ArticleBMJ open2017
Health and economic benefits of reducing sugar intake in the USA, including effects via non-alcoholic fatty liver disease: a microsimulation model.
Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.
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Who cites it
28 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Reduction of Sugar Consumption.International dental journal · 2025Guideline
- Sugar Shockwaves: How the Fructose-Glucose-ChREBP Pathway Hijacks Liver Metabolism.Life (Basel, Switzerland) · 2026Review
- KetoFLEX 12/3 Diet and Cognitive Health: A Precision-Nutrition Perspective on Mechanisms, Emerging Evidence, and Future Directions.Nutrients · 2026Review
- Population health impacts from the taxation of salt and sugar in the United Kingdom.Public health nutrition · 2025Article
- The battle over "food addiction".Frontiers in psychiatry · 2025Review
- The environmental and social opportunities of reducing sugar intake.Proceedings of the National Academy of Sciences of the United States of America · 2024Article
- Modelling impacts of a salt and sugar tax on hypothetical intra-category food substitutions, BMI and environmental footprints in the UK population.European journal of nutrition · 2024Article
- NASH/NAFLD-Related Hepatocellular Carcinoma: An Added Burden.Life (Basel, Switzerland) · 2023Article
- The Impact and Burden of Dietary Sugars on the Liver.Hepatology communications · 2023Review
- Non-alcoholic fatty liver disease and diabetes mellitus as growing aetiologies of hepatocellular carcinoma.JHEP reports : innovation in hepatology · 2023Review
- Sugar and Dyslipidemia: A Double-Hit, Perfect Storm.Journal of clinical medicine · 2023Review
- Article
- The Metabolic Matrix: Re-engineering ultraprocessed foods to feed the gut, protect the liver, and support the brain.Frontiers in nutrition · 2023Article
- Article
- The Effect of Steviol Glycosides on Sensory Properties and Acceptability of Ice Cream.Foods (Basel, Switzerland) · 2022Article
- Prevention and regression of megamitochondria and steatosis by blocking mitochondrial fusion in the liver.iScience · 2022Article
- Rethinking COVID-19 and Beyond: Prevention, Remedies, and Recovery.Frontiers in public health · 2022Article
- The Contribution of Foods Prepared Outside the Home to the Diets of 18- to 30-Year-Old Australians: The MYMeals Study.Nutrients · 2021Article
- Effects of home quarantine during COVID-19 lockdown on physical activity and dietary habits of adults in Saudi Arabia.Scientific reports · 2021Article
- Ultraprocessed Food: Addictive, Toxic, and Ready for Regulation.Nutrients · 2020Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesExcessive consumption of added sugars in the human diet has been associated with obesity, type 2 diabetes (T2D), coronary heart disease (CHD) and other elements of the metabolic syndrome. Recent studies have shown that non-alcoholic fatty liver disease (NAFLD) is a critical pathway to metabolic syndrome. This model assesses the health and economic benefits of interventions aimed at reducing intake of added sugars.
methodsUsing data from US National Health Surveys and current literature, we simulated an open cohort, for the period 2015-2035. We constructed a microsimulation model with Markov chains for NAFLD (including steatosis, non-alcoholic steatohepatitis (NASH), cirrhosis and hepatocellular carcinoma (HCC)), body mass index, T2D and CHD. We assessed reductions in population disease prevalence, disease-attributable disability-adjusted life years (DALYs) and costs, with interventions that reduce added sugars consumption by either 20% or 50%.
findingsThe model estimated that a 20% reduction in added sugars intake will reduce prevalence of hepatic steatosis, NASH, cirrhosis, HCC, obesity, T2D and CHD. Incidence of T2D and CHD would be expected to decrease by 19.9 (95% CI 12.8 to 27.0) and 9.4 (95% CI 3.1 to 15.8) cases per 100 000 people after 20 years, respectively. A 20% reduction in consumption is also projected to annually avert 0.767 million (M) DALYs (95% CI 0.757M to 0.777M) and a total of US$10.3 billion (B) (95% CI 10.2B to 10.4B) in discounted direct medical costs by 2035. These effects increased proportionally when added sugars intake were reduced by 50%.
conclusionsThe decrease in incidence and prevalence of disease is similar to results in other models, but averted costs and DALYs were higher, mainly due to inclusion of NAFLD and CHD. The model suggests that efforts to reduce consumption of added sugars may result in significant public health and economic benefits.
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