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Wang J, Wei Y, Galizzi MM, Kwan HS, Zee BCY, Fung H, Yung TKC, Wong ELY, Yue Q, Lee MKL, Wu Y, Wang K, Wu H, Yeoh EK, Chong KC. Evaluating the impact of sugar-sweetened beverages tax on overweight, obesity, and type 2 diabetes in an affluent Asian setting: A willingness-to-pay survey and simulation analysis. Prev Med 2024; 184:107994. [PMID: 38723779 DOI: 10.1016/j.ypmed.2024.107994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 05/03/2024] [Accepted: 05/06/2024] [Indexed: 05/20/2024]
Abstract
BACKGROUND The potential health effects of taxing sugar-sweetened beverages (SSBs) has been insufficiently examined in Asian contexts. This study aimed to assess the impact of SSB taxation on the prevalence of obesity/overweight and type 2 diabetes mellitus (T2DM) in Hong Kong using a willingness-to-pay (WTP) survey and simulation analysis. METHODS A random telephone survey was conducted with 1000 adults from May to June 2020. We used a contingent valuation approach to assess individuals' WTP for SSBs under four tax payment scenarios (5%, 10%, 40%, and 50% of the current market price). Based on the WTP, a simulation analysis was conducted to project changes in SSB purchase and associated reductions in the prevalence of obesity/overweight and T2DM over a 10-year simulation period. FINDINGS When 5% and 10% taxation rates were introduced, approximately one-third of the population were unwilling to maintain their SSB purchase. Our simulation demonstrated a gradual decline in the prevalence of obesity/overweight and diabetes with a more pronounced decrease when higher taxation rates were introduced. 10% taxation resulted in a mean reduction of 1532.7 cases of overweight/obesity per 100 thousand population at the sixth year, while T2DM prevalence decreased by 267.1 (0.3%). CONCLUSIONS This study underscores the effects of an SSB tax on purchase behaviors and health outcomes in an affluent Asia setting, with a more pronounced influence on adult population. These findings are expected to inform policymakers in making decisions regarding an effective and equitable tax rate on SSBs.
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Affiliation(s)
- Jingxuan Wang
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Yuchen Wei
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong, China
| | - Matteo M Galizzi
- Department of Psychological and Behavioural Science, London School of Economics and Political Science, London, UK
| | - Hoi Shan Kwan
- School of Life Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Benny Chung Ying Zee
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China
| | - Hong Fung
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Tony Ka Chun Yung
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Eliza Lai Yi Wong
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Qianying Yue
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | | | - Yushan Wu
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong, China
| | - Kailu Wang
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong, China
| | - Hongjiang Wu
- Department of Medicine & Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Eng Kiong Yeoh
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong, China
| | - Ka Chun Chong
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong, China; Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China.
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Lin CJ, Chang LY, Wu CC, Chang HY. The effect of childhood depression trajectories on sugar-sweetened beverage habit trajectories in adolescence: Exploring sleep problems as a mediator. Appetite 2024; 194:107199. [PMID: 38160733 DOI: 10.1016/j.appet.2023.107199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 12/24/2023] [Accepted: 12/26/2023] [Indexed: 01/03/2024]
Abstract
Although depression has been linked to the habit of consuming sugar-sweetened beverages (SSBs), little is known about their long-term relationships and the mediating role of sleep problems. This study examines the associations between childhood depressive symptoms trajectories and adolescent SSB-habit trajectories and whether these associations were mediated by sleep problems. Data came from 1560 adolescents participating in a longitudinal study across grades 1 through 12 in northern Taiwan. Group-based trajectory modeling was used to identify development of childhood depressive symptoms and an SSB habit in adolescence. Multinomial logistic regression was conducted to examine the influence of childhood depressive symptoms and adolescent SSB habit. Mediation analysis was conducted to test whether sleep problems mediated the associations examined. Four distinct trajectories of childhood depressive symptoms were identified: low-stable (30.79%), moderate-stable (42.32%), increasing (12.29%), and high-stable (11.60%). Three distinct trajectories of SSB habit in adolescence were identified: low-stable (44.32%), increasing (15.02%), and high-stable (40.65%). Children who had moderate-stable (aOR = 1.35; CI: 1.04-1.77), high-stable (aOR = 2.01; CI: 1.28-3.15), or increasing (aOR = 1.97; CI: 1.26-3.06) trajectories of depressive symptoms relative to those in the low-stable group were significantly more likely to belong to the high-stable trajectory of SSBs than to the low-stable SSBs group. The Z-mediation test showed that sleep problems significantly mediated the associations between trajectories of childhood depressive symptoms and trajectories of SSBs during adolescence (all p < 0.05). Childhood depressive symptoms conferred risks for adolescent SSB habits; and the effects were seen, in part, through increasing sleep problems.
