FDA sugar label could improve health, reduce medical costs, Tufts study says

The Food and Drug Administration (FDA) new mandatory added sugar label could be a cost-effective way to improve health while saving on healthcare costs, according to a new study led by researchers from the Friedman School of Nutrition Science and Policy at Tufts University in Boston, Massachusetts, and the University of Liverpool in England. The modeling study published today in the journal Circulation.

The FDA announced in 2016 several changes to its Nutrition Facts label, including adding the grams and percent Daily Value of added sugar content. The labeling policy is set to take effect some time between 2020 and 2021, according to the FDA, with the deadline for compliance extended to 2020 for large manufacturers and 2021 for small manufacturers.

The researchers used a validated microsimulation model (IMPACT) to estimate the potential health impact, costs, and cost-effectiveness of the FDA's added sugar label based on the two scenarios, which were compared with a "no intervention" baseline scenario between 2018 and 2037. The model generated a sample representative of the U.S. adult population and utilized data from the two most recent National Health and Nutrition Examination Survey cycles, CDC Wonder, meta-analyses, and other validated sources.

The model evaluated health benefits and cost-savings from cardiometabolic health outcomes. Increased healthcare costs from competing diseases could reduce cost-effectiveness, while other health benefits would further contribute to health gains and cost-savings, the researchers said.

The study estimates that the FDA added sugar label could prevent or postpone nearly 1 million cases of cardiometabolic disease, including heart disease, stroke, and type 2 diabetes, over the 20-year period. When combined with possible industry reformulations to reduce added sugar content in packaged foods and beverages, the label could prevent or postpone nearly 3 million cases of cardiovascular disease and diabetes over the same time period.

Specifically, the analysis estimates the added sugar label could prevent or postpone 354,400 cases of cardiovascular disease and 599,300 cases of diabetes; gain 727,000 quality-adjusted life-years (QALYs); and save $31 billion in net healthcare costs and $61.9 billion in societal costs. Taking into consideration possible reformulation by the food industry, the analysis yielded greater corresponding gains, estimating that the new label could prevent or postpone 708,800 cases of cardiovascular disease and 1.2 million cases of diabetes; gain 1.3 million QALYs; and save $57.6 billion in net healthcare costs and $113.2 billion in societal costs.

Researchers say the study is the first to estimate the potential health and economic affects of the new label.  The added sugar label is an important policy step toward reducing consumption of foods and beverages with high added sugar contents, improving health, and lowering healthcare spending, according to Renata Micha, RD, PhD, the study’s co-senior author and research associate professor at the Friedman School of Nutrition Science and Policy.

“These findings have important implications for individuals, policy makers and the food industry alike. Modest industry reformulation would be a powerful way to maximize potential benefits, highlighting industry's critical role in being part of the solution,” she said in a press statement.

The researchers note that Americans consume more than 15 percent of their total calories from added sugars and overconsumption of added sugars is linked to an increased risk of cardiometabolic diseases. These diseases pose large health and economic burdens for the society and the healthcare system. Food labeling could be an effective strategy to support informed consumer choice and reduce added sugar intake, while further stimulating industry reformulation, as supported by recent experience with trans-fat labeling in the U.S., the authors say.