title: 'Traffic-light' nutrition labelling and 'junk-food' tax: a modelled comparison of cost-effectiveness for obesity prevention.
abstract: BACKGROUND
  Cost-effectiveness analyses are important tools in efforts to prioritise interventions for obesity prevention. Modelling facilitates evaluation of multiple scenarios with varying assumptions. This study compares the cost-effectiveness of conservative scenarios for two commonly proposed policy-based interventions: front-of-pack 'traffic-light' nutrition labelling (traffic-light labelling) and a tax on unhealthy foods ('junk-food' tax).
  
  
  METHODS
  For traffic-light labelling, estimates of changes in energy intake were based on an assumed 10% shift in consumption towards healthier options in four food categories (breakfast cereals, pastries, sausages and preprepared meals) in 10% of adults. For the 'junk-food' tax, price elasticities were used to estimate a change in energy intake in response to a 10% price increase in seven food categories (including soft drinks, confectionery and snack foods). Changes in population weight and body mass index by sex were then estimated based on these changes in population energy intake, along with subsequent impacts on disability-adjusted life years (DALYs). Associated resource use was measured and costed using pathway analysis, based on a health sector perspective (with some industry costs included). Costs and health outcomes were discounted at 3%. The cost-effectiveness of each intervention was modelled for the 2003 Australian adult population.
  
  
  RESULTS
  Both interventions resulted in reduced mean weight (traffic-light labelling: 1.3 kg (95% uncertainty interval (UI): 1.2; 1.4); 'junk-food' tax: 1.6 kg (95% UI: 1.5; 1.7)); and DALYs averted (traffic-light labelling: 45,100 (95% UI: 37,700; 60,100); 'junk-food' tax: 559,000 (95% UI: 459,500; 676,000)). Cost outlays were AUD81 million (95% UI: 44.7; 108.0) for traffic-light labelling and AUD18 million (95% UI: 14.4; 21.6) for 'junk-food' tax. Cost-effectiveness analysis showed both interventions were 'dominant' (effective and cost-saving).
  
  
  CONCLUSIONS
  Policy-based population-wide interventions such as traffic-light nutrition labelling and taxes on unhealthy foods are likely to offer excellent 'value for money' as obesity prevention measures.
authors.affiliation: WHO Collaborating Centre for Obesity Prevention, Deakin University, Melbourne, Victoria, Australia. gary.sacks@deakin.edu.au
authors.forename: G
authors.initials: G
authors.lastname: Sacks
authors.forename: J L
authors.initials: JL
authors.lastname: Veerman
authors.forename: M
authors.initials: M
authors.lastname: Moodie
authors.forename: B
authors.initials: B
authors.lastname: Swinburn
mesh_terms: D001315:Australia / Q000453:epidemiology; D003362:Cost-Benefit Analysis; D057140:Fast Foods / Q000009:adverse effects / Q000191:economics*; D005260:Female; D005515:Food Labeling / Q000191:economics* / Q000706:statistics & numerical data; D005518:Food Preferences; D015438:Health Behavior; D006293:Health Promotion / Q000191:economics*; D006801:Humans; D008297:Male; D009753:Nutritive Value; D009765:Obesity / Q000453:epidemiology / Q000517:prevention & control*