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Affiliation(s)
- Chun-Ji Lin
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
| | - Ling-Yin Chang
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan.
| | - Chi-Chen Wu
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
| | - Hsing-Yi Chang
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
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Kisselgoff M, Champagne MR, Dubois R, Turnbull L, LaPlante J, Schultz A, Bombak A, Riediger N. Balancing on the redline: a qualitative study of the experiences purchasing sugar-sweetened beverages among Indigenous adults in a Canadian urban neighbourhood. Can J Public Health 2024; 115:99-110. [PMID: 38036852 PMCID: PMC10853129 DOI: 10.17269/s41997-023-00831-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 10/24/2023] [Indexed: 12/02/2023]
Abstract
OBJECTIVE Growing evidence suggests that inner-city residents actively navigate their food landscape to meet a wide range of socio-economic needs. Given the increasing focus of health policies on sugar-sweetened beverages (SSB) through price-based strategies, it is critical to understand purchasing habits of populations with higher SSB intake. This study examined urban Indigenous adults' SSB shopping behaviour and experiences. METHODS We conducted a community-based participatory research study using semi-structured interviews with a purposive sample of Indigenous adults (≥ 18 years old) from the North End neighbourhood of Winnipeg. Interviews were audio recorded, transcribed verbatim, and thematically analyzed. RESULTS All 20 participants (women = 10; men = 8; two-spirit = 2) consumed SSB on a regular, daily basis either at the time of the interview or at a prior period in their lives. Themes defining residents' SSB shopping behaviour and experiences of shopping for SSB included balancing on the redline, specifically (1) balancing SSB purchasing constraints and facilitators with savvy shopping approaches and (2) balancing (stereo)typical reactions with resilient coping approaches. Residents procured SSB in various stores within and beyond the boundaries of the North End neighbourhood. SSB is a considerable, reoccurring expense, requiring savvy price-shopping strategies in order to access. Indigenous adults experience judgement and stereotyping when purchasing SSB, including intersecting racial, class, and weight stigma. CONCLUSION Purchasing SSB is perceived as a source of judgement when outside of inner-city neighbourhoods. Policymakers should consider how policies directed at SSB, which are consumed by Indigenous and food-insecure populations in greater quantities, may magnify existing racial, class, and weight-based discrimination.
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Affiliation(s)
- Maria Kisselgoff
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, MB, Canada
| | | | | | - Lorna Turnbull
- Faculty of Law, University of Manitoba, Winnipeg, MB, Canada
| | - Jeff LaPlante
- National Indigenous Diabetes Association, Winnipeg, MB, Canada
| | - Annette Schultz
- College of Nursing, University of Manitoba, Winnipeg, MB, Canada
| | - Andrea Bombak
- Department of Sociology, University of New Brunswick, Fredericton, New Brunswick, Canada
| | - Natalie Riediger
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, MB, Canada.
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Wei YH, Lin CH, Yang SN, Wu CY, Yang YN, Tey SL, Su YT. Execution of anticipatory guidance and the knowledge and practice gap among caregivers in Southern Taiwan: A retrospective study. J Formos Med Assoc 2023; 122:1282-1295. [PMID: 37365099 DOI: 10.1016/j.jfma.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 05/20/2023] [Accepted: 06/07/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND/PURPOSE This study examined the practice rate of Anticipatory Guidance (AG) and the gap between knowledge and practice among caregivers. METHODS We retrospectively collected data from caregivers who brought their children for seven age-based well-child visits (birth to 7 years old) and seven corresponding AG checklists for practice (each ranged from 16 to 19 guidance items, 118 items in total) between 2015 and 2017. Practice rates of guidance items and their association with children's sex, age, residence, and body mass index were collected and analyzed. RESULTS We enrolled 2310 caregivers (330 per well-child visit). Average practice rates of guidance items in the seven AG checklists were 77.6%-95.1%, generally without significant differences between urban/rural or male/female children. However, lower (<80%) rates were observed for 32 items, including dental check-ups (38.9%), use of fluoride toothpaste (44.6%), screen time (69.4%), and drinking less sugar-sweetened beverages (SSBs) (75.5%), with corresponding knowledge-to-practice gap rates of 55.5%, 47.9%, 30.3%, and 23.8%, respectively. "Drinking less SSBs" was the only item with a higher obesity rate in the non-achieved group versus the achieved group (16.7% vs. 7.4%, p = 0.036; odds ratio: 3.509, 95% CI: 1.153-10.677, p = 0.027). CONCLUSION Caregivers in Taiwan practiced most AG recommendations. However, dental check-ups, fluoride toothpaste use, drinking less SSBs, and limiting screen time were less executed items. A higher obesity rate was found among 3-7-year-old children whose caregivers failed to practice the "Drink less SSBs" guidance. Strategies to overcome the gap between knowledge and practice are needed to improve these less-achieved guidance items.
