Sugary Drink Warning Labels in Chile, Tax in UK Bear Fruit

Marlene Busko

February 18, 2020

A multipronged law in Chile to lower the consumption of sugar-sweetened beverages and a United Kingdom tax on manufacturing of similar sugar-laden drinks are showing some success, albeit on different outcomes.  

The details and early impact of these two national strategies to try to thwart the rise in obesity and type 2 diabetes are reported in two studies published online in PLOS Medicine.

One study reports that a year after the implementation of Chile's 2016 Law on Food Labeling and Advertising — which is seen as the toughest in the world and requires warning labels on drinks with high-sugar content; restricts ads aimed at children; and bans high-sugar drinks in schools — household purchases of these drinks dropped by almost a quarter.

Moreover, "the reductions [with this multipronged approach] were larger than those observed from single, standalone policies, including sugar-sweetened beverage taxes previously implemented in Latin America," Lindsey Smith Taillie, PhD, MPH, University of North Carolina at Chapel Hill, and colleagues write in the study.

A second study reported on the effect of the UK's 2018 Soft Drinks Industry Levy that requires manufacturers and importers of soft drinks with more than 5 g of sugar per 100 mL to pay a direct tax (levy) to the government.

A year and a half after that levy was implemented, 33.8% fewer beverages in the marketplace had that 5 g per 100 mL sugar content.  

This suggests that the levy "incentivized many manufacturers to reduce sugar in soft drinks," Peter Scarborough, DPhil, associate professor at Nuffield Department of Population Health, University of Oxford, and colleagues report.

Only one third of the cost of the levy to manufacturers and importers was passed on to consumers, and this price increase was not always on targeted drinks.

"These changes could reduce population exposure to liquid sugars and associated health risks," the authors conclude.

Chile's Sugary-Drink Warning Labels, Ad Restrictions, Ban in Schools

In June 2016, Chile, a high-income country with high levels of sugar-sweetened beverage intake, implemented the Law on Food Labeling and Advertising to try to prevent further increases in the prevalence of obesity, as detailed by Medscape Medical News.

Chile was the first country to implement such a national mandatory, front-of-package warning-label system for sugar-sweetened beverages and energy-dense, nonessential foods. This initiative came on the back of trying to tackle the highest obesity rates in Latin America.

The law requires foods and beverages that contain >100 calories, >3 g of saturated fat, >100 mg sodium, and >6 grams of sugar, all per 100 mL (or 100 g) to carry black-and-white warning labels (in the shape of a "STOP" sign) stating "high-in" calories, sugar, sodium, and saturated fat, respectively.


The law also prohibits advertising high-in-sugar foods and beverages to children and bans their sale in schools.

The researchers analyzed beverage-consumption data from 2383 urban households that participated in a national survey in Chile from January 1, 2015 to December 31, 2017. The beverages included sodas, fruit drinks, dairy products, flavored waters, coffees, teas, 100% fruit and vegetable juices, and sports and energy drinks.

A year and a half after the multipronged law came into effect, the volume of sugary drinks consumed by people in these representative households had decreased significantly — by 23.7% (22.8 mL/person/day).

In comparison, earlier tax hikes on these products in Chile and Mexico were linked with much smaller effects. On October 1, 2014, the Chilean government had increased the tax on sugar-sweetened beverages from 13% to 18%, which was associated with a 3.4% reduction consumption of these drinks 1 year later.

And on January 1, 2014, Mexico implemented a 1 peso per liter (approximately 10%) tax on sugar-sweetened beverages, which was associated with a 7.6% decrease in consumption of these beverages 2 years later.

Future research is needed to investigate how Chile's multipronged policy affected consumer behavior, product reformulation, and changes in diet and health outcomes, the authors conclude.

UK's Tax on Manufacturers of Sugary Drinks

After the United Kingdom Soft Drinks Industry Levy was implemented in April 2018, beverage manufacturers and importers had to pay the government £0.18 (US $0.25) per liter for drinks with 5 to 8 g sugar per 100 mL and £0.24 ($0.31) per liter for drinks with >8 g sugar per 100 mL.

Fruit juices and milk-based drinks were exempt.

Scarborough and colleagues measured the impact of these levies on price, product size, number of soft drinks in the marketplace, and the proportion of drinks containing >5 g sugar per 100 mL. They analyzed data from websites of leading supermarkets in the UK at 85 time points between September 2015 and February 2019.

After the levy came into effect, the percentage of drinks with >5 g sugar per 100 mL fell from a projected level of 49% (had there been no levy) to 15%.

The findings suggest that many manufacturers chose to reformulate their sugary drinks to contain 4.5 to <5.0 g per 100 mL.

The size and the number of sugar-sweetened beverages available to consumers hardly changed.

All in all, the levy "was associated with a considerable impact on the soft drinks industry," the authors summarize.

They are currently investigating the impact of the levy on consumer behavior (eg, substitution of other drinks) and health outcomes.

The study by Smith Taillie et al was funded by grants from Bloomberg Philanthropies, the International Development Research Center, and the Population Research Infrastructure Program. The authors have disclosed no relevant financial relationships.

The study by Scarborough et al was funded by grants from the UK National Institute for Health Research Public Health Research program and by the NIHR Oxford Biomedical Research Centre. Scarborough has disclosed no relevant financial relationships. Two other authors are members of the Faculty of Public Health, which has a position statement supporting a soft drink tax. One author is a former member of the UK Health Forum, which had a similar position statement, and has written peer-reviewed and commissioned papers on soft drink taxes. Another author is chair of Sustain: the alliance for better food and farming, which has for more than 8 years campaigned for a sugary drinks tax in the UK.

PLOS Medicine. Study by Smith Taillie et al (Chile food labeling). Full text
PLOS Medicine. Study by Scarborough et al (UK soft drinks tax). Full text
Both published online February 11, 2020.

For more diabetes and endocrinology news, follow us on Twitter and on Facebook


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.