{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T05:39:26Z","timestamp":1777354766161,"version":"3.51.4"},"reference-count":49,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This ecological study describes population-level trends in obesity, sugar-sweetened beverage (SSB) consumption, per-capita sugar purchases and publicly funded healthcare use for obesity-related conditions in Poland around the introduction of a sugar tax in 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed nationally aggregated administrative and survey data from the National Health Fund (NHF), the e-Health Center, the Central Statistical Office (CSO) and the National Public Health Institute (NPHI). Annual time series (2014\u20132024, where available) on per-capita sugar purchases and healthcare use for obesity and major obesity-related comorbidities were evaluated using segmented time-series regression with a 2021 break-point and a COVID-19 (2020) indicator. Survey-based data on SSB and sweets consumption and on overweight and obesity (2018, 2022, 2025), plus cross-sectional BMI data for 2025, were summarized descriptively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Per-capita sugar purchases decreased moderately between 2018 and 2024. Survey data indicated an initial reduction in SSB consumption after 2021, followed by partial rebound by 2025, and a shift towards more frequent sweets consumption, while overweight and obesity continued to rise. For obesity-related conditions, numbers of patients receiving disease-specific healthcare showed a COVID-19-related dip in 2020 and subsequent post-2021 increases, with bariatric surgery and pharmacological treatment of obesity also rising over the study period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In the first 4 years after sugar tax implementation, we observed modest declines in per-capita sugar purchases, transient reductions in SSB consumption and increasing sweets consumption, alongside continued growth in obesity and obesity-related healthcare use. Given the ecological design and short follow-up, these findings represent temporal associations rather than evidence of direct causal effects and underline the need to embed fiscal measures such as a sugar tax within broader, multi-level strategies for obesity prevention, health promotion and access to effective obesity treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1811509","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T04:46:55Z","timestamp":1777351615000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Sugar tax in Poland: population-level trends in obesity, sugar consumption and healthcare utilization"],"prefix":"10.3389","volume":"14","author":[{"given":"Micha\u0142","family":"Seweryn","sequence":"first","affiliation":[{"name":"Faculty of Health Sciences, Andrzej Frycz Modrzewski University","place":["Krakow, Poland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ma\u0142gorzata M.","family":"Ba\u0142a","sequence":"additional","affiliation":[{"name":"Epidemiology and Preventive Medicine, Jagiellonian University Medical College","place":["Krakow, Poland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grzegorz","family":"Juszczyk","sequence":"additional","affiliation":[{"name":"Department of Public Health, Medical University of Warsaw","place":["Warsaw, Poland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filip","family":"Nowak","sequence":"additional","affiliation":[{"name":"National Health Fund","place":["Warsaw, Poland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ewa P\u0142aczkiewicz","family":"Jankowska","sequence":"additional","affiliation":[{"name":"Epidemiology and Preventive Medicine, Jagiellonian University Medical College","place":["Krakow, Poland"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,28]]},"reference":[{"key":"ref1","article-title":"Obesity and overweight","year":"2025"},{"key":"ref2","article-title":"World obesity federation","year":"2025"},{"key":"ref3","article-title":"Overweight and obesity \u2013 BMI statistics, statistics explained","year":"2024"},{"key":"ref4","year":""},{"key":"ref5","article-title":"Controlling the global obesity epidemic","year":""},{"key":"ref6","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1093\/qjmed\/hcx068","article-title":"Sugar and artificially sweetened beverages linked to obesity: a systematic review and meta analysis","volume":"110","author":"Ruanpeng","year":"2017","journal-title":"QJM"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"242","DOI":"10.1016\/j.acvd.2015.10.005","article-title":"Prospective association of sugar-sweetened and artificially sweetened beverage intake with risk of hypertension","volume":"109","author":"KimY","year":"2016","journal-title":"Arch Cardiovasc Dis"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"791","DOI":"10.1111\/ijcp.12841","article-title":"Soft