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Affiliation(s)
- Yi-Hsuan Wei
- Department of Pediatrics, E-Da Dachang Hospital, I-Shou University, Kaohsiung, Taiwan; College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Chyi-Her Lin
- Department of Pediatrics, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan; Department of Pediatrics, National Cheng-Kung University Hospital, Tainan, Taiwan; School of Medicine for International Students, I-Shou University, Kaohsiung, Taiwan
| | - San-Nan Yang
- Department of Pediatrics, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan; School of Medicine for International Students, I-Shou University, Kaohsiung, Taiwan
| | - Chien-Yi Wu
- College of Medicine, I-Shou University, Kaohsiung, Taiwan; Department of Pediatrics, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Yung-Ning Yang
- Department of Pediatrics, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan; School of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Shu-Leei Tey
- Department of Pediatrics, Asia University Hospital, Taichung, Taiwan
| | - Yu-Tsun Su
- Department of Pediatrics, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan; School of Medicine for International Students, I-Shou University, Kaohsiung, Taiwan.
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Reyes-García A, Junquera-Badilla I, Batis C, Colchero MA, Miranda JJ, Barrientos-Gutiérrez T, Basto-Abreu A. How Could Taxes on Sugary Drinks and Foods Help Reduce the Burden Of Type 2 Diabetes? Curr Diab Rep 2023; 23:265-275. [PMID: 37695402 DOI: 10.1007/s11892-023-01519-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 09/12/2023]
Abstract
PURPOSE OF REVIEW Taxes on sugary drinks and foods have emerged as a key strategy to counteract the alarming levels of diabetes worldwide. Added sugar consumption from industrialized foods and beverages has been strongly linked to type 2 diabetes. This review provides a synthesis of evidence on how taxes on sugary products can influence the onset of type 2 diabetes, describing the importance of the different mechanisms through which the consumption of these products is reduced, leading to changes in weight and potentially a decrease in the incidence of type 2 diabetes. RECENT FINDINGS Observational studies have shown significant reductions in purchases, energy intake, and body weight after the implementation of taxes on sugary drinks or foods. Simulation studies based on the association between energy intake and type 2 diabetes estimated the potential long-term health and economic effects, particularly in low- and middle-income countries, suggesting that the implementation of sugary food and beverage taxes may have a meaningful impact on reducing type 2 diabetes and complications. Public health response to diabetes requires multi-faceted approaches from health and non-health actors to drive healthier societies. Population-wide strategies, such as added sugar taxes, highlight the potential benefits of financial incentives to address behaviors and protective factors to significantly change an individual's health trajectory and reduce the onset of type 2 diabetes worldwide, both in terms of economy and public health.
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Affiliation(s)
- Alan Reyes-García
- Center for Population Health Research, National Institute of Public Health, Avenida Universidad 655, Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico
| | - Isabel Junquera-Badilla
- Center for Population Health Research, National Institute of Public Health, Avenida Universidad 655, Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico
| | - Carolina Batis
- CONACYT - Center for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Mexico
| | - M Arantxa Colchero
- Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Mexico
| | - J Jaime Miranda
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Tonatiuh Barrientos-Gutiérrez
- Center for Population Health Research, National Institute of Public Health, Avenida Universidad 655, Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico
| | - Ana Basto-Abreu
- Center for Population Health Research, National Institute of Public Health, Avenida Universidad 655, Santa María Ahuacatitlán, 62100, Cuernavaca, Morelos, Mexico.
