Effective policies to promote sugar reduction in soft drinks: lessons from a comparison of six European countries.

Background: Many countries have sought to incentivise soft drinks manufacturers to reduce sugar in their products as part of efforts to address a growing prevalence of obesity. Are their policies effective?

Methods: Using a difference-in-differences design, we compared trends in the sugar content of 10 695 new sugar-sweetened beverages (SSB) launched between 2010 and 2019 in six European markets, including the UK and France (taxes designed to incentivise reformulation), the Netherlands (policy based on voluntary agreements to reduce sugar), Germany, Italy and Spain (no national policies).

Results: The announcement in 2016 and adoption in 2018 of the UK tax led to yearly reductions in average sugar content of 17% (95% CI: 15-19%) to 31% (13-48%) between 2016 and 2019, compared to 2015, while the 2018 French tax produced a 6% (95% CI: 5-7%) sugar reduction only in 2018, compared to 2017, shortly after it was redesigned to provide a stronger incentive for reformulation.

Market concentration and the healthiness of packaged food and non-alcoholic beverage sales across the European single market.

Objective: To assess the relationship between market concentration and diversity, as indicators of market structure, and the healthiness of food and beverage sales across Europe.

Design: Market share (MS) data per country were used to calculate market concentration, assessed by the four-firm concentration ratio and market diversity, and by the number of companies with ≥1 % MS and the number of companies uniquely present in one European country. The healthiness of food sales was assessed by applying the NOVA classification (level of processing).

Assessment of the Commitments and Performance of the European Food Industry to Improve Population Nutrition.

Food companies could play an important role in improving population diets, but often escape accountability through unspecific commitments. This study evaluated nutrition-related commitments and estimated performance of the largest packaged food and non-alcoholic beverage manufacturers, supermarkets and quick-service restaurants (QSR) in Europe. To quantitatively assess companies' publicly available commitments in 2020, the "Business Impact Assessment on Obesity and Population Nutrition" was applied.

A detailed mapping of the food industry in the European single market: similarities and differences in market structure across countries and sectors.

Background: Food environments are influenced by food industries (packaged food and non-alcoholic beverage manufacturers; supermarkets and quick service restaurants). An important source of this influence is the significant market power held by a limited number of food companies. Market structure analysis, as part of a broader market power research agenda, has received limited attention from the public health community.

The long-run effects of war on health: Evidence from World War II in France.

We investigate the effects of early-life exposure to war on adult health outcomes including cancer, hypertension, angina, infarction, diabetes and obesity. We combine data from the French prospective cohort study E3N on women employed in the French National Education with historical data on World War II. To identify causal effects, we exploit exogenous spatial and temporal variation in war exposure related to the German invasion of France during the Battle of France.

Associations between early-life food deprivation during World War II and risk of hypertension and type 2 diabetes at adulthood.

The Developmental Origins of Health and Disease (DOHaD) framework suggests that early-life experiences affect long-term health outcomes. We tested this hypothesis by estimating the long-run effects of exposure to World War II-related food deprivation during childhood and adolescence on the risk of suffering from hypertension and type 2 diabetes at adulthood for 90,226 women from the French prospective cohort study E3N. We found that the experience of food deprivation during early-life was associated with a higher risk of developing type 2 diabetes (+0.

The impact of the French soda tax on prices and purchases. An ex post evaluation.

We estimate the price and consumption effects of the 2012 French tax on sweetened non-alcoholic drinks using a difference-in-difference approach. Our identification strategy exploits Italian data as a natural control group. We use French and Italian Consumer Price Indices, purchase prices and quantities from the 2011 and 2012 Kantar and GfK home-scan surveys for two French regions and two neighbouring Italian regions, and expenditure data from the 2011 and 2012 Italian Expenditure Survey.

Getting more people on the stairs: The impact of point-of-decision prompts.

Individuals rarely achieve investment activities characterised by up-front costs and delayed benefits. Point-of-decision prompts (PDPs) provide information about a better alternative or a deterrent to the behavioural standard at the moment the decision is made and may affect behaviour by helping individuals perform this type of investment activities. We conducted a field experiment to assess the effects of a PDP intervention that encourages taking the stairs rather than the escalator in three Paris (France) Metro stations for eight weeks from April to July 2014.

Mandatory labels, taxes and market forces: An empirical evaluation of fat policies.

The public-health community views mandatory Front-of-Pack (FOP) nutrition labels and nutritional taxes as promising tools to control the growth of food-related chronic diseases. This paper uses household scanner data to propose an ex-ante evaluation and comparison of these two policy options for the fromage blanc and dessert yogurt market. In most markets, labelling is voluntary and firms display fat labels only on the FOP of low-fat products to target consumers who do not want to eat fat.