Factors influencing the frequency of children's consumption of soft drinks

Assessing through a longitudinal study of dietary habits among Romanian school children: effects of COVID-19 pandemic as well as of a school based educational program for promotion of healthy nutrition

PURPOSE

The outbreak of COVID-19 has forced implementation of safety measures, leading to changes in people's lives. This study investigated several dietary habits among Romanian children before and during the pandemic. Also, it assessed the effectiveness of an educational program promoting healthy diet and evaluated factors influencing certain eating habits.

METHODS

A longitudinal study was conducted in schools. Students were assigned to Control and Intervention groups. Data were collected at baseline (T1) (October -November 2019, 880 children) and post-intervention (T2) (December 2020-February 2021, 484 students). 350 children participated in both assessments.

RESULTS

Baseline measurements revealed inadequate consumptions of fruits, vegetables, dairy products, and increased intake of soft drinks and sweets. At follow-up, the Intervention showed significant improvements on average intake of fruits and vegetables and in children eating ≥ 5 servings/day, compared to its baseline. Regarding self-perceptions on dietary habits during confinement, children from both groups reported healthier behaviors, with a significant decrease of comfort food. Compared to the Control group, Intervention increased its average intake of fruits and vegetables, consumed more ≥ 5 portions/day, reduced the number ≥ 2 cups/day of carbonated beverages and ≥ 3 portions/day of sweets. Age, gender, weight management, body mass index were associated with dietary habits at T1. Age, gender, Intervention group, weight management influenced eating patterns at T2. Eating behaviors at T1 influenced dietary habits at T2.

CONCLUSION

Our program demonstrated positive changes in students' dietary habits, despite challenges of COVID-19. Results highlight the role of health education and emphasize the importance of integrating such programs consistently in schools.

Evaluating attitudes toward soft drink consumption among adults in Saudi Arabia: Five years after selective taxation implementation

Objective

Saudi Arabia (SA) ranked first in soft drink consumption in the Middle East. A decrease in consumption was recorded after a selective 50% increased taxation policy in 2018. This study aimed to assess soft drinks consumption patterns among Saudi Arabian adults and examine the association between different attitudes and patterns post-taxation.

Methods

This cross-sectional study was conducted from October 2022 to March 2023, involving 1,935 Saudi adults aged 20-60 residing in Saudi Arabia. Participants completed online surveys using a validated questionnaire assessing sociodemographic characteristics, soft drink consumption patterns, and attitudes toward soft drinks. Chi-square and odds ratio (OR) tests were used to assess associations between sociodemographic characteristics, soft drink consumption frequency/quantity, and change in consumption patterns owing to selective taxation. Additionally, t-tests, Spearman's coefficient, and hierarchical multiple linear regression were used to measure differences in attitudes and linear relationships.

Results

Overall, 7.5% of the participants reported daily soft drink consumption, with 51.8% of these consuming less than one can per day and 41.2% consuming one can per day. Most (66.2%) reported no change in consumption post-taxation. Attitudes toward soft drink consumption varied significantly, with most agreeing on its health risks but also enjoying the drinks. Multiple regression analysis identified age, education, income, consumption frequency/quantity, and impact of taxation as significant predictors of overall attitudes toward soft drinks.

Conclusions

After taxation, 20% of participants reduced soft drink consumption, underscoring the importance of addressing taxation and intrinsic motivations to foster lasting changes in attitudes and behaviors towards soft drinks.

Impact of carbonated beverages on early onset of osteoporosis: A narrative review

Background: Processed and semi-processed foods are getting popular in the diets of the Western population. The Western diet is almost coupled with consuming carbonated beverages, either alcoholic or nonalcoholic. The presence of sugar, caffeine, and alcohol in different carbonated beverages and detrimental dietary patterns are leading causes of obesity, diabetes, and periodontal diseases in the young population. Aims: This article aims to review the impact of carbonated beverages on early onset of osteoporosis. Methods: A nonsystematic literature review searches in PubMed and Google Scholar electronic databases with predefined terms relating to carbonated beverages, caffeine intake, childhood obesity, osteoporosis, and bone softness. Results: Bone diseases significantly increase due to early exposure to caffeine and phosphoric acid in the pubertal period. Musculoskeletal growth is a dynamic and complex process, and bone mass achievement is of great importance in this process. According to the global burden of diseases, bone disorders consist of "6.8% of total disability-adjusted life-years." The consumption of soft drinks and their impact on bone accretion and bone mineral density in the young population is under research in the current literature on osteoporotic disorders. Since bone is a metabolically active tissue, it's in constant reconstruction mode. This process is regulated by genetic, hormonal, nutritional, and physical factors. Any imbalance in one of these processes might lead to mineral deposition and osteoporosis. Conclusion: Habitual intake of carbonated drinks with added sugars and caffeine is associated with increased body weight and bone fragility; stringent regulations are needed for proper education.

