title: Health benefits of reducing sugar-sweetened beverage intake in high risk populations of California: results from the cardiovascular disease (CVD) policy model.
abstract: BACKGROUND
  Consumption of sugar-sweetened beverage (SSB) has risen over the past two decades, with over 10 million Californians drinking one or more SSB per day. High SSB intake is associated with risk of type 2 diabetes, obesity, hypertension, and coronary heart disease (CHD). Reduction of SSB intake and the potential impact on health outcomes in California and among racial, ethnic, and low-income sub-groups has not been quantified.
  
  
  METHODS
  We projected the impact of reduced SSB consumption on health outcomes among all Californians and California subpopulations from 2013 to 2022. We used the CVD Policy Model - CA, an established computer simulation of diabetes and heart disease adapted to California. We modeled a reduction in SSB intake by 10-20% as has been projected to result from proposed penny-per-ounce excise tax on SSB and modeled varying effects of this reduction on health parameters including body mass index, blood pressure, and diabetes risk. We projected avoided cases of diabetes and CHD, and associated health care cost savings in 2012 US dollars.
  
  
  RESULTS
  Over the next decade, a 10-20% SSB consumption reduction is projected to result in a 1.8-3.4% decline in the new cases of diabetes and an additional drop of 0.5-1% in incident CHD cases and 0.5-0.9% in total myocardial infarctions. The greatest reductions are expected in African Americans, Mexican Americans, and those with limited income regardless of race and ethnicity. This reduction in SSB consumption is projected to yield $320-620 million in medical cost savings associated with diabetes cases averted and an additional savings of $14-27 million in diabetes-related CHD costs avoided.
  
  
  CONCLUSIONS
  A reduction of SSB consumption could yield substantial population health benefits and cost savings for California. In particular, racial, ethnic, and low-income subgroups of California could reap the greatest health benefits.
authors.affiliation: Department of Medicine, University of California San Francisco, San Francisco, California, United States of America ; Division of General Internal Medicine, San Francisco General Hospital, University of California San Francisco, San Francisco, California, United States of America ; UCSF Center for Vulnerable Populations at San Francisco General Hospital, San Francisco, California, United States of America.
authors.forename: Tekeshe A
authors.initials: TA
authors.lastname: Mekonnen
authors.affiliation: School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, United States of America.
authors.forename: Michelle C
authors.initials: MC
authors.lastname: Odden
authors.affiliation: Department of Medicine, University of California San Francisco, San Francisco, California, United States of America ; Division of General Internal Medicine, San Francisco General Hospital, University of California San Francisco, San Francisco, California, United States of America ; UCSF Center for Vulnerable Populations at San Francisco General Hospital, San Francisco, California, United States of America.
authors.forename: Pamela G
authors.initials: PG
authors.lastname: Coxson
authors.affiliation: Department of Medicine, University of California San Francisco, San Francisco, California, United States of America ; Division of General Internal Medicine, San Francisco General Hospital, University of California San Francisco, San Francisco, California, United States of America ; UCSF Center for Vulnerable Populations at San Francisco General Hospital, San Francisco, California, United States of America.
authors.forename: David
authors.initials: D
authors.lastname: Guzman
authors.affiliation: Department of Clinical Pharmacy, School of Pharmacy, University of California San Francisco, San Francisco, California, United States of America.
authors.forename: James
authors.initials: J
authors.lastname: Lightwood
authors.affiliation: Health Policy and Management, Mailman School of Public Health, Columbia University, New York, New York, United States of America.
authors.forename: Y Claire
authors.initials: YC
authors.lastname: Wang
authors.affiliation: Department of Medicine, University of California San Francisco, San Francisco, California, United States of America ; Division of General Internal Medicine, San Francisco General Hospital, University of California San Francisco, San Francisco, California, United States of America ; UCSF Center for Vulnerable Populations at San Francisco General Hospital, San Francisco, California, United States of America ; Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, United States of America.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Bibbins-Domingo
mesh_terms: D001628:Beverages / Q000009:adverse effects*; D001794:Blood Pressure; D015992:Body Mass Index; D002140:California; D003362:Cost-Benefit Analysis / Q000706:statistics & numerical data; D003924:Diabetes Mellitus, Type 2 / Q000191:economics / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D015233:Models, Statistical; D009203:Myocardial Infarction / Q000191:economics / Q000209:etiology / Q000517:prevention & control*; D009765:Obesity / Q000191:economics / Q000209:etiology / Q000517:prevention & control*; D012307:Risk Factors; D013549:Sweetening Agents / Q000009:adverse effects*
chemical_list: D013549:Sweetening Agents