Health behavior patterns of sugar-sweetened beverage consumption among Brazilian adolescents in a nationally representative school-based study

Sugar-Sweetened Beverages and Adverse Human Health Outcomes: An Umbrella Review of Meta-Analyses of Observational Studies

Our aim was to conduct an umbrella review of evidence from meta-analyses of observational studies investigating the link between sugar-sweetened beverage consumption and human health outcomes. Using predefined evidence classification criteria, we evaluated evidence from 47 meta-analyses encompassing 22,055,269 individuals. Overall, 79% of these analyses indicated direct associations between greater sugar-sweetened beverage consumption and higher risks of adverse health outcomes. Convincing evidence (class I) supported direct associations between sugar-sweetened beverage consumption and risks of depression, cardiovascular disease, nephrolithiasis, type 2 diabetes mellitus, and higher uric acid concentrations. Highly suggestive evidence (class II) supported associations with risks of nonalcoholic fatty liver disease and dental caries. Out of the remaining 40 meta-analyses, 29 were graded as suggestive or weak in the strength of evidence (classes III and IV), and 11 showed no evidence (class V). These findings inform and provide support for population-based and public health strategies aimed at reducing sugary drink consumption for improved health.

Costs of obesity attributable to the consumption of sugar-sweetened beverages in Brazil

Excess sugar is considered one of the primary factors contributing to overweight status. In Brazil, sugar-sweetened beverages (SSBs) contain a significant amount of this nutrient and are consumed excessively. These beverages are associated with adverse health outcomes and impose costs on the healthcare system. The literature currently lacks studies that aim to attribute specific nutrients or foods as causes of diseases and also evaluate their economic impact, especially in middle- and low-income countries. This study aims to estimate the direct and indirect costs of obesity, stratified by sex and age group, resulting from the excessive consumption of sugar-sweetened beverages in Brazil from 2008 to 2020, and to project these costs for the year 2036. The estimation of obesity costs attributable to excessive consumption of SSBs was based on relative risks and the population prevalence of obesity, considering expenditures on hospitalizations and outpatient procedures in the Unified Health System (SUS). Cost information was obtained from the health information systems available at SUS. The highest burden attributable to the consumption of SSBs was observed among younger individuals and progressively decreased with advancing age. The total direct costs in the period between 2008 and 2020 amounted to approximately US$ 6.33 million, 87% of which was related to expenses for females. Additionally, deaths resulting from the consumption of SSBs cost the economy US$ 40 million due to the premature loss of productivity. The total costs of obesity attributable to the consumption of SSBs are substantial, impacting public spending and generating social and productivity losses that burden the economy. It is crucial to develop and implement cost-effective fiscal and regulatory policies aimed at preventing and combating obesity.

Combination of sugar-sweetened beverage consumption, screen-based sedentary time, and sleep duration and their association with South Korean adolescents' mental health

Introduction

This study examines the combinations of sugar-sweetened beverage (SSB) consumption, screen-based sedentary time, and sleep duration and their association with adolescents' depressive symptoms and suicidal ideation.

Methods

This research followed a crosssectional study design. Secondary data analysis was conducted on the data collected from 21,046 high school students who had participated in the 17th Korea Youth Risk Behavior Web-Based Survey in 2021. A complex sampling analysis, including descriptive and logistic regression analyses, was conducted in SPSS Statistics 26.0.

Results

The combination of low SSB consumption, excessive screen-based sedentary time, and short sleep duration was associated with an increase in depressive symptoms. In addition, a combination of medium/high SSB consumption, appropriate/excessive screen-based sedentary time, and short sleep duration was associated with an increase in depressive symptoms. Finally, the combination of high SSB consumption, excessive screen-based sedentary time, and short sleep duration was associated with an increase in suicidal ideation.

Discussion

The findings demonstrate that healthcare providers should develop and conduct family-and school-based programs to restrict SSB consumption, screen-based sedentary behaviors, and sleep duration to improve adolescents' mental health.