Potential impact of the adult-targeted LiveLighter "Sugary Drinks" campaign on adolescent consumption: Findings from a national cross-sectional school survey

ISSUE ADDRESSED

To examine the potential impact on trends in reported adolescent sugar-sweetened beverage (SSB) consumption following the adult-targeted Western Australian (WA) LiveLighter "Sugary Drinks" campaign, which is a television-led healthy lifestyle promotion and education mass media campaign that aired in multiple bursts between July 2013 and December 2018.

METHODS

Data were from a repeated cross-sectional survey of Australian secondary school students aged 12-17 years conducted nation-wide in 2009-2010 (n = 13 790 from 238 schools), 2012-2013 (n = 10 309 from 196 schools) and 2018 (n = 9102 from 104 schools).

RESULTS

Significant declines in high SSB consumption (≥4 cups/week) were observed between 2009-2010 and 2012-2013 among students in both WA (27.1% vs 20.3%; odds ratio [OR] = 0.65, 95% confidence interval [CI] = 0.50-0.84, P = .001) and all other states and territories combined (30.6% vs 21.4%; OR = 0.60, 95% CI = 0.53-0.68, P < .001). Compared to 2012-2013, the proportion of students in WA who reported high SSB consumption was significantly lower in 2018 (20.3% vs 9.6%; OR = 0.37, 95% CI = 0.21-0.65, P = .001), whereas this significant decrease was not observed in all other states and territories combined (21.4% vs 17.8%; OR = 0.81, 95% CI = 0.67-0.97, P = .024). Interaction testing indicated that the recent decline observed in WA was more pronounced among female than male students.

CONCLUSIONS

Mass media campaigns targeted towards the Australian adult population may have favourable effects among adolescents with the steeper decline in high SSB consumption observed in WA between 2012-2013 and 2018 coinciding with the repeated airing of the LiveLighter "Sugary Drinks" campaign in this state. SO WHAT?: Government investment in mass media campaigns may hasten declines in adolescents' SSB consumption.

Sugar-Sweetened Beverages and Metabolic Risk in Children and Adolescents with Obesity: A Narrative Review

Sugar-sweetened beverages (SSBs) are major contributors of free sugars to the diet. A strong relationship between SSB intake and weight gain is described.

METHODS

we performed a narrative review to present an overview of the role of SSBs as a pivotal contributor in the development of obesity and metabolism-related complications.

RESULTS

different factors influence SSB consumption in children, including economic variables, individual attributes and behaviors to environmental factors, parent features and parents' behaviors. Data suggest that SSB intake has a negative effect on weight and obesity-related diseases. The leading mechanism linking SSB intake to the risk of gaining weight is decreased satiety and incomplete compensatory reduction in energy intake at meals following ingestion of liquid calories. Additionally, the effects of SSBs on gut microbiota and on eating behaviors were also reported. An association between SSB intake, weight gain and cardiometabolic risks is evident. Consumption of SSBs had a significant impact on the prevalence of obesity and related metabolic risks, including insulin resistance, type 2 diabetes, hypertension and metabolic syndrome.

CONCLUSIONS

Limiting consumption of SSBs and increasing knowledge of the effect of SSBs on early metabolic and cardiovascular disorders will be useful in developing strategies to counteract the problem and to prevent obesity and related complications.Key future research areas for which further studies are needed include investigating the long-term effects of SSBs on health outcomes as well as analyzing the health effects of sugar consumed in solid compared to liquid forms and further elucidating the biological mechanisms of sugar addiction and energy compensation.

[Adolescents' attitude toward soft drinks and factors associated with their consumption]

OBJECTIVE

To evaluate adolescents' attitudes towards soft drinks and identify the underlying factors that are associated with their consumption of such drinks.

METHOD

A cross-sectional study was conducted among 213 adolescents aged between 10 and 19years living in Dhaka, Bangladesh. A structured questionnaire was used to assess their socio-demographic and soft drinks consumption-related characteristics, and their attitudes towards soft drinks. Structural equation modelling was employed to identify the potential factors associated with soft drink consumption among adolescents.

RESULTS

More than 80% of the adolescents consumed soft drinks at least once a week. Overall, adolescents had a positive attitude toward soft drinks. Results revealed that adolescent's attitudes, gender, accessibility of soft drinks at school/college, distance from home to shop, outside food intake habit and parents' soft drinks consumption were the factors associated with their consumption of soft drinks.

CONCLUSION

High proportion of adolescents consumed soft drinks. Thus, a community and individual level nutrition education programme with targeted behaviour change might be helpful to reduce the consumption of sweetened beverages among adolescents.

