In a recent study published in JAMA Network Open, researchers investigated whether implementing a tax on sweetened beverages was associated with changes in the body mass index (BMI) of children in Seattle.

Their findings indicate that the tax was significantly associated with a decrease in BMI among children residing in the Seattle area, suggesting that such taxes may effectively contribute to modest improvements in children’s BMI.

Study: Sweetened Beverage Tax Implementation and Change in Body Mass Index Among Children in Seattle. Image Credit: WH_Pics / Shutterstock

Background

To date, seven US cities have implemented excise taxes on sweetened beverages to improve public health by reducing sugar-sweetened beverage intake, the largest source of added sugar in the US, and to generate revenue for other health programs.

Previous studies have shown that these taxes increase beverage prices and reduce beverage purchases, potentially lowering calorie intake. However, the relationship between these taxes and self-reported sugary beverage consumption is often null, likely due to measurement difficulties and small study sizes.

Assessing health outcomes remains crucial as children, who consume more sweetened beverages, might be more affected by these taxes than adults.

Prior research on sweetened beverage taxes and children’s BMI is limited and shows mixed results: no association in Mauritius, a reduction in obesity among adolescent girls in Mexico, and a BMI decrease among children in three US cities.

About the study

This study used longitudinal BMI data from Seattle to examine the impact of taxes on children’s BMI, hypothesizing lower BMI gains post-tax.

This cohort study included children aged 2 to 18 who resided in urban neighborhoods of three Seattle counties and received primary care from two major hospitals or clinics between 2014 and 2019.

Participants were excluded if they had cancer, undergone bariatric surgery, moved out of the study area, or had extreme BMI values.

The exposure of interest was the tax on sweetened beverages that was implemented in Seattle in early January 2018. Data on weight and height were obtained from electronic health records, and BMI was calculated.

Researchers used BMIp95 (BMI as a percentage of the 95th percentile for age and sex) as the study’s primary outcome.

The study used two statistical models: a synthetic difference-in-differences (SDID) model for children with annual BMI measurements from 2015 to 2019 and a fine stratification average treatment effect (FSATE) weighted within-person change model for children with at least one pre- and post-tax measurement.

Both models adjusted for confounders, with the primary model emphasizing pretreatment trends and individual-level fixed effects. Analyses were conducted using Stata, with statistical significance set at α = .05.

Findings

The study’s primary SDID model comprised a sample of 6313 children (48% female and 52% male) with annual BMI measurements over five years, 28% of whom were from Seattle and 72% from comparison areas.

On average, the participants were 7.7 years old, with a racial/ethnic composition of 13% Asian, 10% Black, 10% Hispanic, 50% White, and 11% of multiple races. The FSATE-weighted model included 22,779 children.

Results showed that post-tax, Seattle children had a more significant reduction in BMIp95 compared to those in non-taxed areas, with an SDID estimate of -0.90 percentage points (95% CI, -1.2 to -0.60).

The FSATE-weighted model showed a similar but slightly larger reduction (β = -1.16 percentage points, 95% CI, -1.91 to -0.41).

Subgroup analyses indicated consistent reductions in BMIp95 across various demographic groups, including different ages, sexes, races, and insurance types, particularly among those with baseline overweight.

Conclusions

The study concluded that the tax on sweetened beverages was correlated with a statistically significant reduction in children’s BMIp95. This finding aligns with previous research, such as studies in Philadelphia, San Francisco, Oakland, and Mexico, which also reported reductions in children’s BMI following beverage tax implementations.

The study’s strengths include its use of longitudinal data, measured heights and weights, and robust statistical methods to control for pretax differences, thereby providing more reliable evidence than prior cross-sectional studies.

Limitations of the study include the lack of direct data on sweetened beverage consumption and the use of medical records with limited socioeconomic details. Additionally, while the SDID model offered internally valid estimates, it required all children to have the same number of outcome measurements, which reduced the sample size and generalizability.

Despite these limitations, the study provides strong evidence that taxes on sweetened beverages can provide practical policy tools to target BMI reductions in children. Future studies can explore this association in other cities with similar taxes to confirm these findings.

The Seattle Mariners beat the Los Angeles Angels on Sunday afternoon, 5-1, at T-Mobile Park. With the win, the M’s swept away the divisional foes and won their sixth game in the last seven tries. As we do after every game, here’s what you need to know:

For a long time, this game was about pitching. Luis Castillo got the win on the mound, tossing 7.0 innings, and allowing no runs on two hits. He walked three and struck out six in moving to 5-6 on the year. He now owns a 2.99 ERA. Leading 1-0 in the bottom of the eighth, the M’s capitalized on some Angels’ miscues to take a 5-0 lead, ultimately winning 5-1.

Luke Raley hit a solo home run in the fourth inning to give the M’s a 1-0 lead. It was his sixth homer of the year and his second in as many games.

Raley got hit by a pitch with the bases loaded in the eighth to make it 2-0 and then Mitch Garver followed up with a three-run double to make it 5-0.

It’s the second Mariners’ sweep of the year, having also swept Cincinnati… The M’s only had five hits in the win…JP Crawford committed his first error of the year… He had been the only qualified shortstop to have not committed an error yet…Mike Baumann pitched the ninth inning and gave up the only run of the game, but it was unearned because of the Crawford error… The M’s will be off Monday before traveling to Oakland.

