Cross-sectional survey of the amount of free sugars and calories in carbonated sugar-sweetened beverages on sale in the UK

Sugar Content and Warning Criteria Evaluation for Popular Sugar-Sweetened Beverages in Taipei, Taiwan

Sugar intake may increase the risk of obesity, cardiovascular disease, diabetes, and dental caries. In Taiwan, people frequently consume sugar-sweetened beverages (SSBs). This study explored the energy and sugar content of Taiwanese SSBs and evaluated them using the Chilean warning label system (>70 kcal/100 mL and >5 g sugar/100 mL) and the World Health Organization (WHO) sugar guideline (≤25 g sugar). A total of 341 SSBs with volumes ≤600 mL were analyzed. No significant differences were observed in sugar per serving among different types of SSBs, but a great variation in portion size (i.e., package size for individual consumption) was noted. The energy and sugar ratios per serving were lower in soft drinks and coffee and tea containing >1 serving than in those containing only one serving. The calorie and sugar ratios per portion were higher in all types of SSBs containing >1 serving per portion than in those containing exactly one serving. Approximately 70.0% of Taiwanese SSBs were classified as high sugar according to the Chilean criteria, and 41.6% of SSBs exceeded the WHO guideline. Moreover, 40.8% of SSBs that were not considered as high sugar according to the Chilean criteria contained >25 g sugar per portion. For individual consumption, it is more clear that nutrition labeling is based on portion rather than serving. Evaluating SSBs on sugar/portion rather than sugar/100 mL will help consumers make better choices.

Sugar Content of Market Beverages and Children's Sugar Intake from Beverages in Beijing, China

(1) Background: This study aims to find the sugar content of market beverages and estimate the sugar intake from beverages among students in Beijing. (2) Methods: Using snapshotting, we collected the sugar content of beverages through their packages or nutrition labels. Combined with the statistic of student beverage consumption, we estimated students' sugar intake. (3) Results: The median sugar content of total beverages was 9.0 g/100 mL, among which the fruits/vegetable juices and beverages had the highest sugar content (10.0 g/100 mL). Sugar content in most beverages in Beijing was generally higher than the recommendations, and fruit/vegetable juices and beverages exceeded the most. The median of sugar intake from beverages among students was 5.3 g/d, and the main sources were fruit/vegetable juices and beverages, protein beverages and carbonated beverages. Sugar intake from beverages differed according to gender, age and living area. Higher sugar intake was found among boys, older students and rural students. (4) Conclusions: Sugar content in market beverages in Beijing were high. Gender, age and residence were the influencing factors of sugar intake. Targeted measures should be taken to decrease the sugar content in beverages, especially the fruit/vegetable juices and beverages and the sugar intake among students.

Sweet Drinks as Fuels for an Alkaline Fuel Cell with Nonprecious Catalysts

Sugar has the potential to create enough energy to power mobile electronics. Various sugar-powered fuel cells have been reported, however, most of them used pure glucose as substrate and enzymes/noble metals as catalysts. In this work, an alkaline fuel cell with cheap catalysts were constructed, and different sweet drinks were used as fuels for power generation. The influence of different substrates on the electrochemical performance was characterized under the controlled conditions. Our experimental results showed that the fuel cell fueled with carbonated soft drinks had the best performance under the conditions of 99.95 g/L chemical oxygen demand and 3M KOH. The power densities of the fuel cell fueled with different substrates decreased in the order of Pepsi (33.41 W/m2) > Sprite (28.38 W/m2) > apple juice (20.63 W/m2) > Coca (16.31 W/m2) > pear juice (15.31 W/m2) > orange juice (12.75 W/m2), which was consistent with linear sweep voltammetry (LSV) and electrochemical impedance spectroscopy (EIS) analysis. This is the first report on alkaline fuel cell (AFC) performance using different sweet drinks as substrate. These values are more than 10 times higher than those of reported microbial fuel cells. Our findings demonstrated that sweet drinks fueled alkaline fuel cells can be a promising energy source for low-power electronics.