Adolescents' perspectives on soft drinks after the introduction of the UK Soft Drinks Industry Levy: A focus group study using reflexive thematic analysis

BACKGROUND

The UK Soft Drinks Industry Levy (SDIL), announced in March 2016 and implemented in April 2018, is a fiscal policy to incentivise reformulation of eligible soft drinks. We aimed to explore perceptions of sugar, sugary drinks and the SDIL among adolescents in the UK post-implementation.

METHODS

23 adolescents aged 11-14 years participated in four focus groups in 2018-2019. A semi-structured topic guide elicited relevant perspectives and included a group task to rank a selection of UK soft drinks based on their sugar content. Braun and Clarke's reflexive thematic analysis was used to undertake inductive analysis.

RESULTS

Four main themes were present: 1) Sweetened drinks are bad for you, but some are worse than others; 2) Awareness of the SDIL and ambivalence towards it 3) The influence of drinks marketing: value, pricing, and branding; 4) Openness to population-level interventions. Young people had knowledge of the health implications of excess sugar consumption, which did not always translate to their own consumption. Ambivalence and a mixed awareness surrounding the SDIL was also present. Marketing and parental and school restriction influenced their consumption patterns, as did taste, enjoyment and consuming drinks for functional purposes (e.g., to give them energy). Openness to future population-level interventions to limit consumption was also present.

CONCLUSIONS

Our findings suggest that adolescents are accepting of interventions that require little effort from young people in order to reduce their sugar consumption. Further education-based interventions are likely to be unhelpful, in contexts where adolescents understand the negative consequences of excess sugar and SSB consumption.

Exploring the social norms regarding parents' food provision in Australia using story completion methodology

Children's diets are not aligned with dietary guidelines, with the social context including social norms being one factor influencing parents' food provision. Little is known about social norms in broad society that parents face when providing food to children. We aimed to determine the social norms surrounding family food provision from the perspectives of Australian adults. This qualitative study used story completion methodology via an online survey to gather hypothetical stories from adults (≥18 years). Participants were presented with a story stem focusing on home food provision. Stories (i.e. data) were coded and analysed using thematic analysis. Five themes were identified from the data (N = 75); 1. Providing a healthy snack, 2. Providing justification for the provision of unhealthy convenience foods, 3. Increasing child autonomy in food provision, 4. Mealtimes are a social occasion, and 5. Contextual factors influencing food provision and social norms. From these themes, social norms were identified around providing healthy foods and justifying non-adherence to healthy eating guidelines and evolution of family life and mealtime values. This study provides new knowledge that there are social norms around parents providing healthy foods and needing to justify non-adherence to healthy eating guidelines, as well as the norm that family life and mealtime values are evolving. This highlights the need to consider the broader context that influences food choices. Furthermore, this study highlights the utility of novel methods in this field.

Determinants of soft drink consumption among children and adolescents in developed countries - a systematic review

OBJECTIVES

Soft drinks are a major component of daily caloric and sugar intake. This is especially true for children and adolescents. The WHO as well as many other institutions currently recommend to increase research on the determinants of soft drink consumption. We submit a current systematic review on this topic.

METHODS

In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, we included all quantitative observational studies that comprise samples from developed countries in the age range 0-18 years and are listed in PubMed, Sociological Abstracts and the Social Sciences Citation Index. Publication period was not limited. The second and the last author screened all 10,392 hits independently with both reviewers being blinded. Interrater reliability (agreement and Cohen's kappa) was 97%/0.73 for the selection of titles, 91%/0.83 for abstracts and 91%/0.80 for full texts.

RESULTS

Results of 43 included studies, published between 2001 and 2017, show that children and adolescents consuming soft drinks tend to be older, male and of lower social status. Important contextual factors promoting consumption include constant availability at home, at schools or elsewhere as well as restrictions by parents and rules concerning drinks during meals or generally at home. The association between media consumption and soft drink consumption is particularly striking. Other factors in the food environment (choice of food and alternative drinks at home, having meals together, motivation, knowledge about nutrition and healthy eating) are of minor importance.

CONCLUSIONS

When introducing interventions parents should play a major role because they serve as physical and social gatekeepers for this early risk factor of juvenile obesity.

High sugar content and body mass index: modelling pathways around the first 1000 d of life, BRISA cohort

OBJECTIVE

Few studies are focused on sugar consumption around the first 1000 d of life. Thus, this work modelled the pathways linking the consumption of sugary drinks in pregnancy and maternal pre-gestational BMI to early child’s exposure to products with high sugar content and to BMI z-score in the second year of life.

DESIGN

BRISA cohort, São Luís, Brazil was used from the baseline to the follow-up at the second year of life.