Magnitude of sugar-sweetened beverage consumption and associated factors among women aged 15-49 years old in two Sub-Saharan African countries

BACKGROUND

The consumption of Sugar-Sweetened Beverages (SSBs) has been linked to the global epidemic of obesity and chronic disease. Following the economic growth, urbanization, and attractive market for beverage companies, the consumption of SSBs is a rising public health challenge in low and middle-income countries. Hence, this study aimed to assess the magnitude of SSBs consumption and associated factors among women of reproductive age group in two SSA countries.

METHODS

This cross-sectional study used data from Integrated Public Use Micro Data Series-Performance Monitoring for Action (IPUMS-PMA) with a total sample of 3759 women aged 15-49 years old in Burkina Faso and Kenya. The data was collected on June - August 2018 in Burkina Faso, and May -August 2018 in Kenya. SSBs consumption was measured by asking a woman if she drank SSBs yesterday during the day or night, whether at home or anywhere else. A mixed-effect logistic regression model was employed to identify associated factors.

RESULT

Half (50.38%) [95%CI; 46.04, 54.71] of women consumed SSBs. Sociodemographic characteristics like primary education (AOR = 1.35; 95%CI: 1.05-1.74), secondary education (AOR = 1.46; 95%CI: 1.13-1.90), being employed (AOR = 1.28; 95%CI: 1.05-1.56),and dietary characteristics like consumption of savory and fried snack (AOR = 1.61; 95%CI = 1.24-2.09), achieved minimum dietary diversity (AOR = 1.67; 95%CI: 1.38-2.01), moderate household food insecurity (AOR = 0.74, 95% CI: 0.58, 0.95), and sever household food insecurity (AOR = 0.71, 95% CI: 0.56, 0.89) had significant statistical association with SSBs consumption.

CONCLUSION

Consumption of SSBs among women in two Sub-Saharan African countries (Burkina Faso and Kenya) is high. Having higher educational status, being employed, achieved minimum dietary diversity, and having low/no household food in-security were found to be significantly associated with SSBs compared with their counterparts. We recommend for further study in other African countries using objective measurements of SSBs consumption.

Consumption of sugar-sweetened beverages and fast foods deteriorates adolescents' mental health

Introduction

Sugar-sweetened beverage (SSB) and fast-food consumption is significantly associated with adolescents' poor mental health. Furthermore, sugar-sweetened beverage and fast-food consumption might form clustered diet patterns with significant positive associations in adolescent high school students. Thus, the combined consumption of SSBs and fast foods may have more negative effects on mental health with synergetic effects than the sum of their independent consumption.

Methods

This study aimed to identify the effects of combining the consumption of sugar-sweetened beverages and fast foods on mental health, including stress, depressive symptoms, and suicidal ideation among Korean high school students. Secondary data from 24,006 high school students were analyzed from the 17th Korea Youth Risk Behavior Web-based Survey, 2021. For statistical analysis, complex sampling analysis using the SPSS Statistics 26.0 software was applied for descriptive statistics and logistic regression analysis.

Results

In Korean adolescents, combining more than medium consumption of sugar-sweetened beverages and fast foods was associated with more stress, depressive symptoms, and suicidal ideation than their independent consumption. In addition, combining high consumption of sugar-sweetened beverages and low to high consumption of fast foods might have dose-dependent negative effects on stress, depressive symptoms, and suicidal ideation in Korean adolescents.

Discussion

Based on the results of this study, healthcare providers in schools and communities might develop various interventions including school/community-based feeding programs and policies targeting the restriction of SSB and fast-food consumption to improve adolescents' mental health.

The Ecuadorian School Food Environment: Association With Healthy and Unhealthy Food and Beverage Consumption and BMI

BACKGROUND

Schools can play an important role in promoting healthy child diet and body weight. However, this issue is understudied in Latin American and other populations undergoing nutrition and epidemiologic transition.

OBJECTIVES

2018 Ecuadorian National Health and Nutrition Survey data were used to examine the association of school food sources with healthy and unhealthy food intake and body mass index (BMI) in primary (n = 12632) and secondary students (n = 6617).

METHODS

Data on school food environment characteristics were collected by questionnaire, intakes of fruits, vegetables, plain water, sweetened beverages, processed snacks, and fast foods by food frequency questionnaire, and BMI using measured weight and height. Data were analyzed using multivariable methods.

