Reformulating packaged foods and drinks by cutting sugar would lead to significant public health improvements in the U.S., and save billions of dollars in healthcare costs, according to a study published in Circulation.
 
The greatest estimated health gains would be among Black and Hispanic adults and Americans with lower income and less education—populations that consume the most sugar due to historical inequities.
 
Research Model
A team of researchers created a model to simulate and quantify the health, economic, and equity impacts of a pragmatic sugar-reduction policy proposed by the U.S. National Salt and Sugar Reduction Initiative (NSSRI), a partnership of more than 100 local, state and national health organizations convened by the New York City Department of Health and Mental Hygiene (NYC DOH).
 
They found cutting 20% of sugar from packaged foods and 40% from beverages would prevent 2.48 million cardiovascular disease events (such as strokes, heart attacks, cardiac arrests), 490,000 cardiovascular deaths, and 750,000 diabetes cases in the U.S. over the lifetime of the adult population,
 
The NSSRI released draft sugar-reduction targets for packaged foods and beverages in 15 categories in 2018. This February, NSSRI finalized the policy with the goal of industry voluntarily committing to gradually reformulate their sugary products.
 
National Policy Goal
The researchers hope their model will build consensus on the need for a national-sugar reformulation policy in the U.S. “We hope that this study will help push the reformulation initiative forward in the next few years,” said Siyi Shangguan, MD, MPH, lead author and attending physician at Massachusetts General Hospital (MGH). “Reducing the sugar content of commercially prepared foods and beverages will have a larger impact on the health of Americans than other initiatives to cut sugar, such as imposing a sugar tax, labeling added sugar content, or banning sugary drinks in schools.”
 
Ten years after the NSSRI policy goes into effect, the U.S. could expect to save $4.28 billion in total net healthcare costs, and $118.04 billion over the lifetime of the current adult population (ages 35 to 79), according to the model. Adding the societal costs of lost productivity of Americans developing diseases from excessive sugar consumption, the total cost savings of the NSSRI policy rises to $160.88 billion over the adult population’s lifetime.
 
Researchers found that the NSSRI policy became cost-effective at six years and cost-saving at nine years. The policy could also reduce disparities, with the greatest estimated health gains among Black and Hispanic adults, and Americans with lower income and less education—populations that consume the most sugar as a historical consequence of inequitable systems.
 
Precedent for Reformulation
Product reformulation efforts have been shown to be successful in reducing other harmful nutrients, such as trans fats and sodium. The U.S., however, lags behind other countries in implementing strong sugar-reduction policies.
 
Consuming sugary foods and beverages is strongly linked to obesity and diseases such as type 2 diabetes and cardiovascular disease, the leading cause of mortality in the U.S. More than two in five American adults are obese, one in two have diabetes or prediabetes, and nearly one in two have cardiovascular disease, with those from lower-income groups being disproportionately burdened.
 
“Sugar is one of the most obvious additives in the food supply to reduce to reasonable amounts,” said Dariush Mozaffarian, MD, DrPH, co-senior author and dean of the Friedman School of Nutrition Science and Policy at Tufts University. “Our findings suggest it’s time to implement a national program with voluntary sugar reduction targets, which can generate major improvements in health, health disparities, and healthcare spending in less than a decade.”
 
Major funding for this study was provided by the National Institutes of Health.