Exclusively drinking sucrose or saline early in life alters adult drinking behavior by laboratory rats

Proper fluid balance is critical for life. Learning plays an important role in shaping the appetitive behaviors required for drinking. Children often forego drinking plain water and instead consume beverages such as milk or juice. What effect this may have on adult thirst responses remains an open question. To model aspects of the human condition, we bred Sprague-Dawley rats and prevented the pups from obtaining fluid other than from nursing. Pups were weaned onto either tap water, 5% sucrose, or 0.45% saline, and given access to only that fluid for at least 7 weeks. We then measured intake of water or sucrose/saline in one-bottle tests after mild hypertonic saline (HS) injection, or overnight fluid deprivation, and in two-bottle tests after HS injection while rats were maintained on their respective fluids, and after all subjects had only water to drink for a week. We found that sucrose- and saline-maintained rats drank less water than did controls after the HS challenge. After overnight fluid deprivation, rats maintained on saline drank less water and more saline, but there was no difference in intake between water-maintained and sucrose-maintained rats. Differences in licking patterns, including more licks/burst for sucrose by sucrose-maintained rats were detected, even in cases when total intake was not different. These data provide evidence that adult rat water intake can be reduced by exclusively drinking sucrose or saline early in life.

Differences in Lifestyle Behaviours of Students between Inner Urban and Peri-urban High Schools: A Cross-Sectional Study in Chongqing, China

Background: Lifestyle behaviours of students from schools in different socioeconomic areas may be different. Few studies have investigated such topics in China. This study aimed to explore the differences in lifestyle behaviours between inner urban high school students (IUHSSs) and peri-urban high school students (PUHSSs). Methods: A cross-sectional survey based on a self-report questionnaire was administered among 1560 high school students (726 from inner urban high schools and 834 from peri-urban high schools) in Chongqing, China. Physical activity, sleep time, screen time and dietary behaviours were assessed according to a series of recommendations of Chinese guidelines. Results: No significant difference was found in meeting the recommendation for daily physical activity between IUHSSs and PUHSSs (7.6% vs. 6.8%, p > 0.05). PUHSSs were more likely to meet the recommendations of weekdays’ sleep time (14.9% vs. 5.4%, p < 0.001), weekdays’ and weekends’ screen time (85.4% vs. 76.7%, p < 0.001; 21.1% vs. 14.3%, p < 0.001), and had higher proportion of high-score group of dietary behaviours (58.6% vs. 36.4%, p < 0.001) than those of IUHSSs. IUHSSs were more likely to meet the recommendation of weekends’ sleep time (75.6% vs. 67.9%, p < 0.001) than that of PUHSSs. Conclusions: A low proportion met the recommendations of physical activity, weekdays’ sleep time and weekends’ screen time among high school students in Chongqing, China. Lifestyle behaviours may differ between inner urban and peri-urban high school students. Additional support or targeted health education should be provided by high schools to improve the lifestyle behaviours of students, especially in inner urban districts.

Reductions in sugar sales from soft drinks in the UK from 2015 to 2018

BACKGROUND

The consumption of free sugars in the UK is more than double the guideline intake for adults and close to triple for children, with soft drinks representing a significant proportion. The aim of this study was to assess how individual soft drink companies and consumers have responded to calls to reduce sugar consumption, including the soft drink industry levy (SDIL), between 2015 and 2018.

METHODS

This was an annual cross-sectional study using nutrient composition data of 7377 products collected online, paired with volume sales data for 195 brands offered by 57 companies. The main outcome measures were sales volume, sugar content and volume of sugars sold by company and category, expressed in total and per capita per day terms.

RESULTS

Between 2015 and 2018, the volume of sugars sold per capita per day from soft drinks declined by 30%, equivalent to a reduction of 4.6 g per capita per day. The sales-weighted mean sugar content of soft drinks fell from 4.4 g/100 ml in 2015 to 2.9 g/100 ml in 2018. The total volume sales of soft drinks that are subject to the SDIL (i.e. contain more than 5 g/100 ml of sugar) fell by 50%, while volume sales of low- and zero-sugar (< 5 g/100 ml) drinks rose by 40%.

CONCLUSION

Action by the soft drinks industry to reduce sugar in products and change their product portfolios, coupled with changes in consumer purchasing, has led to a significant reduction in the total volume and per capita sales of sugars sold in soft drinks in the UK. The rate of change accelerated between 2017 and 2018, which also implies that the implementation of the SDIL acted as an extra incentive for companies to reformulate above and beyond what was already being done as part of voluntary commitments to reformulation, or changes in sales driven by consumer preferences.

Labelling changes in response to a tax on sugar-sweetened beverages, United Kingdom of Great Britain and Northern Ireland

Objective

To evaluate the changes in sugar and energy labelling of carbonated sugar-sweetened soft drinks after the implementation of a tax on sugar-sweetened drinks in the United Kingdom of Great Britain and Northern Ireland.

