Factors Associated with Beverage Intake in Low-Income, Overweight, or Obese Pregnant Women

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.

Assessing sugar-sweetened beverage consumption in early pregnancy using a substance abuse framework

Sugar-sweetened beverages (SSB) are previously reported to jeopardize maternal fetal health, most well-known for gestational diabetes, childhood obesity, and cognitive impairment. Although warnings and diet recommendations urge pregnant women to consume less SSB, there is no noticeable difference in their behavior. How and why reproductive women change their SSB consumption patterns were not investigated previously. Our study aims to investigate beverage consumption patterns and how these patterns change in pregnancy in the context of substance use disorder (SUD). We invited all pregnant women visiting the clinic to answer a structured 20-min questionnaire every trimester during the regular antennal visit. At the end of the study, 337 pregnant women aged over 20 participated. A total of 301 responses entered for final analysis, with a response rate of 89.3%. Our finding showed those with high DSM-5-TR scores reduced SSB intake after becoming pregnant, while those with mild or low DSM-5-TR scores increased SSB intake after becoming pregnant. The top 3 factors related to their SSB consumption were "use despite of known health hazard (n = 133)", "increased desire to drink (n = 88)", and "excessive time spent on seeking SSB (n = 85)". The least reported factors were in the domains of social impairment (ranging from n = 3 to n = 26), pharmacologic effects (i.e., tolerance (n = 24) and withdrawal (n = 70). When participants reduced SSB consumption after becoming pregnant, their choice of beverages largely shifted to sugarless beverage but not much plain water. The result provided new insights in deciphering pregnant women's psychomotor factors for SSB intake, which served as useful references for making clinical or even public health recommendations.

Sugar-sweetened beverage consumption among pregnant women attending general and teaching hospitals in Ibadan, Nigeria : SSB consumption during pregnancy

BACKGROUND

Sugar-sweetened beverages (SSBs) have become a global health concern because of their adverse health effects and their association with the obesity pandemic. It has not received much attention in sub-Saharan Africa, including Nigeria, especially among pregnant women. The pattern, frequency and factors associated with SSBs among pregnant women in Ibadan, Nigeria, were investigated.

DESIGN

Data were from the Ibadan Pregnancy Cohort Study - a prospective cohort study investigating 1745 pregnant women from four comprehensive obstetric facilities in Ibadan. A qualitative food frequency questionnaire (FFQ) was used to assess the pregnant women's intake of food and drinks over the previous months. Sugar-sweetened beverage variable and scores were also generated using the principal component analysis with varimax rotation. Factors associated with high SSB scores were examined using multivariate logistics regression analyses at a 5% significance level.

RESULTS

The most commonly consumed SSBs were cocoa-sweetened beverages, soft drinks, malt drinks, and fruit juice. A quarter of the women (75th percentile) consumed SSB more than once weekly. The factors associated with high SSB on multivariate analysis were; being employed (AOR: 1.52, 95% CI 1.02-2.26), maternal obesity (AOR: 0.065, 95% CI 0.47-0.89), high fruit intake (AOR:3.62, 95% CI 2.62-4.99), high green vegetable consumption (AOR:1.99, 95% CI 1.06-3.74), high milk intake (AOR: 2.13, 95% CI 1.65- 2.74), frequent fast food outlet visit (AOR: 2.19, 95% CI 1.53-1.70), all of these remained significant after adjusting for confounding variables.

CONCLUSION

SSBs were common among our study population. Factors associated with high SSBs intake are crucial for implementing locally relevant public health interventions.