October 17, 2019

A national policy requiring health labels on sugar-sweetened beverages could make a significant impact on the obesity epidemic in the United States, according to results of a microsimulation study from faculty at the UNC Gillings School of Global Public Health.

Dr. Anna Grummon

Dr. Anna Grummon

Anna Grummon, PhD, a recent doctoral graduate in health behavior at the Gillings School, is lead author of “Health Warnings on Sugar-Sweetened Beverages: Simulation of Impacts on Diet and Obesity Among U.S. Adults,” which was published online October 17 by the American Journal of Preventive Medicine.

Other Gillings School authors on the paper are Natalie R. Smith, MS, a doctoral candidate in health policy and management; Shelley D. Golden, PhD, assistant professor of health behavior; Leah Frerichs, PhD, assistant professor of health policy and management; Lindsey Smith Taillie, PhD, assistant professor of nutrition; and Noel T. Brewer, PhD, professor of health behavior.

Excess consumption of sugary drinks like sodas, sports drinks and sweetened teas is a major contributor to obesity, a condition which impacts 40% of American adults and is a leading cause of death. To reduce consumption of these products and combat obesity, policymakers have proposed requiring health warnings on sugary drinks. While randomized trials indicate that health warnings do reduce sugary drink purchases, it has been unclear if these policies would also influence health outcomes like obesity.

“A few studies have shown that when consumers see warning labels on sugary drinks, they buy fewer of those products,” says Grummon, now a postdoctoral fellow at the Harvard T.H. Chan School of Public Health. “We wanted to understand how those changes in beverage purchases would affect health outcomes like body weight and obesity for the population as a whole. To do that, we built a mathematical model that shows how Americans would change what they eat and drink if health warnings were required on sugary drinks nationwide, and how those dietary changes would affect the obesity epidemic.”

Using a microsimulation model of dietary behaviors and body weight, the study found that, relative to the status quo, implementing a national sugar-sweetened beverage health warning policy would reduce intake of these beverages by more than 25 calories/day and total energy intake by 31.2 calories/day. If sustained, these changes in diet would reduce obesity prevalence by about 3.1 percentage points after five years.

Grummon says requiring health warnings on sugary drinks could have a big enough impact on what Americans choose to eat and drink to move the needle on obesity.

“Our study suggests that showing warning labels on sugary drinks is a promising strategy for addressing the obesity epidemic in the U.S.,” she says. “We found that warnings would reduce obesity prevalence by more than three percentage points. While that number might sound modest, on a national scale it equates to more than five million fewer people with obesity.”

Grummon says that, though studies examining sugary drink warning policies have already shown the policies would be broadly beneficial, this is the first known study to examine how sugary drink health warning labels would influence obesity rates across the country.

Dr. Noel Brewer

Dr. Noel Brewer

“Warnings are a highly scalable strategy for helping consumers make healthier choices,” she says. “These findings suggest that warnings are also promising for addressing obesity in the U.S.”

“Several states may soon require health warnings on drinks with added sugar,” says senior author Brewer. “Our study findings can help lawmakers set policies that inform consumers and protect youth from obesity and ill health.”


Contact the Gillings School of Global Public Health communications team at sphcomm@unc.edu.

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