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 (SSBs) among children, after implementation of the health promotion levy.

Design:

Prospective cohort study

Setting:

10 schools in North West Province, South Africa

Participants:

950 children aged 5-9y at baseline and data of 672 children at follow-up. Frequency of intake from healthy and unhealthy food groups were assessed by questionnaire. Anthropometric and sociodemographic information were collected; BMI z-scores (BAZ) were calculated. The health promotion levy was implemented after baseline and follow-up measurements were done after four years. A random intercept generalized linear mixed model analysis was applied to investigate the time effect of the weekly intake of the foods adjusting for BAZ and sociodemographic characteristics of the children.

Results:

The weekly frequency of intake from most food groups remained unchanged at follow-up. The frequency of SSBs intake decreased significantly over four years. Decreased intake of SSBs was not linked to increased intake of healthy foods. Changes in intakes from SSBs were not associated with household income, parental education, or BAZ categories. A decreased frequency of intake from SSBs 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.