Methods

We visited nine main supermarkets before (May 2014) and after (April 2018) the tax came into effect and obtained data from product packaging and nutrition information panels of carbonated sugar-sweetened soft drinks. We used the paired t-test to assess differences in sugar and energy content of the same products between 2014 and 2018.

Findings

We obtained data from 166 products in 2014 and 464 products in 2018, of which 83 products were the same in both years. Large variations in stated sugar content were found between the different carbonated sugar-sweetened soft drinks in both 2014 and 2018 for all products and for the 83 products. The mean sugar content of the 83 products decreased by 42% between 2014 and 2018, from 9.1 g/100 mL (standard deviation, SD: 3.3) to 5.3 g/100 mL (SD: 3.5; P < 0.001). The mean energy content decreased by 40%, from 38 kcal/100 mL (SD: 13) in 2014 to 23 kcal/100 mL (SD: 15) in 2018 (P < 0.001).

Conclusion

The significant decreases in the labelling of sugar and energy content of carbonated sugar-sweetened soft drinks after the levy came into effect suggest this tax has been effective. The sugar content of drinks still varied considerably in 2018, suggesting further reductions in sugar content of these drinks is possible. The levy thresholds should be reduced and the tax increased to drive further reformulation of soft drinks to reduce their sugar content.

The sugar and energy in non-carbonated sugar-sweetened beverages: a cross-sectional study

BACKGROUND

The consumption of non-carbonated sugar-sweetened beverages (NCSSBs) has many adverse health effects. However, the sugar and energy content in NCSSBs sold in China remain unknown. We aimed to investigate the sugar and energy content of NCSSBs in China and how these contents were labelled.

METHODS

A cross-sectional survey was conducted in 15 supermarkets in Haidian District, Beijing from July to October 2017. The product packaging and nutrient information panels of NCSSBs were recorded to obtain type of products (local/imported), serving size, nutrient contents of carbohydrate, sugar and energy. For those NCSSBs without sugar content information, we used carbohydrate content as a replacement.

RESULTS

A total of 463 NCSSBs met the inclusion criteria and were included in our analysis. The median of sugar content and energy content was 9.6 [interquartile range (IQR): 7.1-11.3] g/100 ml and 176 (IQR: 121-201) kJ/100 ml. The median of sugar contents in juice drinks, tea-based beverages, sports drinks and energy drinks were 10.4, 8.5, 5.0 and 7.4 g/100 ml. Imported products had higher sugar and energy content than local products. There were 95.2% products of NCSSBs receiving a 'red'(high) label for sugars per portion according to the UK criteria, and 81.6% products exceeding the daily free sugar intake recommendation from the World Health Organization (25 g). There were 82 (17.7%) products with sugar content on the nutrition labels and 60.2% of them were imported products.

CONCLUSIONS

NCSSBs had high sugar and energy content, and few of them provided sugar content information on their nutrition labels especially in local products. Measures including developing better regulation of labelling, reducing sugar content and restricting the serving size are needed for reducing sugar intakes in China.

Gradual reduction of free sugars in beverages on sale by implementing the beverage checklist as a public health strategy

Background

Sugar-sweetened beverages (SSBs) are a major source of free sugar intake and contribute to obesity and obesity-related diseases. Therefore, we analyzed the effect of a gradual sugar reduction strategy within the so-called 'beverage checklist' on free sugar content in beverages on sale in Austria.

Methods

From 2010 until 2017, data on the amount of free sugar of sweetened beverages (sweetened with sugars, fruit juice and artificial sweeteners) with 0.20-0.75l serving sizes in all main supermarkets and from industry was collected. These data were published annually as the beverage checklist, which displays beverages on sale in Austria. The checklist aims to encourage beverage production with a free sugar content of ≤7.4 g/100 ml and no artificial sweeteners.

Results

Free sugar content in the total supply decreased significantly [7.53 (2.86) vs. 6.75 (2.79) g/100 ml; 10.4%; P < 0.001] over time and also in those for which follow-up data were available until 2017 (n = 100) [7.55 (2.46) vs. 7.28 (2.44) g/100 ml; 3.5%; P < 0.001]. The percentage of beverages fulfilling the guiding criteria increased by 12.8% (P < 0.001) and of those containing sweeteners decreased by 13.3% (after 2012; P = 0.034).

Conclusions

This public health strategy, conducted by a small non-profit organization, showed a reduction in the mean free sugar content by working with the industry to voluntarily reformulate beverages. More beverages with less added sugar were brought to the market, which implies healthier choices. The challenge now is to further engage the industry and also policy makers to achieve a greater reduction in the future.