RESULTS

The major school food sources were competitive foods sold by commercial outlets (73%), School Breakfast Program (SBP; 52%), and home-packed items (37%). Most (69%) competitive food outlets sold fruits and vegetables but only 44% offered free clean drinking water and 60% sold prohibited "red traffic light" foods. Primary and secondary students who bought competitive foods consumed sweetened beverages, processed snacks, and fast food more frequently than nonpurchasers (P = .0001). Those who packed home foods had higher fruit and vegetable intakes (P = .0001). Plain water intakes were reduced among all SBP participants (P = .0001). However, primary students in the SBP consumed fast foods less frequently (P = .0001) and had lower average BMI and odds for being obese compared to nonparticipants (P = .0001).

CONCLUSION

The findings from this nationally representative study underscore the important contribution of the school food environment to child nutrition.

School environment and obesity in adolescents from a Brazilian metropolis: cross-sectional study

Background

Childhood-juvenile obesity is a globally acknowledged public health issue. The school environment has been widely assessed because it is where adolescents stay longer during the day, and it may have impact on obesity. School became a crucial environment for obesity prevention in children and adolescents. The aim of the present study was to associate schools’ internal environment factors and its surrounding areas with obesity in adolescents from a Brazilian metropolis.

Methods

Cross-sectional study based on data from the Study on Cardiovascular Risk in Adolescents. The sample comprised 2,530 adolescents in the age group 12–17 years, who were enrolled in public and private schools in Belo Horizonte City, Brazil. Obesity was the dependent variable based on the cut-off point score-z + 2 for body mass index based on age. School environment’s independent variables were ‘managerial dependence type’, ‘number of drinking fountains’, ‘school sports environment’ and ‘ready-to-eat food shops’ around the school (within an 800 m buffer).

Results

Obesity prevailed in 7.21% in sample. The largest number of drinking fountains decrease by 9% the chances of obesity in adolescents enrolled in public and private schools; however, the second and third terciles recorded for the number of ready-to-eat food shops within the 800 m buffer around schools increased by 24% and 44% the chances of obesity, respectively.

Conclusion

School food environment aspects such as the number of operational drinking fountains and the availability of ready-to-eat food shops around the school were associated with obesity in adolescents from a Brazilian metropolis.

Sex-Based Differences in Factors Associated With Sugar-Sweetened Beverage Consumption Among Korean High School Students

This study aimed to identify sex-based differences in the individual and environmental factors associated with sugar-sweetened beverage (SSB) consumption among Korean high school students. Secondary data were obtained from the 15th (2019) Korea Youth Risk Behavior Web-based Survey. In this study, we analyzed data from 13,066 high school students (5,874 boys and 7,192 girls) who answered questions regarding SSB consumption and individual and environmental factors. Complex sampling analysis (descriptive statistics and logistic regression analysis) was conducted using the SPSS Statistics 26.0 software. Most adolescents (97% boys and 95.2% girls) reported having consumed SSBs in the last seven days. Individual factors, such as increased stress, sleep dissatisfaction, and fast-food intake (more than thrice a week) were positively associated with SSB consumption among adolescent boys and girls. Environmental factors like high education levels (above college) of mothers were negatively associated with SSB consumption among both boys and girls. Furthermore, current alcohol consumption, smoking, low vegetable intake (less than thrice a week) in boys, and more than 2 h a day of screen-based sedentary behavior in girls were positively associated with SSB consumption. According to the results, individual factors associated with SSB consumption varied according to the sex of adolescents. Thus, sex differences in factors associated with SSB consumption in adolescents should be considered as basic knowledge for developing strategies for reducing SSB consumption.

