title: Mortality, hospital days and treatment costs of current and reduced sugar consumption in Israel.
abstract: Consumption of sugar causes tooth decay, overweight and obesity related morbidities. This paper in response to the Minister of Health's request, provides estimates of the mortality, morbidity and health care costs attributable to sugar consumption in Israel along with the effects of reducing sugar consumption.
  
  
  
  Gender specific relative risks of many diseases from overweight (25 < =BMI < 30) and obesity (BMI > =30) were applied to the national gender specific prevalence rates of overweight and obesity in order to calculate the population attributable fraction (PAF) from overweight and obesity. National expenditure on these related diseases was calculated by applying disease-specific data from a recent Canadian study to estimates of disease specific general hospital expenditures in Israel. Disease specific costs attributable to overweight and obesity were estimated from the product of these expenditures and PAF. In addition national costs of treating caries in persons under 18 years of age from sugar were calculated. Similar calculations were made to estimate the burden from sugar in terms of mortality and hospital utilisation. A recent UK modelling study was used to estimate the effect of a national program to reduce calorific consumption of sugar from 12.45 to 10% in 5 years.
  
  
  
  Conditions associated with overweight or obesity accounted annually for 6402 deaths (95% CI 3296-8760) and 268,009 hospital days. Dental costs attributable to sugar consumption were 264 million NIS. In total, obesity, overweight and sugar consumption accounted for 2449 million in direct treatment costs (0.21% of GDP), rising to 4027 million (0.35% of GDP) when indirect costs were included. A national program of reducing energy from sugar consumption from 12.45 to 10% over 5 years is considered have a very feasible short-term goal. Even if the program does not impose taxes on sugar consumption, this would save 778 million NIS as well as 1184 lives.
  
  
  
  Sugar consumption causes a huge monetary and mortality burden. Estimates of potential decreases in this burden justify the current prioritisation given by the health minister of creating and implementing a national program to reduce sugar consumption, which is likely to be cost-saving (ie: averted treatment costs will exceed intervention costs).
authors.affiliation: Israel Ministry of Health, Public Health Services, Yirmiahu Street 39, Jerusalem, 9446724 Israel.
authors.forename: Gary M
authors.initials: GM
authors.lastname: Ginsberg
mesh_terms: D000328:Adult; D000368:Aged; D017281:Cost of Illness; D005247:Feeding Behavior; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007557:Israel; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009765:Obesity / Q000150:complications / Q000209:etiology*; D050177:Overweight / Q000150:complications / Q000209:etiology; D015995:Prevalence; D012067:Religion; D012306:Risk; D000073893:Sugars / Q000627:therapeutic use*
chemical_list: D000073893:Sugars
keywords: Attributable mortality; Hospitalisations; Obesity; Overweight; Sugar