Estimating the potential impact of the UK government’s sugar reduction programme on child and adult health: modelling studyBMJ 2019; 365 doi: https://doi.org/10.1136/bmj.l1417 (Published 17 April 2019) Cite this as: BMJ 2019;365:l1417
- Ben Amies-Cull, MRC DPhil student and honorary academic clinical fellow1 2,
- Adam D M Briggs, academic visitor1,
- Peter Scarborough, associate professor1 3
- 1Centre for Population Approaches to Non-Communicable Disease Prevention, Big Data Institute, University of Oxford, Headington, Oxford OX3 7FZ, UK
- 2Centre for Primary Care, University of Manchester, Manchester, UK
- 3National Institute of Health Research Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Headington, Oxford, UK
- Correspondence to: B Amies-Cull
- Accepted 12 March 2019
Objective To estimate the impact of the UK government’s sugar reduction programme on child and adult obesity, adult disease burden, and healthcare costs.
Design Modelling study.
Setting Simulated scenario based on National Diet and Nutrition Survey waves 5 and 6, England.
Participants 1508 survey respondents were used to model weight change among the population of England aged 4-80 years.
Main outcome measures Calorie change, weight change, and body mass index change were estimated for children and adults. Impact on non-communicable disease incidence, quality adjusted life years, and healthcare costs were estimated for adults. Changes to disease burden were modelled with the PRIMEtime-CE Model, based on the 2014 population in England aged 18-80.
Results If the sugar reduction programme was achieved in its entirety and resulted in the planned sugar reduction, then the calorie reduction was estimated to be 25 kcal/day (1 kcal=4.18 kJ=0.00418 MJ) for 4-10 year olds (95% confidence interval 23 to 26), 25 kcal/day (24 to 28) for 11-18 year olds, and 19 kcal/day (17 to 20) for adults. The reduction in obesity could represent 5.5% of the baseline obese population of 4-10 year olds, 2.2% of obese 11-18 year olds, and 5.5% of obese 19-80 year olds. A modelled 51 729 quality adjusted life years (95% uncertainty interval 45 768 to 57 242) were saved over 10 years, including 154 550 (132 623 to 174 604) cases of diabetes and relating to a net healthcare saving of £285.8m (€332.5m, $373.5m; £249.7m to £319.8m).
Conclusions The UK government’s sugar reduction programme could reduce the burden of obesity and obesity related disease, provided that reductions in sugar levels and portion sizes do not prompt unanticipated changes in eating patterns or product formulation.
Contributors: BA-C acts as guarantor; contributed to the study design, literature search, figures, data analysis, and data interpretation; and wrote the first draft of the manuscript. ADMB contributed to the data analysis, data interpretation, and manuscript preparation. PS contributed to the study design, literature search, figures, data analysis, data interpretation, and manuscript preparation. All authors, internal and external, had full access to all of the data (including statistical reports and tables) in the study and can take responsibility for the integrity of the data and the accuracy of the data analysis. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.
Funding: There was no specific funding for this study. In addition to the authors’ funders, this study was partly supported by the National Institute of Health Research Biomedical Research Centre at Oxford, but it had no input into the study design, collection, analysis, or interpretation of data; writing of the report; or the decision to submit the article for publication. The views expressed are those of the authors and not necessarily those of the National Health Service, National Institute of Health Research, or Department of Health and Social Care. All authors are independent from funders.
Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: part support from the National Institute of Health Research Biomedical Research Centre at Oxford for the submitted work; BA-C was supported by grants from the National Institute of Health Research and Medical Research Council; ADMB was supported by grants from the Commonwealth Fund, National Institute of Health Research, and Wellcome Trust; and PS supported by grants from the British Heart Foundation and National Institute of Health Research, outside the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.
Ethical approval: The terms of the University of Oxford (where the research took place) medical sciences interdivisional research ethics committee were consulted and this proposal did not require ethics approval because it involves only fully anonymised precollected data.
Data sharing: Modelled outcomes data are available from the corresponding author. National Diet and Nutrition Survey data are available with standard conditions of use.
The lead author and guarantor affirm that the manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that there are no discrepancies from the study as originally planned.
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