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Health and Economic Impacts of a Sugar-Sweetened Beverage Warning Label in the US: A Micro-Simulation Study


 
 
 Sugar-sweetened beverage (SSB) consumption is linked to weight gain, type 2 diabetes and cardiovascular disease (CVD). Health warning labels on SSBs have been proposed in the US to discourage consumption. Yet, the potential health and economic impacts of SSB warning labels have not been quantified. We aimed to estimate the health and economic impacts of a SSB warning label in the US.
 
 
 
 We used the validated Tufts Diabetes-CVD Microsimulation Model to estimate the impact of implementing a national SSB warning label in the U.S., compared to current status quo, on incident diabetes and CVD. Model inputs included nationally representative demographic, clinical, and SSB intake data from NHANES 2015–2016; policy effects on consumer intakes and SSB-disease effects from meta-analyses; disease data from CDC wonder database; and policy implementation costs and healthcare costs from established sources. Findings were evaluated over 10 years and a lifetime horizon, and costs (in 2019 USD) discounted at 3% annually. NHANES sampling weights were used to translate model estimates to nationally representative population estimates; and alternative scenarios evaluated smaller policy effects on consumer consumption, derived from prior interventional studies testing effects of SSB warning labels.
 
 
 
 Among 138 million US adults aged 40–79 years at baseline, 56% were SSB consumers, with mean intake of 1.10 servings/day (95% CI, 0.97, 1.23). Over 10 years, the SSB warning label was estimated to prevent 254 thousand (145, 362) incident CVD events and 231 thousand (–45, 507) diabetes cases, with $30.6 billion (29.2, 32.0) savings in healthcare costs. Over lifetime, corresponding values were 708 thousand (328, 1087), 422 thousand (77, 767), and $78.3 billion (43.8, 112.8), respectively. In sensitivity analyses with a 40% smaller policy effect size, corresponding lifetime values were 348 thousand (38, 658), 246 thousand (–98, 590), and $40.8 billion (31.5, 50.0) over a lifetime, respectively.
 
 
 
 Implementing a national SSB warning label could generate substantial health gains and cost savings for the US population.
 
 
 
 NIH, NHLBI.