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Castetbon K, Assakali W, Thiébaut I, Desbouys L. Decreasing consumption of sugar-sweetened beverages and Raising tap water consumption through Interventions based on Nutrition and sustainability for Kids: study protocol of the "DRINK" cluster randomised controlled trial. Trials 2023; 24:611. [PMID: 37752525 PMCID: PMC10521418 DOI: 10.1186/s13063-023-07643-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 09/11/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Effectiveness of actions to reduce sugar-sweetened beverage (SB) consumption in children still needs to be improved. Furthermore, the growing concern about sustainable food systems encourages to develop sustainability-based interventions. The objective of this cluster randomised controlled trial is to evaluate the long-term effectiveness of nutrition- and environmental sustainability-based interventions on the reduction in SB intake and on the increase in tap water consumption in 3rd to 6th grade primary school children (8 to 11 years of age). METHODS Forty-eight French-speaking Belgian primary schools (equivalent to around 3500 pupils involved in the evaluation) are randomised using a factorial plan: (i) control, (ii) nutrition-based intervention, (iii) sustainability-based intervention, and (iv) both. The interventions (encouragement of water breaks; provision of posters, leaflets, reusable cups, and glass bottles; website; meetings at school) were undertaken from February 2022 to June 2023. Evaluation includes questionnaires for the children and their parents on various determinants of dietary behaviour, a 4-day diary to collect information on the child's beverage consumption, and audits at schools. The first evaluation was conducted in Spring 2021 before any intervention, with the two post-intervention evaluations being held in 2022 and 2023. The main quantitative judgement criterion will be the change over time in the mean SB consumption (in ml/day) in the intervention groups compared with the control group. Given the context of the research (school), the safety of the intervention, and the content of data collection, a consent was acknowledged as unnecessary by the Ethical Committee of the Faculty of Psychology (ULB; n°073/2021), but children and parents are explicitly informed of their right to refuse to fill in the questionnaires. DISCUSSION Multicomponent interventions based on nutrition and on environmental sustainability, alone or mixed, will provide an original and topical insight into health promotion at school around dietary behaviours. The dissemination plan will enable to widely inform stakeholders, school staff, and families, in addition to the scientific community through the usual medium (articles, conferences), about the research findings in 2024-2025. TRIAL REGISTRATION ISRCTN Registry ISRCTN99843102. Retrospectively registered on 25 May 2021.
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Affiliation(s)
- Katia Castetbon
- Research Center in "Epidemiology, Biostatistics and Clinical Research", School of Public Health, Université libre de Bruxelles (ULB), CP598, Route de Lennik 808, Brussels, 1070, Belgium.
| | - Wassila Assakali
- Research Center in "Epidemiology, Biostatistics and Clinical Research", School of Public Health, Université libre de Bruxelles (ULB), CP598, Route de Lennik 808, Brussels, 1070, Belgium
| | - Isabelle Thiébaut
- Club Européen des Diététiciens de L'Enfance (CEDE), Esplanade 17, Ath, 7800, Belgium
| | - Lucille Desbouys
- Research Center in "Epidemiology, Biostatistics and Clinical Research", School of Public Health, Université libre de Bruxelles (ULB), CP598, Route de Lennik 808, Brussels, 1070, Belgium
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Duffy E, Ng SW, Hall MG, Bercholz M, Rebolledo N, Musicus A, Taillie LS. Sociodemographic disparities in purchases of fruit drinks with policy relevant front-of-package nutrition claims. Public Health Nutr 2023; 26:1585-1595. [PMID: 37211358 PMCID: PMC10410375 DOI: 10.1017/s1368980023000691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 02/08/2023] [Accepted: 04/12/2023] [Indexed: 05/23/2023]
Abstract
OBJECTIVE Our objectives were to describe sociodemographic characteristics associated with the purchase of (1) any fruit drinks and (2) fruit drinks with specific front-of-package (FOP) nutrition claims. DESIGN Cross-sectional. SETTING USA. PARTICIPANTS We merged fruit drink purchasing data from 60 712 household-months from 5233 households with children 0-5 years participating in Nielsen Homescan in 2017 with nutrition claims data. We examined differences in predicted probabilities of purchasing any fruit drinks by race/ethnicity, income and education. We constructed inverse probability (IP) weights based on likelihood of purchasing any fruit drinks. We used IP-weighted multivariable logistic regression models to examine predicted probabilities of purchasing fruit drinks with specific FOP claims. RESULTS One-third of households with young children purchased any fruit drinks. Non-Hispanic (NH) Black (51·6 %), Hispanic (36·3 %), lower-income (39·3 %) and lower-educated households (40·9 %) were more likely to purchase any fruit drinks than NH White (31·3 %), higher-income (25·8 %) and higher-educated households (30·3 %) (all P < 0·001). In IP-weighted analyses, NH Black households were more likely to purchase fruit drinks with 'Natural' and fruit or fruit flavour claims (6·8 % and 3·7 %) than NH White households (4·5 % and 2·7 %) (both P < 0·01). Lower- and middle-income (15·0 % and 13·8 %) and lower- and middle-educated households (15·4 % and 14·5 %) were more likely to purchase fruit drinks with '100 % Vitamin C' claims than higher-income (10·8 %) and higher-educated households (12·9 %) (all P < 0·025). CONCLUSIONS We found a higher likelihood of fruit drink purchases in lower-income, lower-educated, NH Black and Hispanic households. Experimental studies should determine if nutrition claims may be contributing to disparities in fruit drink consumption.
