Authors: Yue Huang, Chris Kypridemos, Junxiu Liu, Yujin Lee, Jonathan Pearson-Stuttard, Brendan Collins, Piotr Bandosz, Simon Capewell, Laurie Whitsel, Parke Wilde, Dariush Mozaffarian, Martin O'Flaherty, Renata Micha
Summary: Background: Excess added sugars, particularly from sugar-sweetened
beverages, are a major risk factor for cardiometabolic diseases including
cardiovascular disease and type 2 diabetes mellitus. In 2016, the US Food and
Drug Administration mandated the labeling of added sugar content on all
packaged foods and beverages. Yet, the potential health impacts and cost effectiveness
of this policy remain unclear.
Methods: A validated microsimulation model (US IMPACT Food
Policy model) was used to estimate cardiovascular disease and type 2
diabetes mellitus cases averted, quality-adjusted life-years, policy costs,
health care, informal care, and lost productivity (health-related) savings
and cost-effectiveness of 2 policy scenarios: (1) implementation of the US
Food and Drug Administration added sugar labeling policy (sugar label),
and (2) further accounting for corresponding industry reformulation (sugar
label+reformulation). The model used nationally representative demographic
and dietary intake data from the National Health and Nutrition Examination
Survey, disease data from the Centers for Disease Control and Prevention
Wonder Database, policy effects and diet-disease effects from meta-analyses,
and policy and health-related costs from established sources. Probabilistic
sensitivity analysis accounted for model parameter uncertainties and
population heterogeneity.
Results: Between 2018 and 2037, the sugar label would prevent 354 400
cardiovascular disease (95% uncertainty interval, 167 000–673 500) and
599 300 (302 400–957 400) diabetes mellitus cases, gain 727 000 (401 300–
1 138 000) quality-adjusted life-years, and save $31 billion (15.7–54.5) in net
healthcare costs or $61.9 billion (33.1–103.3) societal costs (incorporating
reduced lost productivity and informal care costs). For the sugar
label+reformulation scenario, corresponding gains were 708 800 (369 200–
1 252 000) cardiovascular disease cases, 1.2 million (0.7–1.7) diabetes mellitus
cases, 1.3 million (0.8–1.9) quality-adjusted life-years, and $57.6 billion
(31.9–92.4) and $113.2 billion (67.3–175.2), respectively. Both scenarios
were estimated with >80% probability to be cost saving by 2023.
Conclusions: Implementing the US Food and Drug Administration added
sugar labeling policy could generate substantial health gains and cost savings
for the US population.
Source: Circulation, 2019