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Soft drink prices sales body mass index and diabetes: Evidence from a panel of low- middle- and high-income countries

机译：软饮料价格销售体重指数和糖尿病：来自低中高收入国家的证据

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We take advantage of four different cross-country datasets containing data on 78 countries for the period 1999–2014, in order to assess the relationship of carbonated soft drinks’ sales, as well as their prices, with body mass index (BMI), overweight, obesity and diabetes. Using an ecological study design and multivariate regression longitudinal estimation approaches, we find that carbonated soft drink sales were significantly positively related to BMI, overweight and obesity – but only in the low and lower-middle income countries. This finding was robust to a number of sensitivity and falsification checks. In this sub-sample, an increase in per capita soft drink sales by 1 litre per year was related to an increase of BMI by about 0.009 kg/m2 (p < 0.1).. This is a small effect, implying that halving annual consumption per capita in this group of countries would result in a drop of BMI by only about 0.03 kg/m2. Although soft drink prices were negatively related to weight-related outcomes in the sample of higher middle income and high income countries, this finding was not robust to falsification checks. The results thus suggest that sales restrictions to steer consumers away from soft drinks could indeed have a beneficial health effects in poorer countries, although the effect magnitude appears to be very small. However, given potential limitations of using ecological research design, results from individual level studies would be required to further ascertain the role of soft drink sales and prices in obesity and diabetes.
机译：我们利用四个不同的跨国数据集，其中包含1999-2014年间78个国家/地区的数据，以便评估碳酸软饮料的销售及其价格与体重指数（BMI），超重之间的关系。 ，肥胖和糖尿病。使用生态研究设计和多元回归纵向估计方法，我们发现碳酸软饮料的销售与BMI，超重和肥胖显着正相关-但仅在中低收入国家/地区。这一发现对许多敏感性和伪造性检查都是可靠的。在此子样本中，人均软饮料销售量每年增加1升，与BMI大约增加0.009 kg / m 2 （p <0.1）相关。效果很小，这意味着将这组国家的人均年消费量减半将导致BMI下降仅约0.03 kg / m 2 。尽管在较高的中等收入和高收入国家的样本中，软饮料价格与体重相关的结果呈负相关，但这一发现对伪造检查并不可靠。结果表明，限制销售以使消费者远离软饮料确实可以在较贫穷的国家产生有益的健康影响，尽管影响程度似乎很小。但是，由于使用生态研究设计的潜在局限性，需要进一步进行个人水平研究的结果，才能进一步确定软饮料的销售和价格在肥胖症和糖尿病中的作用。

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