SETTING

A theoretical model was constructed to analyse associations between variables from prenatal period (socio-economic status, age, frequency of sugary drinks consumption during pregnancy and pre-gestational BMI), birth weight, exclusive breast-feeding and two outcomes: higher calories from products with added sugar as a percentage of the total daily energy intake and BMI z-score at follow-up at the first 2 years of life, using structural equation modelling.

PARTICIPANTS

Data of pregnant women (n 1136) and their offspring.

RESULTS

Higher pre-gestational BMI (standardised coefficient (SC) = 0·100; P = 0·008) and higher frequency of sugary drinks consumption during pregnancy (SC = 0·134; P < 0·001) resulted in high percentage of daily calories from products with added sugar in the second year of child, although no yet effect was observed on offspring weight at that time.

CONCLUSIONS

Maternal obesity and sugary drinks consumption in pregnancy increased the risk of early exposure (before to 2 years) and high exposure of child to added sugar, showing perpetuation of the unhealthy dietary behaviours in the first 1000 d of life.

Applying the socio-ecological model to understand factors associated with sugar-sweetened beverage behaviours among rural Appalachian adolescents

OBJECTIVE

The objective of the current study was to identify factors across the socio-ecological model (SEM) associated with adolescents' sugar-sweetened beverage (SSB) intake.

DESIGN

This cross-sectional study surveyed adolescents using previously validated instruments. Analyses included descriptive statistics, ANOVA tests and stepwise nonlinear regression models (i.e., two-part models) adjusted to be cluster robust. Guided by SEM, a four-step model was used to identify factors associated with adolescent SSB intake - step 1: demographics (i.e., age, gender), step 2: intrapersonal (i.e., theory of planned behaviour (attitudes, subjective norms, perceived behavioural control, behavioural intentions), health literacy, media literacy, public health literacy), step 3: interpersonal (i.e., caregiver's SSB behaviours, caregiver's SSB rules) and step 4: environmental (i.e., home SSB availability) level variables.

SETTING

Eight middle schools across four rural southwest Virginia counties in Appalachia.

PARTICIPANTS

Seven hundred ninety seventh grade students (55·4 % female, 44·6 % males, mean age 12 (sd 0·5) years).

RESULTS

Mean SSB intake was 36·3 (sd 42·5) fluid ounces or 433·4 (sd 493·6) calories per day. In the final step of the regression model, seven variables significantly explained adolescent's SSB consumption: behavioural intention (P < 0·05), affective attitude (P < 0·05), perceived behavioural control (P < 0·05), health literacy (P < 0·001), caregiver behaviours (P < 0·05), caregiver rules (P < 0·05) and home availability (P < 0·001).

CONCLUSIONS

SSB intake among adolescents in rural Appalachia was nearly three times above national mean. Home environment was the strongest predictor of adolescent SSB intake, followed by caregiver rules, caregiver behaviours and health literacy. Future interventions targeting these factors may provide the greatest opportunity to improve adolescent SSB intake.

Is it still still water? Relationships between sparkling sensitivity and consumption frequency of carbonated waters

Little is known about how sensitivity to trigeminal stimulation such as carbonation is affected by consumption habits and consumer characteristics. The aim of this study was to determine how detection thresholds for and perception of sparkling sensations in carbonated mineral water are affected by frequency of consumption of carbonated water and individual consumer characteristics. One hundred subjects differing in sparkling water consumption frequency (non-consumers, infrequent consumers, frequent consumers) participated. First, sparkling sensation detection thresholds were determined using the method of best estimate threshold (BET) with CO₂ concentrations ranging from 0.03 to 1.05 g/L. Secondly, intensity of sparkling sensation and liking of five sparkling waters (CO₂ concentrations ranging from 0.21 to 4.92 g/L) were assessed. To characterize consumers, consumption frequency of sparkling water, sensitivity to 6-n-propylthiouracil (PROP taster status) and consumer characteristics were determined. Average detection threshold of sparkling sensation (BET) was 0.44 g/L CO₂ concentration. BET of sparkling sensation was not affected by consumption frequency of sparkling water and was not related to PROP taster status and consumer characteristics. Perception of sparkling intensity and liking of carbonated mineral water were significantly affected by consumption frequency of sparkling water. Sparkling sensations were perceived significantly more intensive by non-consumers compared to infrequent and frequent consumers. Surprisingly, non-consumers liked sparkling water significantly more than infrequent or frequent consumers. We conclude that consumption frequency of and preferences for carbonated water do not influence detection thresholds of sparkling sensations but influence suprathreshold intensity perception of sparkling sensations in carbonated water.