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Affiliation(s)
- Emily Duffy
- Department of Nutrition, University of North Carolina at Chapel Hill Gillings School of Global Public Health and Carolina Population Center, 123 W Franklin St, Chapel Hill, NC27516, USA
| | - Shu Wen Ng
- Department of Nutrition, University of North Carolina at Chapel Hill Gillings School of Global Public Health and Carolina Population Center, 123 W Franklin St, Chapel Hill, NC27516, USA
| | - Marissa G Hall
- Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health and Carolina Population Center, and UNC Lineberger Comprehensive Cancer Center, School of Medicine, Chapel Hill, NC, USA
| | | | - Natalia Rebolledo
- Department of Nutrition, University of North Carolina at Chapel Hill Gillings School of Global Public Health and Carolina Population Center, 123 W Franklin St, Chapel Hill, NC27516, USA
| | - Aviva Musicus
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Lindsey Smith Taillie
- Department of Nutrition, University of North Carolina at Chapel Hill Gillings School of Global Public Health and Carolina Population Center, 123 W Franklin St, Chapel Hill, NC27516, USA
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Li L, Xia J, Huang Z, Liu W, Cui Z, Zhang Y, Zhang S, Zou Y, Liu W, Qi Z. Sugar-sweetened beverage consumption retarded weight gain but not induced depression and anxiety-like behaviors in mice. Life Sci 2023; 317:121469. [PMID: 36736765 DOI: 10.1016/j.lfs.2023.121469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 01/22/2023] [Accepted: 01/29/2023] [Indexed: 02/04/2023]
Abstract
AIMS To assess the effects of sugar-sweetened beverage (SSB) consumption and exercise on behaviors. METHODS Twenty-four male mice were divided into four groups: the water + sedentary (WS), the SSB + sedentary (CS), the water + exercise (WE), and the SSB + exercise (CE). After three-month of interventions, forced swim test (FST), open field test (OFT), and morris water maze (MWM) were conducted. Then, mRNA levels of MAO-A, COMT, and 5-HT1A and protein levels of synapsin, STAT3, A2AR, CRTC1, CREB, and BDNF were measured. RESULTS Under a similar baseline body weight condition, SSB consumption reduced the weight gain from the 3rd week (p < 0.05, or p < 0.01). Exercise decreased the escape latency in the CE group when compared to the CS group on day5 (p < 0.01) and increased the time in the target quadrant in the WE group than the WS group on day4 (p < 0.05) and 5 (p < 0.01) during MWM. No significant differences were found during the FST and OFT. COMT mRNA level was increased after SSB consumption (p < 0.05), but no differences were found in the MAO-A and 5-HT1A mRNA levels and the concerned biomarkers, all of which were previously reported to be associated with depression and anxiety-like behaviors. CONCLUSION SSB consumption reduced weight gain but not result in depression and anxiety-like behaviors in mice. Therefore, the behavioral effects of exercise were not significant. This is not consistent with the results of previous epidemiological surveys of humans.
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Yan T, Shi L, Xu K, Bai J, Wen R, Liao X, Dai X, Wu Q, Zeng L, Peng W, Wang Y, Yan H, Dang S, Liu X. Habitual intakes of sugar-sweetened beverages associated with gut microbiota-related metabolites and metabolic health outcomes in young Chinese adults. Nutr Metab Cardiovasc Dis 2023; 33:359-368. [PMID: 36577637 DOI: 10.1016/j.numecd.2022.10.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 10/05/2022] [Accepted: 10/31/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND AIMS Reducing consumption of sugar-sweetened beverages (SSBs) is a global public health priority because of their limited nutritional value and associations with increased risk of obesity and metabolic diseases. Gut microbiota-related metabolites emerged as quintessential effectors that may mediate impacts of dietary exposures on the modulation of host commensal microbiome and physiological status. METHODS AND RESULTS This study assessed the associations among SSBs, circulating microbial metabolites, and gut microbiota-host co-metabolites, as well as metabolic health outcomes in young Chinese adults (n = 86), from the Carbohydrate Alternatives and Metabolic Phenotypes study in Shaanxi Province. Five principal component analysis-derived beverage drinking patterns were determined on self-reported SSB intakes, which were to a varying degree associated with 143 plasma levels of gut microbiota-related metabolites profiled by untargeted metabolomics. Moreover, carbonated beverages, fruit juice, energy drinks, and bubble tea exhibited positive associations with obesity-related markers and blood lipids, which were further validated in an independent cohort of 16,851 participants from the Regional Ethnic Cohort Study in Northwest China in Shaanxi Province. In contrast, presweetened coffee was negatively associated with the obesity-related traits. A total of 79 metabolites were associated with both SSBs and metabolic markers, particularly obesity markers. Pathway enrichment analysis identified the branched-chain amino acid catabolism and aminoacyl-tRNA biosynthesis as linking SSB intake with metabolic health outcomes. CONCLUSION Our findings demonstrate the associations between habitual intakes of SSBs and several metabolic markers relevant to noncommunicable diseases, and highlight the critical involvement of gut microbiota-related metabolites in mediating such associations.
