The Association Between Global Sugar Trade, Tariff and Sugar Availability: A Longitudinal Analysis (2010–2021)

Background Sugar consumption is a major driver of non-communicable diseases globally. While domestic policies often focus on individual behavior, international trade and tariffs significantly influence the food environment. This study investigates the longitudinal trends and associations between global sugar trade metrics, protective tariffs, and sugar availability across 183 countries from 2010 to 2021, categorized by their Human Development Index (HDI). Methods A longitudinal analysis was conducted using secondary data from the World Trade Organization (WTO) and the Food and Agriculture Organization (FAO). Variables included sugar imports, exports, domestic production, domestic supply, and applied tariffs. Data were analyzed using descriptive statistics, Chi-square tests, and Generalized Estimating Equations (GEE) to account for the correlated nature of longitudinal data. Models were stratified by HDI levels to evaluate the impact of globalization across different economic contexts. Results Between 2010 and 2021, global values for sugar imports, exports, production, and tariffs generally increased, though the magnitude of change varied significantly by period and HDI level. GEE modeling revealed that Domestic Supply was positively associated with Sugar Availability in low, high, and very high HDI countries; however, no significant association was observed in medium HDI countries. Notably, a significant positive association between Tariffs and Sugar Availability was found exclusively in high HDI countries (p < 0.001), suggesting that higher tariffs in these regions do not consistently function as a barrier to sugar availability or import volume. Conclusions The relationship between sugar trade metrics and sugar availability is highly context-dependent and varies by a nation's development level. Our findings challenge the conventional assumption that higher tariffs universally reduce sugar availability. These results underscore the need for cross-sectoral policy alignment between trade and public health to address the global sugar epidemic effectively, particularly in high-HDI nations where traditional trade barriers may be less effective.