Attitudes toward sweetened soft drinks and consumption patterns among Saudi women: A cross-sectional study

Although sweetened soft drink consumption (SDC) has negative consequences on health, this dietary habit is common among the Saudi population (Saudi Arabia). Food selection and consumption are complex behaviors and associated with several constructs described by social cognitive theory. This study assessed the pattern of sweetened SDC and its associated behavioral and theoretical factors, with focus on attitude and expectations related to SDC among Saudi women. Participants (n = 773) answered an online questionnaire on SDC patterns (frequency of consumption and quantity) and attitudes influencing those patterns. Association of attitudes with frequency of sweetened SDC was assessed using Spearman's test that revealed a positive and significant association between frequency and quantity of SDC (Spearman's rho = 0.34, df = 771, p < .0001). Highest correlations were observed between frequency of consumption and positive attitudes toward the perception of sweetened soft drinks as indispensable while eating, enjoyable, and value indispensable during social gathering (Spearman's rho = 0.58, 0.55 and 0.40, respectively, df = 771, p < .0001). Multiple regression analysis of attitudes showed considering soft drinks enjoyable and essential at eating were positively associated with consumption. Saudi Women are consuming soft drinks at high rates despite self-reporting this behavior as unhealthy. Social cognitive factors could potentially be predictors of unhealthy dietary behaviors among Saudi women. Designing nutrition education campaigns and culture-tailored information is warranted.

The stability of children's salivary peptidome profiles in response to short-term beverage consumption

BACKGROUND

Salivary peptidome profiling analysis has advantages of simplicity and non-invasiveness and great potentiality for screening, monitoring or primary diagnosis of diseases, but may be subjected to change against interferences like diet.

METHODS

We conducted a 5-day study to investigate the influence of 3 kinds of beverages (orange juice, sugar-free tea, and sugar-free liquid yoghurt; water as control) on children's salivary peptidome using mass spectrometry techniques.

RESULTS

All the groups shared a relatively stable pattern in heatmaps during the experimental days. Principal component analysis plot presented slight shifts in all the intervention groups between the baseline and intervention period while samples were not distinctly separated by date. The numbers of significantly changed peptides after short-term orange juice and tea intervention were four and three, respectively, while no changes occurred in the yoghurt group and control. Four of these peptides were identified as histatin-3, collagen alpha-1(IV) chain, zinc finger protein 805, and quinolinate synthase A.

CONCLUSIONS

Salivary peptidome has its own stability against beverage intervention, confirming the feasibility and validity of using it as a potential reference for the healthy state of the body, with diet habits recorded and considered as a confounder if necessary.

Relations between sweetened beverage consumption and individual, interpersonal, and environmental factors: a 6-year longitudinal study in German children and adolescents

OBJECTIVES

This study aims to characterize the consumption of sweetened beverages (SB) among young people in Germany in terms of individual and interpersonal-environmental correlates.

METHODS

A representative sample of children and adolescents from Germany was assessed twice, 6 years apart (total longitudinal sample n = 11,691 children and adolescents aged between 0 and 17 years old; weighted). The relations between individual and interpersonal-environmental factors at baseline with SB intake 6 years later were analysed using bivariate and multivariate methods.

RESULTS

The majority of children and adolescents in Germany consume sweetened beverages weekly, 23% daily. SB consumption is particularly high in boys and often accompanied by other unhealthy lifestyle behaviours including a high level of tobacco and media consumption with a concurrent deficiency in fruit and vegetable consumption. Interpersonal factors associated with higher sweetened beverage consumption include low socio-economic status, tobacco consumption of parents, and older maternal age.

CONCLUSIONS

Research on factors that correlate with sweetened beverage consumption is crucial to design effective interventions. Our findings underline the importance of complex, multi-level interventions to target sweetened beverage intake and obesity.

Socio-economic and cultural disparities in diet among adolescents and young adults: a systematic review

OBJECTIVE

To explore dietary differences according to socio-economic and sociocultural characteristics of adolescents and young adults.

DESIGN

A systematic review was conducted.

SETTING

The main search source was MEDLINE, consulted between January 2012 and March 2017. Quality of selected studies was assessed based on dietary measurement method, sample selection, socio-economic indicator choice and statistical modelling.

PARTICIPANTS

Cross-sectional and longitudinal studies, assessing relationships between socio-economic status and dietary intake (patterns, scores and food groups) in the 10- to 40-year-old general population of high-income countries, were selected.

RESULTS

Among the 7250 reports identified, forty were selected, seventeen of which were of high quality; their conclusions, related only to adolescents, were combined and presented. The most favourable dietary patterns, higher dietary scores, greater consumption of fruits, vegetables and dairy products, and lower consumption of sugary sweetened beverages and energy-dense foods, were associated with better parental socio-economic status, particularly in terms of higher education. Migrant status was associated with plant-based patterns, greater consumption of fruits and vegetables and of sugary sweetened beverages and energy-dense foods. For the other food groups, and for young adults, very few high-quality studies were found.

