title: SSB taxes and diet quality in US preschoolers: estimated changes in the 2010 Healthy Eating Index.
abstract: Taxing sugar-sweetened beverages (SSBs) has been proposed as a strategy to combat child obesity. Yet it is unclear how a tax on SSBs might influence the overall quality of diet in preschool children. Thus, we use simulated price increases and the 2010 Healthy Eating Index (HEI-2010) to explore the relationship between SSB taxes and diet quality in preschool children.
  
  
  
  Price and purchase data from the 2009-2012 Nielsen Homescan Panel and a two-part marginal effects model were used to estimate relative changes in purchases with a 20% increase in the price of SSBs. Demand elasticities were applied to dietary intake data for children ages 2-5 years from the National Health and Nutrition Examination Survey (2009-2010 and 2011-2012) to estimate the impact of a 20% SSB tax on dietary intake and quality (HEI-2010).
  
  
  
  A 20% increase in the price of SSBs was associated with lower total caloric intake (-28 kcal d-1, p < 0.01), caloric intake from juice drinks (-20 kcal d-1, p < 0.01), added sugars (-4.1 servings d-1, p = 0.03), refined grains (-0.63 servings d-1, p < 0.01) and total meat (-0.56 servings d-1, p < 0.01). Beneficial decreases in empty calories and refined grains were offset by unfavourable changes in fatty acid profile, total protein, vegetables and fruit, such that total HEI scores (0-100 range) were not meaningfully changed with a 20% increase in SSB price (difference: -0.85, p < 0.01).
  
  
  
  A 20% tax on SSBs could decrease caloric intake, and intakes of added sugars and SSBs, but may not improve diet quality as an isolated intervention among US preschool children.
authors.affiliation: Department of Epidemiology MD Anderson Cancer Center, The University of Texas, Houston, Texas, (USA), 77030.
authors.forename: C N
authors.initials: CN
authors.lastname: Ford
authors.affiliation: Department of Nutrition and Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Poti
authors.affiliation: Department of Nutrition and Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: S W
authors.initials: SW
authors.lastname: Ng
authors.affiliation: Department of Nutrition and Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: B M
authors.initials: BM
authors.lastname: Popkin
mesh_terms: D001628:Beverages / Q000191:economics / Q000706:statistics & numerical data*; D002675:Child, Preschool; D004032:Diet; D000072001:Diet, Healthy / Q000191:economics / Q000706:statistics & numerical data*; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D009749:Nutrition Surveys; D063766:Pediatric Obesity / Q000453:epidemiology*; D013549:Sweetening Agents / Q000191:economics*; D013660:Taxes / Q000706:statistics & numerical data*; D014481:United States
chemical_list: D013549:Sweetening Agents
keywords: Beverage tax; obesity prevention; preschool child; sugar-sweetened beverage tax.