According to a recent statement from the World Health Organization, the consumption of added sugar in sodas or sweetened beverages is a significant factor increasing the global rate of obesity and type 2 diabetes.
To help combat their alarming public health crisis, the Mexican government implemented a 10% excise tax (one peso or $0.06 USD per liter) on SSBs in 2014. The expectation of the tax is that it will reduce SSB intake and prevent downstream negative health outcomes and the economic burden of health-related costs. In 2014, the sales of taxed SSBs in Mexico fell an average of 6%, but it is unknown as to what the impact of the tax will be on the reduction of chronic diseases like diabetes in the long-term.
Using national demographic and epidemiologic data, a group of researchers developed a simulation model of cardiovascular disease (Cardiovascular Disease Policy Model -Mexico) to project the potential long-term impact of Mexico’s soda tax on diabetes, cardiovascular disease, mortality, and associated health care costs in adults aged 35 to 94 years of age over a period of 10 years. The change in SSB intake and the degree to which SSB calories would be replaced with calories from other sources were taken into account. A 10% decrease in SSB consumption and a caloric compensation between 0 and 100%, where all calories are translated to weight changes or no weight changes, respectively, were assumed and modeled in the main analysis.
Before projecting the impact of the reduction of SSB intake, a base case was established using relevant health data from the year 2012. On average, Mexican men consumed 1.24 servings of SSBs and women 0.86 servings, where one serving is equal to the size of a standard soda can (355ml). Study model simulations projected that 3.9 million new cases of diabetes and 1.2 million deaths associated with cardiovascular disease would occur in adults over the 10-year period between 2013 and 2022 if no changes were made to SSB consumption.
If there was a sustained, population-wide 10% reduction in SSB consumption with 39% caloric compensation, the researchers projected that the number of new cases of diabetes would be reduced by 200,000, translating into a 5% lower incidence than with no SSB consumption changes over the 10-year time period. The reduction in diabetes burden would have a profound impact on Mexico’s economy, with almost 1 billion international dollars in savings of direct healthcare costs incurred by diabetes patients. If the degree of caloric compensation was assumed to be 100% (all calories replaced by other caloric sources) or 0% (no calories replaced), the number of diabetes cases could be reduced by as few as 66,000 or as many as 265,000 cases, respectively.
Similar to diabetes, cardiovascular disease events and deaths were projected to be reduced following a 10% reduction in SSB intake and 39% caloric compensation. The decrease in SSB consumption would translate into 46,000 fewer incident cases of coronary heart disease, 6,000 fewer stroke cases, 11,000 less stroke-related deaths, and 19,000 less deaths from all causes. The projected decreases in events and deaths were most prominent in the youngest age group at 35-44 years of age, and were less so with each increasing age group. If the degree of caloric compensation was assumed to be 100% or 0%, the reduction in SSB consumption could prevent as few as 1,500 myocardial infarctions or as many as 22,000. The reduction in SSB consumption is projected to have a greater impact on men than women in any scenario, and on the 35-44 years of age group examined in the simulation.
This study revealed three main results. First, the Mexican SSB tax is projected to have a significant impact on the reduction of incident cases of diabetes and cardiovascular disease, as well as mortality over 10 years. Second, the SSB tax will affect adults between the ages of 35 to 44 years old the most, likely with increasing impact as they grow older. Last, the implementation of an SSB tax has a legitimate place in the health toolkit to combat the health epidemics of obesity, diabetes, and cardiovascular disease in Mexico, and may serve as a model for other countries to follow suit.
Written By: Fiona Wong, PhD