Diabetes research and clinical practice · 2025
Long-term impact of a sugar-sweetened beverage tax and increased physical activity on obesity and diabetes burden in Central and Eastern European Countries: a microsimulation model.
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Aisul Muhlis Abdu Nafan, Varga Orsolya
Аннотация
AIMS: This study models the potential health impacts of combining fiscal and behavioral policies, specifically, sugar-sweetened beverage (SSB) taxation and increases in physical activity (PA), across six Central and Eastern European (CEE) countries.
METHODS: We simulated the effects of a 20 % SSB tax combined with a 15 % increase in PA on obesity, type 2 diabetes mellitus (T2DM), and mortality over 30 years in Bulgaria, Czechia, Hungary, Poland, Romania, and Slovakia. Sensitivity analyses examined alternative scenarios, including SSB substitution with water, a 30 % fruit and vegetable subsidy.
RESULTS: Combined SSB taxation and PA increases would have a significant impact on low-income adults aged 15-49 in Czechia, Hungary, and Romania, whereas high-income groups benefit most in Bulgaria, Poland, and Slovakia. It could prevent between 7,344 (95 % UI: 4,520, 10,168) T2DM cases in Slovakia and 24,142 (95 % UI: 18,809, 29,474) in Poland. Obesity reductions are projected to peak in the early to mid-2030 s, with T2DM and mortality benefits accruing more gradually.
CONCLUSIONS: Integrating fiscal and behavioural policies could reduce the burden of obesity, T2DM, and related inequalities in CEE countries, supporting strategies aligned with the WHO and Sustainable Development Goals.
METHODS: We simulated the effects of a 20 % SSB tax combined with a 15 % increase in PA on obesity, type 2 diabetes mellitus (T2DM), and mortality over 30 years in Bulgaria, Czechia, Hungary, Poland, Romania, and Slovakia. Sensitivity analyses examined alternative scenarios, including SSB substitution with water, a 30 % fruit and vegetable subsidy.
RESULTS: Combined SSB taxation and PA increases would have a significant impact on low-income adults aged 15-49 in Czechia, Hungary, and Romania, whereas high-income groups benefit most in Bulgaria, Poland, and Slovakia. It could prevent between 7,344 (95 % UI: 4,520, 10,168) T2DM cases in Slovakia and 24,142 (95 % UI: 18,809, 29,474) in Poland. Obesity reductions are projected to peak in the early to mid-2030 s, with T2DM and mortality benefits accruing more gradually.
CONCLUSIONS: Integrating fiscal and behavioural policies could reduce the burden of obesity, T2DM, and related inequalities in CEE countries, supporting strategies aligned with the WHO and Sustainable Development Goals.