Low-income, Hispanic and African-American Californians need to have a tax on sodas and other sugary beverages if they are going to have reduced risk of diabetes - which could be a substantial cost for taxpayers in a world of government health care.

Over the course of the next decade, the scholars estimate that lowered incidence of these diseases would save over half a billion dollars in medical costs. 2 or perhaps 3 of each 20,000 people.

They previously modeled the national health effects of a penny-per-ounce tax over the course of 10 years and found that it would reduce consumption among adults by 15 percent, modestly lower the prevalence of diabetes and obesity and perhaps prevent tens of thousands of coronary heart events, strokes and premature deaths.

The new analysis considered a range of reductions in sugary beverage consumption among Californians. By assuming a decline of 10 to 20 percent in the consumption of soda and other sugary beverages from the tax, researchers concluded that new cases of diabetes and coronary heart disease would drop statewide, and those health benefits would be greatest in poor and minority communities. The numerical model predicted that one in 20,000 Californians would avoid diabetes. This estimate would double for Hispanics and poor Californians and triple for African Americans.



Projected incident diabetes decrease at different levels of SSB consumption reduction with variation of BMI effects. Credit and link:
doi:10.1371/journal.pone.0081723

"Poor and minority communities in California and nationally have very high rates of diabetes, a chronic condition with potentially devastating health complications," said Kirsten Bibbins-Domingo, MD, PhD, UCSF professor of medicine and director of the UCSF Center for Vulnerable Populations at San Francisco General Hospital and Trauma Center. "Although many steps are needed to reverse the rising diabetes trends in the state, our study suggests that efforts to curb sugary beverage consumption can have a significant positive impact, particularly in those most likely to be affected."

More than 10 million Californians drink at least one sugar-sweetened beverage, such as soda, fruit punch or sports drinks, every day, and surveys show that blacks, Hispanics and the poor consume more of their daily calories from sugar-sweetened beverages than whites and those in higher income brackets. Higher sugar intake is associated with a variety of health risks, including type 2 diabetes, obesity, high blood pressure and coronary heart disease.

Many of the predicted health benefits from cutting consumption of sugary beverages depend on the assumption that people will not replace those calories by eating and drinking more of other things. Given this, researchers examined three different scenarios: that none of the calories would be replaced, that about 40 percent of the calories would be replaced and that all of the calories would be replaced.

Even under the most pessimistic scenario, diabetes and coronary heart disease incidence went down with less sugary beverage consumption, although much less than it would if consumers did not replace all of the calories.

"Drinking sugary beverages increases the risk for obesity and diabetes," said Claire Wang, MD, ScD, co-director of Columbia's Obesity Prevention Initiative. "This hurts our communities and burdens our healthcare system."

San Francisco Supervisors are considering two proposals to tax sugary beverages by two cents per ounce. San Francisco has previously sought to ban Happy Meals, goldfish and golf.


Citation: Mekonnen TA, Odden MC, Coxson PG, Guzman D, Lightwood J, et al. (2013) Health Benefits of Reducing Sugar-Sweetened Beverage Intake in High Risk Populations of California: Results from the Cardiovascular Disease (CVD) Policy Model. PLoS ONE 8(12): e81723. doi:10.1371/journal.pone.0081723