CONCLUSIONS

The socio-economic gradient in adolescent diets requires confirmation by higher-grade studies of a wider set of food groups and must be extended to young adult populations. Future nutritional interventions should involve the most vulnerable adolescent populations, taking account of socio-economic status and migration.

“Drink It or Not”: Soft Drink Anticonsumption Behavior and the Mediating Effect of Behavioral Intentions

Increased health risks and obesity resulting from soft drink consumption have received considerable attention worldwide. The purpose of this empirical study was to explore the antecedents of soft drink anticonsumption behavior in China using structural equation modeling techniques by analysis of moment structures (AMOS). Soft drink anticonsumers think that these drinks are unhealthy, and consumer attitude and behavioral intention towards anticonsumption behavior were found to be significant. Individual and sociocultural factors were also positively associated with anticonsumption of soft drinks in China. Future studies could examine gender differences in anticonsumption behavior. A large sample size would be more reflective in other contexts. Regarding health and obesity-reduction concerns, this study provides useful implications for marketers and policymakers. Soft drink marketers can integrate obesity-reduction efforts through social marketing. This study has put forward a conceptual framework for soft drink anticonsumption behavior focusing on health concerns and the effect of sociocultural factors on anticonsumption.

Added Sugar and Dental Caries in Children: A Scientific Update and Future Steps

Excess added sugars, particularly in the form of sugar-sweetened beverages, is a leading cause of tooth decay in US children. Although added sugar intake is rooted in behavioral and social factors, few evidence-based, theory-driven socio-behavioral strategies are currently available to address added sugar intake. Dental health professionals are in a position to help identify and address problematic sugar-related behaviors in pediatric patients and advocate for broader upstream approaches, including taxes, warning labels, and policy changes, that can help reduce added sugar intake, prevent tooth decay, and improve health outcomes in vulnerable child populations.

EXPLORING THE EFFECTS OF CONSUMERS’ NUTRITIONAL KNOWLEDGE AND INFORMATION INTEREST ON THE ACCEPTANCE OF ARTIFICIAL SWEETENER USAGE IN SOFT DRINKS

Together with the increasing health awareness levels of consumers’, artificial food additives have been highly criticized by the public. However, these kinds of sweeteners are still being used widely all over the world. One of the sectors that prefer mostly these kinds of sweeteners is the soft drink industry. High fructose corn syrup, which has been associated with serious health problems recently, is one of these additives which is highly preferred in the soft drink industry. Upon examining the situation, it is understood that there is a conflict between the implementations of the soft drink industry and consumer attitudes towards them. However, it is seen that the consumers’ perspective is not clarified enough empirically in terms of this issue. This means that the players of the soft drink industry have a lack of insight in terms of consumer thoughts and attitudes regarding artificial sweetener usage in soft drinks. Owing to this research gap in the literature and the importance of the subject in terms of consumer well-being, this study aims to explore the antecedents for the acceptance of high fructose corn syrup usage in soft drinks. To reach this aim, four research questions represented to understand how frequent consumers prefer soft drinks containing high fructose corn syrup, to reveal consumers’ attitudes and acceptance towards high fructose corn syrup and to understand how nutritional knowledge and nutritional information interest affect consumers’ acceptance specifically on high fructose corn syrup usage in soft drinks. To answer these questions, a structured survey was developed and conducted on 888 soft drink consumers who are aware of high fructose corn syrup in soft drinks as an additive

Sugar-Sweetened Beverage Attitudes and Consumption During the First 1000 Days of Life

OBJECTIVES

To examine the relationship of parental sugar-sweetened beverage (SSB) attitudes with SSB consumption during the first 1000 days of life-gestation to age 2 years.

METHODS

We studied 394 Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)-enrolled families during the first 1000 days of life in northern Manhattan, New York, in 2017. In regression models, we assessed cross-sectional relationships of parental SSB attitude scores with habitual daily parent SSB calories and infant SSB consumption, adjusting for demographic and socioeconomic characteristics.

RESULTS

Each point higher parental SSB attitude score was associated with lower parental SSB consumption (-14.5 median kcals; 95% confidence interval [CI] = -22.6, -6.4). For infants, higher parental SSB attitude score was linked with lower odds of infant SSB consumption (adjusted odds ratio [AOR] = 0.84; 95% CI = 0.71, 0.99), and adjustment for socioeconomic factors slightly attenuated results (AOR = 0.85; 95% CI = 0.71, 1.02).

CONCLUSIONS

During the first 1000 days of life, greater negativity in parental attitudes toward SSB consumption was associated with fewer parental calories consumed from SSBs and lower likelihood of infant SSB consumption. Public Health Implications. Parental attitudes toward SSBs should be targeted in future childhood obesity interventions during pregnancy and infancy.

