Blog: Marking 5 years of the Soft Drinks Industry Levy – how can sugar taxes support children and young people’s health?

by Beth Bradshaw | 5 April, 2023 9:00 am

The 5th April marks an important anniversary for public health policy in the UK. Five years ago today, the UK Government officially introduced the Soft Drinks Industry Levy (SDIL). Designed as a tax to encourage soft drink manufacturers to reduce the sugar content of their drinks, the SDIL has removed over 45,000 tonnes of sugar from soft drinks from supermarket shelves[1][1].

According to the World Health Organisation (WHO), over 85 countries and cities currently operate a form of a tax on sugar-sweetened beverages (SSBs) and promote such taxes as an evidence-based policy option for the prevention of non-communicable diseases[2][2].

This is in light of the evidence that shows frequent consumption of SSBs is associated with several implications on children and young people’s (CYP) health – including weight gain[3][3], tooth decay[4][4] and type 2 diabetes[5][5].

The SDIL was announced in the UK in Part 1 of the Childhood Obesity Plan in 2018, in a bid to promote healthier weight in children and young people.

However, leading researchers in the field have argued that the evidence on SSB taxes largely relate to impact on sales and purchases of SSBs, and overall reductions in sugar content of SSBs. Yet the evidence supporting claims on beneficial impacts to CYPs health is not as strong. There is also limited evidence demonstrating the role of SSB taxes on oral health.

Food Active recently undertook a Rapid Evidence Assessment* (REA) on the impact of SSB taxes on CYP’s health, to better understand what the current evidence base can tell us and inform a series of recommendations for policymakers and future research. The REA includes 20 research papers* conducted across the globe, including two studies conducted in the UK to model the potential impacts of the SDIL, and another tracking associations between children’s weight through the National Child Measurement Programme and the implementation of the SDIL. This blog is a summary of this REA, and the key findings are represented in the infographic below.

 

[6]

 

Can SSB taxes improve children and young people’s diets?

 

Can SSB taxes promote healthier weight in children and young people?

 

Can SSB taxes promote good oral health outcomes in children and young people?

 

Conclusions and recommendations

It is clear to see that SSBT have the potential to make a small and positive impact on CYP health, however there are some important aspects that policymakers need to consider.

This REA identified that the greater the SSBT threshold, the greater the health benefits to CYP. This is echoed by the WHO, who recommend a 20% tax is the minimum threshold to support improvements to health (World Health Organisation, 2022). Studies identified in this REA which used lower thresholds of 10% had markedly lower health benefits for CYP.

Substitution effects of SSBT were also not measured in most of the studies identified in this REA. Where they were measured, effects included an increase in consumption of non-taxed drinks such as milk-based drinks and fruit juices. In the UK, such drinks are exempt from the SDIL and are now some of the most sugar-dense drinks available on the market (for example a 400ml of Friji Fudge Brownie Milkshake contains 43.6g sugar – accounting for 145% of an adults recommended sugar intake and 181% of a child aged 7-10’s recommended intake). Substitution effects are important to consider in terms of the wider impacts on the diet of SSBT, and whether policymakers need to extend the tax to these drinks to ensure the benefits to CYP’s health are harnessed.

Furthermore, this REA suggests there may be a relationship between SSBT and CYP obesity prevalence in those living in deprived and low-income households. SSBTs may therefore support wider efforts to reduce the obesity gap between the most and least deprived children and address health inequalities, which is commonly reported in economically developed countries. In the UK, the latest NCMP figures demonstrate that children living in the most deprived households are more than twice as likely to experience overweight or obesity when compared to their more affluent peers – and the gap continues to grow.

Finally, even where improvements to CYP diet, weight and oral health have been reported, these are relatively small changes. It is important to recognise that the impact of SSBTs on CYP’s health will be limited in isolation and in the absence of additional policy measures. SSBTs should therefore be regarded as one component of a wider strategy to tackle the complex issues of poor diet, obesity, and poor oral health, as opposed to a ‘silver bullet’. Policymakers should explore other options in tandem to maximise the potential of SSBTs and address other drivers of these issues, such as food and drink marketing and advertising. Here in the UK, important legislation to limit the advertising and marketing of less healthy food and drink, including SSBs, has just been delayed until October 2025. The initial implementation date was the end of 2022. These delays come at a time where 10.1% of 5-year-olds are living with obesity[6][7], and 29.3% have enamel and/or dentinal decay[7][8].