Sugar and energy content of carbonated sugar-sweetened beverages in Haidian District, Beijing: a cross-sectional study

OBJECTIVE

The consumption of carbonated sugar-sweetened beverages (CSSBs) is associated with a range of health problems, but little is known about the sugar and energy content of CSSBs in China. The study aimed to investigate the sugar and energy content of CSSBs in Beijing, China.

STUDY DESIGN

We carried out a cross-sectional survey in 15 different supermarkets from July to October 2017 in Haidian District, Beijing.

METHODS

The product packaging and nutrient labels of CSSBs were recorded by a snapshot in time to obtain company name, product name, serving size, and nutrient content, that is, carbohydrate, sugar and energy. For CSSB labels not showing sugar content, we used carbohydrate content as substitute. The sugar and energy content of CSSBs within each type of flavour were compared using Kruskal-Wallis test. The sugar content within the recommended levels was described using frequency. We also compared the sugar and energy content of top 5 CSSBs in terms of sales among three countries (China, UK and USA).

RESULTS

A total of 93 CSSB products were found. The median sugar content was 9.3 (IQR: 5.7-11.2) g/100 mL, and the energy content was 38 (IQR: 23-46) kcal/100 mL. There were 79 products labelled 'Red' (high) per serving based on the criteria set in the UK (>11.25 g/100 mL). We found 62.4% of CSSBs had sugar content per serving that exceeds the daily free sugar intake for adults (25 g) recommended by the WHO. Some of the branded products sold in China had higher sugar content when they were compared with those in Western countries.

CONCLUSIONS

CSSBs in Beijing, China have high sugar and energy content. Reduction in sugar content and serving size of CSSBs and taxation policy on beverages will be beneficial in reducing sugar intake in China.

The nutritional content of supermarket beverages: a cross-sectional analysis of New Zealand, Australia, Canada and the UK

OBJECTIVE

To compare the nutritional content, serving size and taxation potential of supermarket beverages from four different Western countries.

DESIGN

Cross-sectional analysis. Multivariate regression analysis and χ 2 comparisons were used to detect differences between countries.

SETTING

Supermarkets in New Zealand (NZ), Australia, Canada and the UK.

SUBJECTS

Supermarket beverages in the following categories: fruit juices, fruit-based drinks, carbonated soda, waters and sports/energy drinks.

RESULTS

A total of 4157 products were analysed, including 749 from NZ, 1738 from Australia, 740 from Canada and 930 from the UK. NZ had the highest percentage of beverages with sugar added to them (52 %), while the UK had the lowest (39 %, P<0.001).

CONCLUSIONS

There is substantial difference between countries in the mean energy, serving size and proportion of products eligible for fiscal sugar taxation. Current self-regulatory approaches used in these countries may not be effective to reduce the availability, marketing and consumption of sugar-sweetened beverages and subsequent intake of free sugars.

Cross-sectional surveys of the amount of sugar, energy and caffeine in sugar-sweetened drinks marketed and consumed as energy drinks in the UK between 2015 and 2017: monitoring reformulation progress

OBJECTIVES

To investigate the sugar, energy and caffeine content of sugar-sweetened drinks marketed and consumed as energy drinks available in the UK.

STUDY DESIGN

We carried out a cross-sectional survey in 2015 and 2017 of energy drinks available in the main UK retailers.

METHODS

The sugar (sugars g/100 mL), energy (kcal/100 mL), caffeine (mg/100 mL) and serving size were collected from product packaging and nutrition information panels of energy drinks available in the nine main UK grocery retailers, three health and beauty retailers and one convenience store.

RESULTS

The number of formulations (per 100 mL) and number of products (per serving) have fallen (from 75 to 49 and from 90 to 59) between 2015 and 2017, respectively. Energy drinks surveyed showed a 10% reduction in sugar, from 10.6 to 9.5 g/100 mL (P=0.011) and a 6% reduction in energy content (P=0.005) per 100 mL between 2015 and 2017. The average caffeine content of energy drinks, with a warning label, has remained high at 31.5±0.9 in 2015 and 31.3±1.0 mg/100 mL in 2017. Despite there being reductions, sugar, energy and caffeine content remain at concerning levels in 2017.

CONCLUSIONS

To reduce the harmful impact of energy drinks, further reduction in sugar and a reduction in caffeine by reformulation are urgently needed. Other measures such as ban on the sale of energy drinks to children and smaller product sizes should also be explored, while warning labels should be kept. A reduction in sugar, energy and caffeine content and overall energy drinks consumption could be beneficial in reducing sugar, energy and caffeine intake of consumers of energy drinks.