國人飲用含糖飲料盛行率與其相關疾病之全民健保醫療費用估計

Prevalence of sugar-sweetened beverage consumption and estimated National Health Insurance-related medical expenditures among Taiwanese people

"目標：本研究旨在分析台灣民眾含糖飲料飲用盛行率，並計算族群可歸因風險百分比以估計民眾喝含糖飲料造成相關疾病醫療負擔情形。方法：本研究利用2013－2016年「國民營養健康狀況變遷調查」區分年齡別與性別，呈現含糖飲料飲用盛行率，並採用國外文獻中含糖飲料相關疾病之相對風險數值，計算族群可歸因風險百分比，爾後相乘2015－2017年全民健保資料庫中門診與住院健保相關疾病就醫費用，獲得我國民眾飲用含糖飲料所造成之醫療負擔。結果：10,443位民眾調查顯示，3－12歲有近4成的幼學童於最近一個月有喝市售含糖蔬果汁，而13－35歲的民眾9成7於最近一個月都有喝含糖飲料，36歲以上之民眾則約7成，且普遍男性喝含糖飲的比例比女性高。含糖飲料飲用造成相關疾病風險的部分，健保主診斷疾病醫療費用年均約為87億元（95％信賴區間為49－124億元），而主次診斷醫療費用年均約233億元（95％信賴區間為138－324億元）。結論：含糖飲料飲用盛行率有明顯的年齡差異，其中年輕世代含糖飲料飲用盛行率明顯較高。不過，因為本研究進行分析時所使用的部分參數援用國外數據，同時也未將含糖飲品與疾病之劑量反應關係納入計算，這對本研究結果的推論增加一些限制。但如何減少含糖飲料飲用過量，以降低民眾健康危害與相關醫療成本支出，仍是未來重要且迫切的健康政策課題。"

Objectives: To analyze the prevalence of sugar-sweetened beverage (SSB) consumption in Taiwan and estimate the population attributable risk percentage (PAR%) to evaluate the medical care burden of SSB consumption. Methods: The prevalence of SSB consumption was calculated by age and sex according to data from the Taiwan Nutrition and Health Survey collected between 2013 and 2016. The disease-specific relative risks of SSB consumption were determined by reviewing the literature. The medical care costs of diseases attributable to SSB intake were estimated by multiplying PAR% by average annual medical expenditures from 2015 to 2017 according to data in the National Health Insurance Research Database. Results: Among the 10,443 enrollees in this study, 40% of children aged 3-12 years reported consuming sugar-sweetened juice in the preceding month; for adults aged 13-35 and ≥36 years, who had consumed SSB, the relevant percentages were 97% and 70%, respectively. Men reported higher SSB consumption than women did. The average annual health insurance medical expenditure attributable this SSB overconsumption was NT$8.7-23.3 billion (95% confidence interval: NT$4.9-32.4 billion). Conclusions: We identified a distinct and elevated pattern in the prevalence of SSB consumption among young people. Although we extracted the disease risk from the literature and did not consider the dose-response relationship between SSB consumption and disease, the results clearly indicate that SSB overconsumption is related to disease incidence; the corresponding increase in medical care burden is a critical health policy concern.