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Affiliation(s)
- Tao Yan
- School of Food Engineering and Nutritional Science, Shaanxi Normal University, Xi' an, Shaanxi, China
| | - Lin Shi
- School of Food Engineering and Nutritional Science, Shaanxi Normal University, Xi' an, Shaanxi, China; Division of Food and Nutrition Science, Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden.
| | - Kun Xu
- Global Health Institute, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Jinyu Bai
- School of Food Engineering and Nutritional Science, Shaanxi Normal University, Xi' an, Shaanxi, China
| | - Ruixue Wen
- School of Food Engineering and Nutritional Science, Shaanxi Normal University, Xi' an, Shaanxi, China
| | - Xia Liao
- Department of Nutrition, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Xiaoshuang Dai
- BGI Institute of Applied Agriculture, BGI-Agro, Shenzhen, China
| | - Qian Wu
- Global Health Institute, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Lingxia Zeng
- Global Health Institute, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Wen Peng
- Nutrition and Health Promotion Center, Department of Public Health, Medical College, Qinghai University, Xining, Qinghai, China
| | - Youfa Wang
- Global Health Institute, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China; School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Hong Yan
- Global Health Institute, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Shaonong Dang
- Global Health Institute, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China.
| | - Xin Liu
- Global Health Institute, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China.
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Liu XT, Xiong JY, Xu YJ, Zhao L, Libuda L, Cheng G. Prospective association of family members' sugar-sweetened beverages intake with children's sugar-sweetened beverages consumption in China. Eur J Nutr 2023; 62:175-84. [PMID: 35931834 DOI: 10.1007/s00394-022-02971-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 07/19/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE We aimed to investigate whether parental and siblings' sugar-sweetened beverage (SSB) intake had prospective impact on children's SSB consumption, and the potential sex difference in these associations. METHODS This study included a total of 904 children and their parents enrolled from 2004 to 2011 China Health and Nutrition Survey (CHNS) cohort study. SSB consumption information was estimated using a short dietary questionnaire and total energy intake was assessed with three-day 24-h dietary assessments at recruitment and follow-up surveys. Multivariate logistic or linear regression analyses were used to assess the association for SSB consumption between parents, siblings and children after adjusting for age, body mass index (BMI) z-score, household income and parental educational level. RESULTS In this study, a majority (87.6%) of children consumed SSB. Among them, the median consumption of SSB was 70.3 ml/day per capita and 205.4 ml/day per consumer. Parental SSB consumption was relevant to children's SSB consumption, and this association was more pronounced in boys than in girls. Meanwhile, fathers seemed to have a stronger impact on whether children consume SSB than mothers which was reflected by lower P and higher OR. Additionally, children's SSB intake was prospectively associated with their older siblings' SSB consumption (P for trend < 0.03). CONCLUSIONS Parental and older siblings' SSB consumption was relevant to children's SSB intake. Particularly, boys were more susceptible to parental impact than girls, and fathers seemed to have a greater influence on children than mothers.
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Miller C, Dono J, Scully M, Morley B, Ettridge K. Adolescents' knowledge and beliefs regarding health risks of soda and diet soda consumption. Public Health Nutr 2022; 25:3044-53. [PMID: 35983831 DOI: 10.1017/S1368980022001719] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To examine Australian adolescents' knowledge and beliefs regarding potential health consequences of soda and diet soda consumption and nutritional aspects of soda and explore associations with consumption. DESIGN A survey utilising a nationally representative sample (stratified two-stage probability design) assessed knowledge of nutritional contents and health consequences of soda, and beliefs regarding health risks of diet soda, and soda and diet drink consumption. SETTING Australia. PARTICIPANTS 9102 Australian school students (12-17 years) surveyed in 2018. RESULTS Adolescents had lower nutritional knowledge (sugar content (22·2 %), exercise equivalent (33·9 %), calories/kJ (3·1 %)) than general knowledge of health risks (87·4 %) and some health effects (71·7-75·6 % for tooth decay, weight gain and diabetes), with lower knowledge of heart disease (56·0 %) and cancer (19·3 %). Beliefs regarding health effects of diet soda were similar, albeit not as high. In general, female sex, older age and less disadvantage were associated with reporting health effects of soda and diet soda, and nutritional knowledge of soda (P < 0·001). Those reporting tooth decay, weight gain, heart disease and diabetes as health effects of soda and diet soda were lower consumers of soda and diet drinks (P < 0·001), as were those with higher nutritional knowledge (sugar content and exercise equivalent; P < 0·001). CONCLUSIONS This study highlights possible knowledge gaps regarding the health effects of soda and nutritional knowledge for public health intervention. When implementing such interventions, it is important to monitor the extent to which adolescents may consider diet drinks as an alternative beverage given varied beliefs about health consequences and evolving evidence.