drinks and sweetened beverages and the risk of cardiovascular disease and mortality: a systematic review and meta-analysis","volume":"70","author":"Narain","year":"2016","journal-title":"Int J Clin Pract"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"725","DOI":"10.1017\/S0007114514001329","article-title":"Association between sugar sweetened and artificially sweetened soft drinks and type 2 diabetes: systematic review and dose\u2013response meta-analysis of prospective studies","volume":"112","author":"Greenwood","year":"2014","journal-title":"Br J Nutr"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1356","DOI":"10.1161\/CIRCULATIONAHA.109.876185","article-title":"Sugar-sweetened beverages, obesity, type 2 diabetes mellitus, and cardiovascular disease risk","volume":"121","author":"Malik","year":"2010","journal-title":"Circulation"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1093\/ajcn\/84.1.274","article-title":"Intake of sugar-sweetened beverages and weight gain: a systematic review","volume":"84","author":"Malik","year":"2006","journal-title":"Am J Clin Nutr"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"e7492","DOI":"10.1136\/bmj.e7492","article-title":"Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies","volume":"346","author":"Te Morenga","year":"2012","journal-title":"BMJ"},{"key":"ref13","article-title":"World Health Organization (WHO). WHO urges global action to curtail consumption and health impacts of sugary drinks","year":"2016"},{"key":"ref14","volume-title":"Fiscal Policies for Diet and Prevention of Noncommunicable Diseases: Technical Meeting Report, 5\u20136 May 2015, Geneva, Switzerland","year":"2016"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1095","DOI":"10.1093\/eurpub\/ckad157","article-title":"Effective policies to promote sugar reduction in soft drinks: lessons from a comparison of six European countries","volume":"33","author":"Allais","year":"2023","journal-title":"Eur J Pub Health"},{"key":"ref16","article-title":"HM Government. Policy paper: soft drinks industry Levy published 5 December 2016","year":"2016"},{"key":"ref17","article-title":"Global Food Research Program (University of North Carolina at Chapel Hill). Countries that have implemented taxes on sugar-sweetened beverages (SSBs) | obesity evidence hub","year":""},{"key":"ref18","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1093\/eurpub\/ckab211","article-title":"Sugar-sweetened beverage taxes in Europe: learning for the future","volume":"32","author":"Thow","year":"2022","journal-title":"Eur J Pub Health"},{"key":"ref19","volume-title":"Sugar-Sweetened Beverage Taxes in the WHO European Region: Success Through Lessons Learned and Challenges Faced","year":""},{"key":"ref20","volume-title":"Sejm of the Republic of Poland. Op\u0142ata od \u015brodk\u00f3w spo\u017cywczych - Rozdzia\u0142 3a - Zdrowie publiczne. - Dz.U.2024.1670","year":""},{"key":"ref21","volume-title":"Sejm of the Republic of Poland. A government bill to amend certain acts in connection with the promotion of health-promoting consumer choices (in Polish). Document no. 210","year":"2019"},{"key":"ref22","volume-title":"World Bank. Business, employment, and productivity impacts of sugar-sweetened beverage taxes","year":"2020"},{"key":"ref23","volume-title":"Tax Foundation. Soda Taxes Won\u2019t Fix Global Health","year":""},{"key":"ref24","volume-title":"Supreme Audit Office of Poland (Najwy\u017csza Izba Kontroli). Wp\u0142ywy z op\u0142aty cukrowej i od alkoholu wydane niezgodnie z przeznaczeniem","year":"2025"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"2583","DOI":"10.1210\/jc.2004-0535","article-title":"Medical consequences of obesity","volume":"89","author":"Bray","year":"2004","journal-title":"J Clin Endocrinol Metab"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1186\/1471-2458-9-88","article-title":"The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis","volume":"9","author":"Guh","year":"2009","journal-title":"BMC Public Health"},{"key":"ref27","volume-title":"Sytuacja zdrowotna ludno\u015bci Polski i jej uwarunkowania \u2013 2018","year":"2019"},{"key":"ref28","volume-title":"Sytuacja zdrowotna ludno\u015bci Polski i jej uwarunkowania \u2013 2022","year":"2023"},{"key":"ref29","volume-title":"Sytuacja zdrowotna ludno\u015bci Polski i jej uwarunkowania \u2013 2025","year":"2025"},{"key":"ref30","volume-title":"Wiadomo\u015bci Spo\u017cywcze. RAPORT NAPOJOWY 2025: Polacy wydaj\u0105 na te produkty niemal 28 mld z\u0142 rocznie","year":"2025"},{"key":"ref31","volume-title":"Dostawy na rynek krajowy oraz spo\u017cycie niekt\u00f3rych artyku\u0142\u00f3w konsumpcyjnych na 1 mieszka\u0144ca w 2019 r","year":"2020"},{"key":"ref32","volume-title":"Dostawy na rynek krajowy oraz spo\u017cycie niekt\u00f3rych artyku\u0142\u00f3w konsumpcyjnych na 1 mieszka\u0144ca