Lifestyle patterns associated with common mental disorders in Brazilian adolescents: Results of the Study of Cardiovascular Risks in Adolescents (ERICA)

The association between lifestyle factors and mental health has been evaluated in isolation; however, there has been a lack of information about lifestyle patterns and Common Mental Disorders (CMD) in adolescents. Therefore, the present study aims to assess the association between sets of lifestyle patterns and the occurrence of CMD in Brazilian adolescents evaluated in a national school-based cross-sectional survey. The outcome variable considered was presence of CMD. Lifestyle patterns were identified from the Principal Component Analysis. Consumption of foods, water and alcoholic beverages, sleep, physical activity, and smoking were used to identify patterns as explanatory variables. Sociodemographic characteristics, administrative dependence of the school and, nutritional status, were considered adjustment factors in the regression model. A total of 70,427 adolescents were evaluated. The principal component analysis identified three lifestyle patterns: high consumption of ultra-processed foods and low consumption of unprocessed or minimally processed foods (pattern 1); high consumption of alcoholic beverages and tobacco in the last 30 days (pattern 2); and high consumption of water and high level of physical activity (pattern 3). In the adjusted model, in patterns 1 and 2, the third tertile presented greater chance of CMD (OR 1.68; CI 95% 1.51-1.87 and OR 1.38; CI 95% 1.19-1.60, respectively). In pattern 3, the second (OR 0.88; CI 95% 0.80-0.96) and the third (OR 0.80; CI 95% 0.72-0.88) tertiles presented lower chances of CMD among the adolescents evaluated. Therefore, we suggest that health-promoting practices aimed at adolescents include multiple behaviors, with the objective of ensuring physical, mental, and social well-being.

Characteristics of the School Food Environment Affect the Consumption of Sugar-Sweetened Beverages Among Adolescents

Sugar-sweetened beverages are widely available and accessible in school environment, and their presence and characteristics of this environment can influence their consumption. This study examines the association of drinking fountains per 100 students, soft drink sales, soft drink advertising, and the presence of street vendors and sugar-sweetened beverages consumption among adolescents in Brazil. This cross-sectional study was carried out using data from the Study of Cardiovascular Risk in Adolescents that was conducted between March 2013 and December 2014. The sample comprised 71,475 adolescents aged 12–17 years from 1,247 public and private schools in Brazilian cities. Sugar-sweetened beverages consumption was the dependent variable. The main effect was the school food environment, which was evaluated based on drinking fountains per 100 students, soft drink sales, soft drink advertising, and the presence of street vendors. Public and private schools that sold soft drinks were associated with higher average sugar-sweetened beverages consumption among adolescents. Our study highlights the importance of creating healthy school food environments by banning sugar-sweetened beverages in schools accordingly.

Relationships of beverage consumption and actigraphy-assessed sleep parameters among urban-dwelling youth from Mexico

OBJECTIVE

To examine whether usual beverage intake was associated with sleep timing, duration and fragmentation among adolescents.

DESIGN

Usual beverage intake was assessed with a FFQ. Outcomes included sleep duration, midpoint (median of bed and wake times) and fragmentation, assessed with 7-d actigraphy. Sex-stratified linear regression was conducted with sleep characteristics as separate outcomes and quantiles of energy-adjusted beverage intake as exposures, accounting for age, maternal education, physical activity and smoking.

SETTING

Mexico City.

PARTICIPANTS

528 adolescents residing in Mexico City enrolled in a longitudinal cohort.

RESULTS

The mean age (sd) was 14·4 (2·1) years; 48 % were male. Among males, milk and water consumption were associated with longer weekday sleep duration (25 (95 % CI 1, 48) and 26 (95 % CI 4, 47) more minutes, in the 4th compared to the 1st quartile); and higher 100 % fruit juice consumption was related to earlier weekday sleep timing (-22 (95 % CI -28, 1) minutes in the 1st compared to the last quantile; P = 0·03). Among females, soda was associated with higher sleep fragmentation (1·6 (95 % CI 0·4, 2·8) % in the 4th compared to the 1st), and coffee/tea consumption was related to shorter weekend sleep duration (-23 (95 % CI -44, 2) minutes in the 4th compared to the 1st).

CONCLUSIONS

Among females, adverse associations with sleep were observed for caffeinated drinks, while males with higher consumption of healthier beverage options (water, milk and 100 % juice) had evidence of longer and earlier-timed sleep. Potential mechanisms involving melatonin and tryptophan should be further investigated.