Decreased frequency of sugar-sweetened beverages intake among young children following the implementation of the health promotion levy in South Africa

Abstract Objective: This study assessed the association between baseline sociodemographic variables, body composition and 4-year changes in the intake of food groups, including sugar-sweetened beverages (SSB) among children, after the implementation of the health promotion levy. Design: Prospect...

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Main Authors: H Salome Kruger, Tertia van Zyl, Makama A Monyeki, Cristian Ricci, Ruan Kruger
Format: Article
Language:English
Published: Cambridge University Press 2025-01-01
Series:Public Health Nutrition
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Online Access:https://www.cambridge.org/core/product/identifier/S1368980024002623/type/journal_article
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author H Salome Kruger
Tertia van Zyl
Makama A Monyeki
Cristian Ricci
Ruan Kruger
author_facet H Salome Kruger
Tertia van Zyl
Makama A Monyeki
Cristian Ricci
Ruan Kruger
author_sort H Salome Kruger
collection DOAJ
description Abstract Objective: This study assessed the association between baseline sociodemographic variables, body composition and 4-year changes in the intake of food groups, including sugar-sweetened beverages (SSB) among children, after the implementation of the health promotion levy. Design: Prospective cohort study. Setting: Ten schools in North West Province, South Africa. Participants: 950 children aged 5–9 years at baseline and data of 672 children at follow-up. The frequency of intake from healthy and unhealthy food groups was assessed by questionnaire. Anthropometric and sociodemographic information were collected; BMI-for-age z-scores were calculated. The health promotion levy was implemented after baseline and follow-up measurements were done after 4 years. A random intercept generalised linear mixed model analysis was applied to investigate the time effect of the weekly intake of the foods adjusting for BMI-for-age z-scores and sociodemographic characteristics of the children. Results: The weekly frequency of intake from most food groups remained unchanged at follow-up. The frequency of SSB intake decreased significantly over 4 years. Decreased intake of SSB was not linked to increased intake of healthy foods. Changes in intakes from SSB were not associated with household income, parental education or BMI-for-age z-score categories. A decreased frequency of intake from SSB was observed following the implementation of the health promotion levy after baseline, in line with reports of national decreases in SSB sales in South Africa since 2017. Conclusions: The decreased frequency of SSB intakes following the implementation of the health promotion levy in South Africa may indicate that health policies can promote healthier dietary habits.
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institution Kabale University
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language English
publishDate 2025-01-01
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spelling doaj-art-e3dde0f6e6a54f24a5b20416e19add012025-01-24T05:14:07ZengCambridge University PressPublic Health Nutrition1368-98001475-27272025-01-012810.1017/S1368980024002623Decreased frequency of sugar-sweetened beverages intake among young children following the implementation of the health promotion levy in South AfricaH Salome Kruger0https://orcid.org/0000-0002-5365-1777Tertia van Zyl1Makama A Monyeki2https://orcid.org/0000-0002-4156-8394Cristian Ricci3Ruan Kruger4Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa Medical Research Council Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South AfricaCentre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa Medical Research Council Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South AfricaPhysical Activity, Sport and Recreation Research Focus Area, North-West University, Potchefstroom, South AfricaAfrica Unit for Trans-disciplinary Health Research, North-West University, Potchefstroom, South AfricaMedical Research Council Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa Hypertension in Africa Research Team, North-West University, Potchefstroom, South Africa Abstract Objective: This study assessed the association between baseline sociodemographic variables, body composition and 4-year changes in the intake of food groups, including sugar-sweetened beverages (SSB) among children, after the implementation of the health promotion levy. Design: Prospective cohort study. Setting: Ten schools in North West Province, South Africa. Participants: 950 children aged 5–9 years at baseline and data of 672 children at follow-up. The frequency of intake from healthy and unhealthy food groups was assessed by questionnaire. Anthropometric and sociodemographic information were collected; BMI-for-age z-scores were calculated. The health promotion levy was implemented after baseline and follow-up measurements were done after 4 years. A random intercept generalised linear mixed model analysis was applied to investigate the time effect of the weekly intake of the foods adjusting for BMI-for-age z-scores and sociodemographic characteristics of the children. Results: The weekly frequency of intake from most food groups remained unchanged at follow-up. The frequency of SSB intake decreased significantly over 4 years. Decreased intake of SSB was not linked to increased intake of healthy foods. Changes in intakes from SSB were not associated with household income, parental education or BMI-for-age z-score categories. A decreased frequency of intake from SSB was observed following the implementation of the health promotion levy after baseline, in line with reports of national decreases in SSB sales in South Africa since 2017. Conclusions: The decreased frequency of SSB intakes following the implementation of the health promotion levy in South Africa may indicate that health policies can promote healthier dietary habits. https://www.cambridge.org/core/product/identifier/S1368980024002623/type/journal_articleSugar-sweetened beveragesSugar taxChildrenSouth Africa
spellingShingle H Salome Kruger
Tertia van Zyl
Makama A Monyeki
Cristian Ricci
Ruan Kruger
Decreased frequency of sugar-sweetened beverages intake among young children following the implementation of the health promotion levy in South Africa
Public Health Nutrition
Sugar-sweetened beverages
Sugar tax
Children
South Africa
title Decreased frequency of sugar-sweetened beverages intake among young children following the implementation of the health promotion levy in South Africa
title_full Decreased frequency of sugar-sweetened beverages intake among young children following the implementation of the health promotion levy in South Africa
title_fullStr Decreased frequency of sugar-sweetened beverages intake among young children following the implementation of the health promotion levy in South Africa
title_full_unstemmed Decreased frequency of sugar-sweetened beverages intake among young children following the implementation of the health promotion levy in South Africa
title_short Decreased frequency of sugar-sweetened beverages intake among young children following the implementation of the health promotion levy in South Africa
title_sort decreased frequency of sugar sweetened beverages intake among young children following the implementation of the health promotion levy in south africa
topic Sugar-sweetened beverages
Sugar tax
Children
South Africa
url https://www.cambridge.org/core/product/identifier/S1368980024002623/type/journal_article
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AT makamaamonyeki decreasedfrequencyofsugarsweetenedbeveragesintakeamongyoungchildrenfollowingtheimplementationofthehealthpromotionlevyinsouthafrica
AT cristianricci decreasedfrequencyofsugarsweetenedbeveragesintakeamongyoungchildrenfollowingtheimplementationofthehealthpromotionlevyinsouthafrica
AT ruankruger decreasedfrequencyofsugarsweetenedbeveragesintakeamongyoungchildrenfollowingtheimplementationofthehealthpromotionlevyinsouthafrica