w 2024 r","year":"2025"},{"key":"ref33","volume-title":"Realizacja zada\u0144 zwi\u0105zanych z poborem i wydatkowaniem op\u0142at od \u015brodk\u00f3w spo\u017cywczych oraz od napoj\u00f3w alkoholowych i informacja o wynikach kontroli (article in Polish)","year":""},{"key":"ref34","year":""},{"key":"ref35","doi-asserted-by":"publisher","first-page":"155689","DOI":"10.1016\/j.metabol.2023.155689","article-title":"Milestones in the journey towards addressing obesity; past trials and triumphs, recent breakthroughs, and an exciting future in the era of emerging effective medical therapies and integration of effective medical therapies with metabolic surgery","volume":"148","author":"Kokkorakis","year":"2023","journal-title":"Metabolism"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"433","DOI":"10.3390\/healthcare11030433","article-title":"Pharmacological support for the treatment of obesi-ty\u2014present and future","volume":"11","author":"Kosmalski","year":"2023","journal-title":"Healthcare"},{"key":"ref37","volume-title":"NFZ o zdrowiu: Oty\u0142o\u015b\u0107 i jej konsekwencje","year":"2024"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"1161521","DOI":"10.3389\/fendo.2023.1161521","article-title":"Obesity and type 2 diabetes mellitus: connections in epidemiology, pathogenesis, and treatments","volume":"14","author":"Ruze","year":"2023","journal-title":"Front Endocrinol (Lausanne)"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"364","DOI":"10.1038\/nrendo.2014.44","article-title":"The pathophysiology of hypertension in patients with obesity","volume":"10","author":"DeMarco","year":"2014","journal-title":"Nat Rev Endocrinol"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"1433","DOI":"10.1097\/00004872-199412000-00018","article-title":"Body mass index and blood pressure in Korean men and women: the Korean National Blood Pressure Survey","volume":"12","author":"Jones","year":"1994","journal-title":"J Hypertens"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"650","DOI":"10.1038\/sj.ijo.0802944","article-title":"Change in body mass index and its impact on blood pressure: a prospective population study","volume":"29","author":"Dr\u00f8yvold","year":"2005","journal-title":"Int J Obes"},{"key":"ref42","volume-title":"Endotext","author":"Feingold","year":"2023"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"11974","DOI":"10.1038\/s41598-024-62892-5","article-title":"Association between obesity and the prevalence of dyslipidemia in middle-aged and older people: an observational study","volume":"14","author":"Zheng","year":"2024","journal-title":"Sci Rep"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"1869","DOI":"10.1002\/art.39707","article-title":"Association between overweight and obesity and risk of clinically diagnosed knee, hip, and hand osteoarthritis: a population-based cohort study","volume":"68","author":"Reyes","year":"2016","journal-title":"Arthritis Rheumatol"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"103221","DOI":"10.1016\/j.eclinm.2025.103221","article-title":"The relationship between obesity and obstructive sleep apnea in four community-based cohorts: an individual participant data meta-analysis of 12,860 adults","volume":"83","author":"Esmaeili","year":"2025","journal-title":"EClinicalMedicine"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"3015","DOI":"10.1001\/jama.284.23.3015","article-title":"Longitudinal study of moderate weight change and sleep-disordered breathing","volume":"284","author":"Peppard","year":"2000","journal-title":"JAMA"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"103043","DOI":"10.1016\/j.arcmed.2024.103043","article-title":"Global prevalence of nonalcoholic fatty liver disease: an updated review meta-analysis comprising a population of 78 million from 38 countries","volume":"55","author":"Amini-Salehi","year":"2024","journal-title":"Arch Med Res"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"2221","DOI":"10.1056\/NEJMoa2307563","article-title":"Semaglutide and cardiovascular outcomes in obesity without diabetes","volume":"389","author":"Lincoff","year":"2023","journal-title":"N Engl J Med"},{"key":"ref49","volume-title":"Financial Equilibrium and Efficiency in Polish Health Care System. R\u00f3wnowaga Finansowa oraz efektywno\u015b\u0107 w Polskim Systemie Ochrony Zdrowia","author":"Golinowska","year":"2012"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1811509\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T04:47:09Z","timestamp":1777351629000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1811509\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,28]]},"references-count":49,"alternative-id":["10.3389\/fpubh.2026.1811509"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1811509","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,28]]},"article-number":"1811509"}}