Promoting Water Consumption on a Caribbean Island: An Intervention Using Children's Social Networks at Schools

Sugar-sweetened beverage (SSB) consumption and the associated childhood obesity are major concerns in the Caribbean, creating a need for interventions promoting water consumption as a healthy alternative. A social network-based intervention (SNI) was tested among Aruban children to increase their water consumption and behavioral intention to do so and, consequently, to decrease SSB consumption and the associated behavioral intention. In this study, the moderating effects of descriptive and injunctive norms were tested. A cluster randomized controlled trial was completed in schools (mean age = 11 years ± SD = 0.98; 54% girls). Children were assigned to the intervention group (IG; n = 192) or control group (CG; n = 185). IG children were exposed to peer influencers promoting water consumption and CG children were not. Regression analyses showed that water consumption increased for IG children with a high injunctive norm score (p = 0.05); however, their intention to consume more water remained unchanged (p = 0.42). Moreover, IG children showed a decrease in SSB consumption (p = 0.04) and an increase in their intention to consume less SSB (p = 0.00). These findings indicate that SNIs are a promising instrument for health behavioral changes for Aruba and other islands in the Caribbean region.

Contribution of discretionary food and drink consumption to socio-economic inequalities in children's weight: prospective study of Australian children

BACKGROUND

In high-income countries, children with a lower socio-economic position (SEP) are more likely to gain excess weight compared with children with a higher SEP. The extent to which children's consumption of discretionary food and drinks contributes to the development of these inequalities over childhood has not been examined.

METHODS

The study sample comprised 3190 children from the nationally representative Longitudinal Study of Australian Children. Linear and logistic regression models were fitted in accordance with the product of coefficients mediation method to determine the contribution of cumulative consumption of sweet drinks, discretionary hot foods, savoury snacks and sweet snacks from the first year of life, over a period of 10 years, on the relationship between SEP and children's body mass index (BMI) z-score at age 10-11 years.

RESULTS

At age 10-11, mean BMI z-score was 0.17 in the highest SEP tertile, 0.33 in the middle and 0.47 in the lowest tertile. Corresponding values for overweight and obesity prevalence were 16.6%, 25.7% and 32.7%, respectively. Eleven per cent [95% confidence interval (CI) 4.77%, 19.84%] of the observed difference in BMI z-score at age 10-11 years was mediated by socio-economic differences in consumption of sweet drinks and discretionary hot foods including pies and hot chips throughout childhood.

CONCLUSIONS

Findings indicate that consumption of sweet drinks and discretionary hot food, from the first year of life, is likely to contribute to the development of inequalities in excess weight among children. Poor dietary intake is a key risk factor for excess weight gain among children and a reduction in discretionary food and drinks is likely to contribute to the dual goal of improving overall weight and reducing socio-economic inequalities in weight gain across childhood. To maximally reduce inequalities in weight gain across childhood, additional determinants must also be identified and targeted.

Parental perspectives on hand, foot, and mouth disease among children in Hong Kong: a longitudinal study

Hand, foot, and mouth disease (HFMD), usually a self-limiting illness for young children, could cause a significant burden for parents because it can take up to 1-2 weeks for a sick child to recover. We conducted a two-wave longitudinal study over one summer peak season (May-July 2014) of HFMD to examine parents' HFMD-related risk perceptions and protective responses. In total, 618 parents with at least one child aged ⩽12 years, recruited using randomly-dialled household telephone calls completed the baseline survey interview, 452 of whom subsequently completed the follow-up survey. Around two-thirds of participants perceived the chance of their child being infected by HFMD was 'zero/very small/small' but the likelihood of being hospitalized once infected was 'somewhat likely/likely/very likely'. At follow-up, 82% reported washing child's hands frequently (Hygiene), 16% would keep their child away from school if HFMD cases were identified in school (Distancing) and 23% were 'very likely/certainly' to take the child for HFMD vaccination if available (Vaccination). Anticipated regret was consistently the strongest predictor for Hygiene (OR 3.34), and intention of Distancing (OR 2.58) and Vaccination (OR 3.16). Interventions focusing on anticipated regret may be effective to promote protective behaviour against HFMD among parents for their children.

Home Sweet Home: Parent and Home Environmental Factors in Adolescent Consumption of Sugar-Sweetened Beverages

OBJECTIVE

Sugar-sweetened beverages (SSBs) are key contributors to obesity among youth. We investigated associations among parental and home-related factors (parental attitudes and consumption; home availability) regarding 3 types of SSBs-soda, sports drinks, and fruit-flavored drinks-with consumption of each type of SSB in a general school-based sample of adolescents.

METHODS

Data were collected across 3 school semesters, from 2009 to 2011. A total of 1313 seventh grade student-parent dyads participated. Students completed in-class surveys across 9 schools in a large Los Angeles school district; their parents completed telephone interviews. Youth were asked about their SSB consumption (soda, sports drinks, and fruit-flavored drinks), and parents were asked about their attitudes, consumption, and home availability of SSBs.