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Pasmans K, Meex RCR, Trommelen J, Senden JMG, Vaughan EE, van Loon LJC, Blaak EE. L-arabinose co-ingestion delays glucose absorption derived from sucrose in healthy men and women: a double-blind, randomised crossover trial. Br J Nutr 2022; 128:1072-81. [PMID: 34657640 DOI: 10.1017/S0007114521004153] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Dietary interventions to delay carbohydrate digestion or absorption can effectively prevent hyperglycaemia in the early postprandial phase. L-arabinose can specifically inhibit sucrase. It remains to be assessed whether co-ingestion of L-arabinose with sucrose delays sucrose digestion, attenuates subsequent glucose absorption and impacts hepatic glucose output. In this double-blind, randomised crossover study, we assessed blood glucose kinetics following ingestion of a 200-ml drink containing 50 g of sucrose with 7·5 g of L-arabinose (L-ARA) or without L-arabinose (CONT) in twelve young, healthy participants (24 ± 1 years; BMI: 22·2 ± 0·5 kg/m2). Plasma glucose kinetics were determined by a dual stable isotope methodology involving ingestion of (U-13C6)-glucose-enriched sucrose, and continuous intravenous infusion of (6,6-2H2)-glucose. Peak glucose concentrations reached 8·18 ± 0·29 mmol/l for CONT 30 min after ingestion. In contrast, the postprandial rise in plasma glucose was attenuated for L-ARA, because peak glucose concentrations reached 6·62 ± 0·18 mmol/l only 60 min after ingestion. The rate of exogenous glucose appearance for L-ARA was 67 and 57 % lower compared with CONT at t = 15 min and 30 min, respectively, whereas it was 214 % higher at t = 150 min, indicating a more stable absorption of exogenous glucose for L-ARA compared with CONT. Total glucose disappearance during the first hour was lower for L-ARA compared with CONT (11 ± 1 v. 17 ± 1 g, P < 0·0001). Endogenous glucose production was not differentially affected at any time point (P = 0·27). Co-ingestion of L-arabinose with sucrose delays sucrose digestion, resulting in a slower absorption of sucrose-derived glucose without causing adverse effects in young, healthy adults.
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13
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Liu H, Liu Y, Shi M, Zhou Y, Zhao Y, Xia Y. Meta-analysis of sugar-sweetened beverage intake and the risk of cognitive disorders. J Affect Disord 2022; 313:177-185. [PMID: 35780967 DOI: 10.1016/j.jad.2022.06.048] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 05/23/2022] [Accepted: 06/20/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Previous epidemiological studies revealed inconsistent associations between sugar-sweetened beverage (SSB) consumption and cognitive disorders, but there have been no meta-analyses of the pooled results. Thus, a meta-analysis was performed to determine the association between SSB consumption and cognitive disorders. METHODS A systematic search of the literature prior to May 20, 2022 was performed using the PubMed and Web of Science databases. Random effects models were used to calculate and combine odds ratios (ORs) depending on the degree of heterogeneity. RESULTS 13 studies met the inclusion criteria. A total of 242,014 participants (2752 in three cross-sectional studies and 239,262 in ten cohort studies) were included. A random effects meta-analysis, according to the comprehensive analysis of SSB consumption, was associated with a greater prevalence of cognitive disorders (OR = 1.17, 95 % CI = 1.05-1.29; I2 = 90.1 %). Subgroup analyses of study design, type of SSB, or cognitive disorders outcome was performed. In subgroup analyses, we found that SSB intake was associated with a higher prevalence of cognitive disorders in cohort studies, middle-aged and elderly population, and participants with sugar-sweetened soft drinks. However, no significant association was found in other subgroups. CONCLUSION Our results indicate that SSB intake is positively associated with the prevalence of cognitive disorders. Therefore, attention should be paid to reducing SSB intake as an early intervention for cognitive disorders.
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Affiliation(s)
- Huiyuan Liu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yashu Liu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Mengyuan Shi
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yuhan Zhou
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yuhong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yang Xia
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
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de Menezes RCE, Oliveira JS, Almendra R, de Lira PIC, Costa EC, Leal VS, Santana P. Influence of food environment on ultra-processed drinks consumption among an economically vulnerable population in a metropolitan area in Brazil: A multilevel analysis. Health Place 2022; 77:102869. [PMID: 35932598 DOI: 10.1016/j.healthplace.2022.102869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 05/26/2022] [Accepted: 07/12/2022] [Indexed: 11/26/2022]
Abstract
Ultra-processed drinks (UPDs) consumption is increasing, and this intake has been associated with the risk of illness and death. Data on individuals (n = 430) and food stores (n = 231) were collected in an economically vulnerable area in Recife-Brazil, and multilevel regression models were applied to assess the association between UPDs consumption with food environment characteristics. The results show 29.5% of individuals consume UPDs, higher UPD consumption was significantly associated with age (OR: 0.96), lower educational levels (OR:2.06), high density of stores predominantly selling UPFs (OR:2.34) and lower availability of FV in stores (OR:0.49). The applied methodology can inform food environment interventions to reduce UPDs consumption.
