Higher sweet beverage tax shows null result in lowing Philadelphia youth obesity

Children’s Hospital of Philadelphia, the University of Pennsylvania, Harvard Medical School and the Harvard T.H. Chan School of Public Health found no significant changes in pediatric weight outcomes two years after implementing the Philadelphia beverage tax. The study assessed whether the 2017 tax on sweetened beverages influenced standardized body mass index (zBMI) and obesity prevalence among youth.

Added sugar consumption, particularly from sugar-sweetened beverages (SSBs), is thought to contribute to adverse child health outcomes like excess weight gain and metabolic syndrome. In the United States, 65% of children exceed recommended sugar intake, with SSBs accounting for approximately 40% of added sugars.

Taxation of SSBs is an often proposed strategy to reduce population sugar consumption. The seven U.S. cities with SSB taxes are reportedly seeing declines in SSB purchases while raising more than $133 million per year—but does it actually reduce obesity in youth?

In the study, “The Philadelphia Beverage Tax and Pediatric Weight Outcomes,” published online in JAMA Pediatrics, researchers utilized electronic health records from a pediatric primary care network in the Philadelphia region to conduct panel and cross-sectional analyses to see if the added tax reduced youth obesity.

The panel included 136,078 youth aged 2 to 18 years with at least one BMI measurement before the tax (2014–2016) and after the tax (2018–2019). The cross-sectional analysis encompassed 258,584 youth with 2014 to 2019 BMI measurements. Measurements were standardized to zBMI, which accounts for age and sex differences among children and adolescents rather than raw BMI data.

The main outcomes measured in the study were changes in zBMI and obesity prevalence between Philadelphia youth (exposed to the tax) and those in surrounding counties (control group). Results indicated no significant differences in zBMI change or obesity prevalence between the groups.

In the panel analysis, the difference in zBMI change was –0.004, and the odds ratio for obesity prevalence was 1.02. Similar findings (1.01) were observed in the cross-sectional analysis. While some subgroup analyses showed small statistically significant changes in zBMI by race, age, Medicaid status, and baseline weight, these differences were inconsistent and of low clinical significance.

Results indicate that the Philadelphia beverage tax was not associated with changes in pediatric weight outcomes during the two years following its implementation. The findings suggest that multiple public policy strategies may be necessary to address pediatric obesity effectively. The good news is that communities with SSB taxes already have a way to pay for those new strategies.

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