Continue to follow our Inside the Mariners coverage on social media by liking us on Facebook and by following Brady on “X” @wdevradiobrady

Putting an emphasis on the trenches in their first draft entering the Mike Macdonald era, the Seattle Seahawks invested three of their eight picks on offensive linemen, including snagging UConn guard Christian Haynes in the third round as a potential day one starter.

Considering Seattle lost all three of its interior starters from last season in free agency, starting with four-year starting left guard Damien Lewis, the shift towards the line of scrimmage shouldn’t have come as a surprise. Luckily for general manager John Schneider, he has an asset at his disposal that most NFL teams can’t rival in Hall of Famer Steve Hutchinson, who serves as a football consultant for the front office and actively takes part in pro scouting.

Having witnessed Hutchinson’s fantastic NFL career and building a strong relationship with him dating back to his time as a scout for the Seahawks, Senior Bowl director Jim Nagy believes his presence gives the organization a tremendous advantage evaluating the offensive line, which unfortunately wasn’t a strong suit for the scouting department during most of Pete Carroll’s tenure as head coach.

“They’re lucky to have Hutch as part of that scouting department now, that is an unbelievable resource for them.” Nagy said during an interview on the Locked On Seahawks podcast. “Not all players who scout are great scouts. But just talking offensive linemen over the years with Hutch, he knows exactly what he’s looking at. He’s really dialed into the makeup of these players.”

Since Hutchinson, who earned All-Pro honors seven times in his illustrious career, joined the scouting department prior to the 2020 season, Seattle has found more success selecting quality offensive linemen via the draft. In his first year back with the organization, Lewis arrived as a third-round pick out of LSU and immediately earned a spot in the starting lineup at left guard. Prior to bolting for Carolina in March, he started 61 games in four seasons with the franchise.

With only three picks in the 2021 draft, Hutchinson carried a strong voice in Seattle’s decision to select of Stone Forsythe in the sixth round. Thrust into action for eight starts at right tackle in 2023, the former Florida standout has developed into a solid reserve swing tackle as he enters the final year of his rookie deal, providing good value for a late day three pick.

Two years ago, the Seahawks reinvented their offensive line by selecting tackles Charles Cross and Abraham Lucas, installing them as Week 1 starters and only the third pair of rookie tackles to open a season starting for an NFL team since 1970. Though injuries marred Lucas’ second season, both players remain foundational pieces for the offensive line moving forward, while center Olu Oluwatimi and guard Anthony Bradford, who were drafted in 2023, will have a chance to carve out long-term starting roles this summer.

As Nagy noted, Hutchinson has continued to swing a big stick for Seattle’s scouting department, spending extensive time visiting with line prospects this past fall as well as at the Senior Bowl.

“When you get a Steve Hutchinson coming to your school, you’re not going to treat him like every other scout on the road right?” Nagy said. “I’m surprised more teams haven’t done that with legendary players because these schools roll out the red carpet for Hutch when he goes in. Not only does he get to watch the guy practice and watch tape like all the other scouts, I’m sure he sits there for however long as he wants to sit there and watch tape and talk football with them. So you know it’s a great resource for John [Schneider].”

Having done his homework on the road meeting and speaking with numerous prospects, Schneider leaned heavily on Hutchinson’s expertise and opinion throughout draft weekend. As everyone in the room sweated out the process waiting to pick at 81 overall, per Seahawks.com, the esteemed general manager turned to Hutchinson and asked him what he thought of Haynes.

In response, Hutchinson told Schneider he thought Haynes was going to be a “really good [expletive] player,” and moments later, the Seahawks turned his name in as the selection. With the Hall of Famer actively involved throughout the process entering a busy day three of the draft, the team later added Utah guard Sataoa Laumea and Findlay tackle Michael Jerrell in the sixth round, adding more depth and upside to the offensive line.

Per Nagy, who reached out to Hutchinson after the draft concluded, the consultant couldn’t have been happier with the trio of linemen Seattle landed despite not having a second round pick due to the Leonard Williams trade from last October.

“I know he liked Christian Haynes,” Nagy said, again referencing Hutchinson’s presence as an underrated move for the Seahawks front office. “He was fired up after the draft after those three guys. I texted him and he was excited about all of the offensive linemen they took.”

Looking towards the 2024 season and beyond, the Seahawks have plenty of questions left to address along the offensive line with a new coach in Scott Huff taking over. After missing 11 games last season, Lucas underwent offseason knee surgery and likely won’t be back on the field until the start of training camp at the earliest, while Cross has yet to take the jump towards becoming a top-10 left tackle as the organization envisioned when they drafted him ninth overall two years ago.

In the interior, with three starting jobs left to fill, Oluwatimi has just one career start under his belt and Bradford endured a rocky stretch of play starting 10 games as a rookie last season. It remains to be seen whether either of them will emerge as a viable long-term option, but veteran center Nick Harris and Haynes will be ready to push them for a starting spot right away, while Laken Tomlinson should provide a steady stop gap at left guard for Seattle with Laumea developing behind him.

Given the youth and lack of experience overall up front, time will tell if the Seahawks can finally assemble a cohesive offensive line that becomes a strength for the team. But unlike most of the 2010s where the franchise struggled to draft and develop linemen, with Hutchinson leaving a major imprint on the construction of the group and Huff ready to make his mark, there’s no shortage of optimism and excitement about what the unit can potentially become.