Evidence map›Paper›PMID 30982338›Full record

ArticleCirculation2019

Cost-Effectiveness of the US Food and Drug Administration Added Sugar Labeling Policy for Improving Diet and Health.

Yue Huang, Chris Kypridemos, Junxiu Liu, Yujin Lee, Jonathan Pearson-Stuttard, Brendan Collins, Piotr Bandosz, Simon Capewell, Laurie Whitsel, Parke Wilde and 4 more

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Circulation, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 2 pooled it
7.8field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

28 citing papers in PubMed, 2 syntheses or guidelines pooled it, 54 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
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  4. Review
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  6. Simulated retail food environments: A literature review of systems science approaches to advance equity in access to healthy diets.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2025
    Review
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  11. Cardiovascular Disease in Saudi Arabia: Facts and the Way Forward.Journal of the Saudi Heart Association · 2023
    Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 8 institutions in 6 countries.

Yue HuangFriedman School of Nutrition Science and Policy, Tufts University, Boston, MA (Y.H., J.L., Y.L., P.W., D.M., R.M.).
Chris KypridemosDepartment of Public Health and Policy, University of Liverpool, UK (C.K., J.P.-S., B.C., P.B., S.C., M.O.).
Junxiu LiuFriedman School of Nutrition Science and Policy, Tufts University, Boston, MA (Y.H., J.L., Y.L., P.W., D.M., R.M.).
Yujin LeeFriedman School of Nutrition Science and Policy, Tufts University, Boston, MA (Y.H., J.L., Y.L., P.W., D.M., R.M.).
Jonathan Pearson-StuttardDepartment of Public Health and Policy, University of Liverpool, UK (C.K., J.P.-S., B.C., P.B., S.C., M.O.).
Brendan CollinsDepartment of Public Health and Policy, University of Liverpool, UK (C.K., J.P.-S., B.C., P.B., S.C., M.O.).
Piotr BandoszDepartment of Public Health and Policy, University of Liverpool, UK (C.K., J.P.-S., B.C., P.B., S.C., M.O.).
Simon CapewellDepartment of Public Health and Policy, University of Liverpool, UK (C.K., J.P.-S., B.C., P.B., S.C., M.O.).
Laurie WhitselAmerican Heart Association, Washington DC (L.W.).
Parke WildeFriedman School of Nutrition Science and Policy, Tufts University, Boston, MA (Y.H., J.L., Y.L., P.W., D.M., R.M.).
Dariush MozaffarianFriedman School of Nutrition Science and Policy, Tufts University, Boston, MA (Y.H., J.L., Y.L., P.W., D.M., R.M.).
Martin O'FlahertyDepartment of Public Health and Policy, University of Liverpool, UK (C.K., J.P.-S., B.C., P.B., S.C., M.O.).
Renata MichaFriedman School of Nutrition Science and Policy, Tufts University, Boston, MA (Y.H., J.L., Y.L., P.W., D.M., R.M.).
Food-PRICE (Policy Review and Intervention Cost-Effectiveness) Project
Tufts University · USAmerican Heart Association · USCenter For Policy Research · USI.R.C.C.S. Oasi Maria SS · ITNational Public Health Laboratory · NPPublic Health England · GBSwansea University · GBUniversity of Liverpool · GB

Funding

Economic Analyses of Policy Strategies to Improve Diet and Reduce CVDR01HL130735 · NHLBI · TUFTS UNIVERSITY BOSTON · PI MICHA, EIRINI (RENATA) · 2016 to 2019
$3.1M
NHLBI NIH HHS R01 HL130735
6 · The paper itself

Abstract

backgroundExcess added sugars, particularly from sugar-sweetened beverages, are a major risk factor for cardiometabolic diseases including cardiovascular disease and type 2 diabetes mellitus. In 2016, the US Food and Drug Administration mandated the labeling of added sugar content on all packaged foods and beverages. Yet, the potential health impacts and cost-effectiveness of this policy remain unclear.

methodsA validated microsimulation model (US IMPACT Food Policy model) was used to estimate cardiovascular disease and type 2 diabetes mellitus cases averted, quality-adjusted life-years, policy costs, health care, informal care, and lost productivity (health-related) savings and cost-effectiveness of 2 policy scenarios: (1) implementation of the US Food and Drug Administration added sugar labeling policy (sugar label), and (2) further accounting for corresponding industry reformulation (sugar label+reformulation). The model used nationally representative demographic and dietary intake data from the National Health and Nutrition Examination Survey, disease data from the Centers for Disease Control and Prevention Wonder Database, policy effects and diet-disease effects from meta-analyses, and policy and health-related costs from established sources. Probabilistic sensitivity analysis accounted for model parameter uncertainties and population heterogeneity.

resultsBetween 2018 and 2037, the sugar label would prevent 354 400 cardiovascular disease (95% uncertainty interval, 167 000-673 500) and 599 300 (302 400-957 400) diabetes mellitus cases, gain 727 000 (401 300-1 138 000) quality-adjusted life-years, and save $31 billion (15.7-54.5) in net healthcare costs or $61.9 billion (33.1-103.3) societal costs (incorporating reduced lost productivity and informal care costs). For the sugar label+reformulation scenario, corresponding gains were 708 800 (369 200-1 252 000) cardiovascular disease cases, 1.2 million (0.7-1.7) diabetes mellitus cases, 1.3 million (0.8-1.9) quality-adjusted life-years, and $57.6 billion (31.9-92.4) and $113.2 billion (67.3-175.2), respectively. Both scenarios were estimated with >80% probability to be cost saving by 2023.

conclusionsImplementing the US Food and Drug Administration added sugar labeling policy could generate substantial health gains and cost savings for the US population.

Indexed as

Energy IntakeNutritive ValueCardiovascular DiseasesChoice BehaviorComputer SimulationConsumer BehaviorCost-Benefit AnalysisCost SavingsDietary SugarsDiet, HealthyFeeding BehaviorFood LabelingHealth Care CostsHumansModels, EconomicNutritional StatusDietary Sugarscardiovascular diseasescost-benefit analysisdiabetes mellitusdietfood labelingpolicyprevention & control

Identifiers

PMID30982338
PMCPMC6546520
OpenAlexW2937033843

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.