RESULTS

We estimated expected rates of youth SSB consumption for hypothetical parents at very low (5th) and very high (95th) percentiles for home/parental risk factors (ie, they consumed little, had negative attitudes, and did not keep SSBs in the home; or they consumed a lot, had positive attitudes, and did keep SSBs in the home). Youth of lower-risk parents (at the 5th percentile) were estimated to drink substantially less of each type of beverage than did youth of higher-risk parents (at the 95th percentile). For example, youth with higher-risk parents averaged nearly double the SSB consumption of youth of lower-risk parents (2.77 vs 1.37 glasses on the previous day; overall model significance F_22,1312 = 3.91, P < .001).

CONCLUSIONS

Results suggest a need to focus on parental and home environmental factors when intervening to reduce youths' SSB consumption.

Consumption of Carbonated Soft Drinks Among Young Adolescents Aged 12 to 15 Years in 53 Low- and Middle-Income Countries

OBJECTIVES

To compare consumption of carbonated soft drinks among young adolescents in 53 low- and middle-income countries (LMICs).

METHODS

We used 2009 to 2013 Global School-based Student Health Survey data to assess 137 449 young adolescents aged 12 to 15 years with available data (via a standardized questionnaire) on frequency of carbonated soft drink consumption.

RESULTS

Overall, young adolescents reported having consumed carbonated soft drinks 1.39 times per day (95% confidence interval [CI] = 1.26, 1.51), and 54.3% of adolescents reported consuming a carbonated soft drink at least once per day. Frequency (times per day) varied greatly across countries, ranging from 0.52 (95% CI = 0.43, 0.60) in Kiribati to 2.39 (95% CI = 2.25, 2.53) in Suriname.

CONCLUSIONS

Our data confirm that consumption of carbonated soft drinks is frequent among young adolescents in LMICs. Our findings highlight the need for interventions in these countries to reduce adolescents' carbonated soft drink consumption.

Predictors of the frequency of Australian children's consumption of unhealthy foods

BACKGROUND

Child obesity interventions need to be based on a sound understanding of the factors that influence children's diets.

OBJECTIVE

To investigate the relationship between a range of predictor variables and the frequency with which Australian children consume energy-dense, nutrient-poor (EDNP) foods.

METHODS

A web panel provider was used to access 1302 parents of Australian children aged 8-14 years who responded to an online survey about their children's diets. Structural equation modelling was conducted to test a model of the factors contributing to the frequency of children's unhealthy food consumption.

RESULTS

Of the tested variables, consumption of EDNP foods was primarily influenced by parents' attitudes to these foods, children's pestering behaviours and perceived social norms relating to children's consumption of these products. Both pestering and social norms had significant direct effects on consumption frequency as well as indirect effects via their impact on parents' attitudes to EDNP foods.

CONCLUSION

Environmental factors that contribute to both pestering and social norms are likely to be critical considerations in the development of child obesity interventions.

Heritability of high sugar consumption through drinks and the genetic correlation with substance use

BACKGROUND

High sugar consumption contributes to the rising prevalence of obesity. Sugar can have rewarding effects that are similar to, but less strong than, the effects of addictive substances. People who consume large amounts of sugar also tend to use more addictive substances, but it is unclear whether this is due to shared genetic or environmental risk factors.

OBJECTIVE

We examined whether there are genetic influences on the consumption of sugar-containing drinks and whether genetic factors can explain the association with substance use.

DESIGN

The frequency of consumption of sugar-containing drinks (e.g., cola, soft drinks, and energy drinks) and addictive substances (nicotine, caffeine, alcohol, cannabis, and illicit drugs) was obtained for 8586 twins who were registered at the Netherlands Twin Register (women: 68.7%; mean ± SD age: 33.5 ± 15.3 y). Participants were categorized as high or low sugar consumers (>1 compared with ≤1 SD above daily consumption in grams) and as high or low substance users (≥2 compared with <2 substances). Through bivariate genetic modeling, genetic and environmental influences on sugar consumption, substance use, and their association were estimated.

RESULTS

Genetic factors explained 48% of the variation in high sugar consumption, whereas unique environmental factors explained 52%. For high substance use, these values were 62% and 38%, respectively. There was a moderate phenotypic association between high sugar consumption and high substance use (r = 0.2), which was explained by genetic factors (59%) and unique environmental factors (41%).

CONCLUSIONS

The positive association between high sugar consumption and high substance use was partly due to unique environmental factors (e.g., social situations). Genetic factors were also of influence, suggesting that neuronal circuits underlying the development of addiction and obesity are related. Further research is needed to identify genes that influence sugar consumption and those that overlap with substance use.