Soda Tax & Its Effect on Childhood Obesity

A penny-an-ounce tax on sweetened beverages would have a bigger effect on childhood obesity in the United States than would after-school physical activity programs or a ban on fast food advertising directed at children, a new study has claimed.

A tax would also be easier to implement than the other programs and would raise a substantial amount of revenue that could be used to fund other anti-obesity initiatives, the researchers wrote in a paper published in the American Journal of Preventive Medicine (Kristensen et al., 2014).

Alyson H Kristensen, lead author and a senior research scientist at the Partnership for Prevention – a non-partisan organisation in Washington, DC that advocates prevention and health promotion policies – cited evidence that childhood obesity in the US may have leveled off and begun to decline but that nearly one in three people aged 2-19 was still overweight or obese. The overall obesity rate in this age group was 17%. The rate was lower in non-Hispanic white youths (14%) and was higher among Hispanic youths (21.3%) and non-Hispanic black youths (24.3%).

In the study, Kristensen and her colleagues used a microsimulation analysis to assess the possible effect of three policies on rates of obesity if they were implemented nationwide by the federal government: after-school physical activity programs, a ban on fast food television advertising targeting children, and an excise tax of one cent an ounce on sugar sweetened beverages such as sodas, sports drinks, and sugar sweetened teas. Obesity was defined as having a body mass index at or above the 95th percentile for age and sex, and overweight was defined as having a body mass index at or above the 85th percentile but below the 95th percentile.

The simulation found that after-school physical activity programs would lead to a 1.8% reduction in obesity rates among children aged 6-12 and a 1.9% reduction among adolescents aged 13-18. The effect would be greatest among black and Hispanic adolescents, with obesity rates falling by 2.3% and 2.4% respectively, compared with 1.6% among whites.

However, the study showed that the penny-an-ounce excise tax on sugar sweetened beverages would have the biggest overall effect on obesity, reducing the rate by 2.4%. This approach would “also reduce disparities, especially in adolescents,” the researchers said, adding, “Obesity in blacks and Hispanics would drop by 3.0 and 2.9 percentage points, respectively, compared with 2.0 percentage points in whites.” The effect was smaller among white people because, firstly, they had a lower baseline rate of obesity, and secondly, white people generally have higher incomes and would be less affected by the higher prices on taxed beverages, the researchers explained.

A ban on television advertising was found to have the greatest behavioral effect but also the smallest effect on obesity – reducing the obesity rate by just 0.6% and the rate of overweight by 0.2%. This small effect was due to the intervention’s narrow focus on fast food, the researchers said, and the fact that other meals would be substituted for those that would have been eaten at a fast food restaurant.

“All three policies could reduce childhood obesity prevalence, particularly among blacks and Hispanics, who have higher rates of obesity than whites, thus demonstrating that federal policy could alter the childhood obesity epidemic,” the researchers said.

They concluded that, in addition to having a bigger effect, the penny-an-ounce tax would have other advantages: it would face fewer legal hurdles, be easier to implement, generate more than $13bn (£7.9bn; €9.9bn) a year in revenue, and lead to a reduction in obesity among adults as well as children.

Reference (In Article)

Kristensen AH, Flottemesch TJ, Maciosek MV, Jenson J, Barclay G, Ashe M, et al. (2014) Reducing Childhood Obesity through US Federal Policy: A Microsimulation Analysis. American Journal of Preventive Medicine.


BMJ 2014;349:g5456


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