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 Sugar reduction in packaged foods can save millions of lives


The results of a microsimulation study published in Circulation found that eliminating 20 percent of the sugar from packaged foods and 40 percent from beverages could prevent 2.48 million cardiovascular disease events (including strokes, heart attacks, and cardiac arrests), 490,000 cardiovascular deaths, and 750,000 diabetes cases in the United States over a person's lifetime.

Researchers from the Massachusetts General Hospital (MGH), Tufts University's Friedman School of Nutrition Science and Policy, Harvard T.H. Chan School of Public Health, and the New York City Department of Health and Mental Hygiene (NYC DOH) developed a model to simulate and quantify the health, economic, and equity consequences of a pragmatic sugar-reduction policy proposed by the United States Surgeon General (US Surgeon General) and the World Health Organization (WHO) (NSSRI). Over 100 local, state, and national health organizations have come together under the auspices of the New York City Department of Health to form the National Statistical Research Institute. In 2018, it released draft sugar reduction targets for packaged foods and beverages in 15 categories, with the final targets to be released in 2019. The National Sugar Standards and Research Institute (NSSRI) finalized its policy in February, with the goal of getting the sugary food industry to agree to gradually reformulate its products.

Implementing a national policy, on the other hand, will necessitate government assistance in monitoring companies' progress toward targets and in reporting publicly on their progress. The researchers hope that their model will aid in the development of consensus regarding the need for a national sugar reformulation policy in the United States of America. According to lead author Siyi Shangguan, MD, MPH, an attending physician at Massachusetts General Hospital, "We hope that this study will contribute to the advancement of the reformulation initiative over the next few years." reducing the sugar content of commercially prepared foods and beverages will have a greater impact on Americans' health than other sugar-cutting measures such as imposing a sugar tax, labeling added sugar content, or prohibiting sugary beverages in schools," the researchers concluded.

According to the model, the United States could save $4.28 billion in total net healthcare costs in the first ten years after the NSSRI policy is implemented, and $118.04 billion over the lifetime of the current adult population (ages 35 to 79). The total cost savings associated with the NSSRI policy, including the societal costs associated with lost productivity due to Americans developing diseases as a result of excessive sugar consumption, reach $160.88 billion over the lifetime of the adult population when all costs associated with sugar consumption are taken into consideration. Because the calculations were conservative, it is almost certain that these benefits are overstated. Furthermore, the study demonstrated that even a partial compliance by industry with the policy could result in significant health and economic benefits for the population.


Researchers discovered that the NSSRI policy became cost-effective and cost-saving after six years, according to their findings. As a result, it has the potential to reduce disparities in health, with the greatest estimated health gains among African-American and Hispanic adults, as well as those from lower-income and less-educated backgrounds – groups that have historically consumed the most sugar as a result of inequitable systems.

Other potentially harmful nutrients, such as trans fats and sodium, have been successfully reduced as a result of product reformulation initiatives. When it comes to sugar reduction policies, the United States lags far behind other countries, with the United Kingdom, Norway, and Singapore taking the lead in efforts to reformulate sugar in their products. If the National Sugar Reduction Initiative's proposed sugar-reduction targets are met, the United States may yet be able to claim the title of world leader in protecting its citizens from the dangers of excessive sugar consumption. In Shangguan's opinion, "the National Sugar Reform Initiative policy is by far the most meticulously designed and comprehensive sugar reform initiative in the world."

In the United States, the consumption of sugary foods and beverages is strongly associated with obesity and diseases such as type 2 diabetes and heart disease, which are the leading causes of death. The obesity rate in the United States is higher than two-thirds, one-in-two have diabetes or prediabetes, and nearly one-in-two suffer from cardiovascular disease, with lower-income groups bearing disproportionately the burden of these conditions.

The Friedman School of Nutrition Science and Policy at Tufts University is co-senior author and dean Dariush Mozaffarian, MD, DrPH, who is also a senior author and the dean of the Friedman School. "Sugar is one of the most obvious food additives to reduce to safe levels," he says. "Our findings indicate that a national program with voluntary sugar reduction targets is long overdue, and that such a program could result in significant improvements in health, health disparities, and healthcare spending in less than a decade."

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