The SDIL is considered as a key milestone for public health, however the benefits will only be maximised when it has been bolstered by other important measures that seek to address other drivers of obesity and poor oral health in CYP.


* This REA was conducted in March 2023 following the Collins et al. (2015) framework. A maximum of 20 papers were gathered through two databases (SCOPUS and Web of Science), using search terms which have been refined and tested. The papers included in this assessment were:

 


References:

[1][9] https://www.beveragedaily.com/Article/2019/07/23/Battle-lines-drawn-over-UK-sugar-tax-and-milkshake-extension#:~:text=It%20says%20the%20UK’s%20Soft,%E2%80%8B%E2%80%8B%20from%20the%20tax[10].

[2][11] World Health Organisation (2022) WHO manual on sugar-sweetened beverage taxation policies to promote healthy diets. Geneva: World Health Organisation. Available at: https://www.who.int/publications/i/item/9789240056299 (Accessed: 29th March 2023).

[3][12] Bucher Della Torre, S., Keller, A., Depeyre, L.J., and Kruseman, M. (2016) ‘Sugar-Sweetened Beverages and Obesity Risk in Children and Adolescents: A Systematic Analysis on How Methodological Quality May Influence Conclusions’, Journal of the Academy of Nutrition and Dietetics, 116(4), pp. 638-659. doi: 10.1016/j.jand.2015.05.020.

[4][13] Valenzuela, M.J., Waterhouse, B., Aggarwal, V.R., Bloor, K. and Doran, T. (2021) ‘Effect of sugar-sweetened beverages on oral health: a systematic review and meta-analysis’, European journal of public health, 31(1), pp. 122-129. doi: 10.1093/eurpub/ckaa147.

[5][14] Wang M, Yu M, Fang L, Hu RY. Association between sugar-sweetened beverages and type 2 diabetes: A meta-analysis. J Diabetes Investig. 2015 May;6(3):360-6. doi: 10.1111/jdi.12309. Epub 2014 Dec 11. PMID: 25969723; PMCID: PMC4420570.

[6][15] https://digital.nhs.uk/data-and-information/publications/statistical/national-child-measurement-programme/2021-22-school-year#:~:text=It%20covers%20children%20in%20Reception,as%20well%20as%20geographic%20analyses[16].

[7][17] https://www.gov.uk/government/statistics/oral-health-survey-of-5-year-old-children-2022/national-dental-epidemiology-programme-ndep-for-england-oral-health-survey-of-5-year-old-children-2022[18]

Links:
  1. [1]: #_edn1
  2. [2]: #_edn2
  3. [3]: #_edn3
  4. [4]: #_edn4
  5. [5]: #_edn5
  6. [Image]: https://foodactive.org.uk/wp-content/uploads/2023/04/SSB-taxes.png
  7. [6]: #_edn6
  8. [7]: #_edn7
  9. [1]: #_ednref1
  10. https://www.beveragedaily.com/Article/2019/07/23/Battle-lines-drawn-over-UK-sugar-tax-and-milkshake-extension#:~:text=It%20says%20the%20UK’s%20Soft,%E2%80%8B%E2%80%8B%20from%20the%20tax: https://www.beveragedaily.com/Article/2019/07/23/Battle-lines-drawn-over-UK-sugar-tax-and-milkshake-extension#:~:text=It%20says%20the%20UK
  11. [2]: #_ednref2
  12. [3]: #_ednref3
  13. [4]: #_ednref4
  14. [5]: #_ednref5
  15. [6]: #_ednref6
  16. https://digital.nhs.uk/data-and-information/publications/statistical/national-child-measurement-programme/2021-22-school-year#:~:text=It%20covers%20children%20in%20Reception,as%20well%20as%20geographic%20analyses: https://digital.nhs.uk/data-and-information/publications/statistical/national-child-measurement-programme/2021-22-school-year#:~:text=It%20covers%20children%20in%20Reception,as%20well%20as%20geographic%20analyses
  17. [7]: #_ednref7
  18. https://www.gov.uk/government/statistics/oral-health-survey-of-5-year-old-children-2022/national-dental-epidemiology-programme-ndep-for-england-oral-health-survey-of-5-year-old-children-2022: https://www.gov.uk/government/statistics/oral-health-survey-of-5-year-old-children-2022/national-dental-epidemiology-programme-ndep-for-england-oral-health-survey-of-5-year-old-children-2022

Source URL: https://foodactive.org.uk/blog-marking-5-years-of-the-soft-drinks-industry-levy-how-can-sugar-taxes-support-children-and-young-peoples-health/