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Affiliation(s)
| | | | - Ricardo Almendra
- Centre of Studies in Geography and Spatial Planning, University of Coimbra, Portugal; Department of Geography and Turism, University of Coimbra, Portugal.
| | | | - Emília Chagas Costa
- Physical Education and Sports Science Unit, Vitória Academic Center, Federal University of Pernambuco, Brazil.
| | - Vanessa Sá Leal
- Nutrition Unit, Vitória Academic Center, Federal University of Pernambuco, Brazil.
| | - Paula Santana
- Centre of Studies in Geography and Spatial Planning, University of Coimbra, Portugal; Department of Geography and Turism, University of Coimbra, Portugal.
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Pacheco LS, Lacey JV Jr, Martinez ME, Lemus H, Sears DD, Araneta MRG, Anderson CAM. Association Between Sugar-Sweetened Beverage Intake and Mortality Risk in Women: The California Teachers Study. J Acad Nutr Diet 2022; 122:320-333.e6. [PMID: 34389488 DOI: 10.1016/j.jand.2021.08.099] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 07/28/2021] [Accepted: 08/05/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND The evidence linking sugar-sweetened beverage (SSB) intake and mortality risk is conflicting, and associations between various SSB subtypes and mortality remain unclear. OBJECTIVE To examine the association between baseline SSB intake, subtypes of SSB intake, and mortality risk in women. DESIGN Prospective cohort study. PARTICIPANTS/SETTING Participants of the California Teachers Study (n = 100,314; median age = 53 years) free of cardiovascular disease, cancer, and diabetes at baseline (1995-1996) were followed from 1995 to 2015. Baseline SSB intake was defined as caloric soft drinks (regular soft drinks, not diet soda), sweetened bottled waters or teas, and fruit drinks; and was derived from a self-administered food frequency questionnaire. MAIN OUTCOME MEASURE Mortality was ascertained via annual linkage with state- and nationwide mortality records and the National Death Index over 20 years. STATISTICAL ANALYSIS Multivariable-adjusted Cox proportional hazards models were used to generate hazard ratios (HRs) and 95% CIs for assessing associations between SSB intake and mortality. Rare/never consumers were the comparator group. RESULTS There were a total of 14,143 deaths over 20 years (30.5% from cardiovascular disease; 29.2% from cancer). In women who consumed ≥ 7 servings/week of SSBs at baseline (4% of participants), the multivariable-adjusted HRs were not significant for all-cause, cardiovascular disease-specific, or cancer-specific mortality. Consuming ≥ 7 servings/week of baseline caloric soft drink was associated with a higher risk of all-cause (HR = 1.26, 95% CI 1.10 to 1.46; P for trend = 0.02) and cancer-specific (HR = 1.33, 95% CI 1.08 to 1.63; P for trend = 0.08) mortality. In secondary analyses, consuming ≥ 1.5 c/day of baseline SSBs was associated with all-cause mortality (HR = 1.12, 95% CI 1.02 to 1.24; P for trend = 0.01). CONCLUSIONS Although the baseline frequency of total SSB intake was not significantly associated with mortality, consuming ≥ 7 servings/week of caloric soft drinks was associated with higher risk of all-cause and cancer-specific mortality. Findings support public health efforts to reduce caloric soft drink consumption.
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Miller C, Ettridge K, Pettigrew S, Wittert G, Wakefield M, Coveney J, Roder D, Martin J, Brownbill A, Dono J. Warning labels and interpretive nutrition labels: Impact on substitution between sugar and artificially sweetened beverages, juice and water in a real-world selection task. Appetite 2021; 169:105818. [PMID: 34838869 DOI: 10.1016/j.appet.2021.105818] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 11/16/2021] [Accepted: 11/17/2021] [Indexed: 11/16/2022]
Abstract
Effective strategies to reduce free sugar intake are needed. This study examined exposure to a warning label, independently and in conjunction with a Health Star Rating (HSR) label, on the selection of commercially available cold beverages with real decision-making stakes. Participants (N = 511, 47.9% female, mean = 21.7 (SD = 6.1) years) accessed an online convenience store app via an on-campus laptop to select one of 10 beverages (5 sugar-sweetened beverages [SSBs], 1100% fruit juice, 2 artificially sweetened beverages [ASBs] and 2 waters). The task was repeated with the addition of a warning label on high-sugar drinks in Round 2, and the addition of an HSR label on all drinks in Round 3. Participants were informed that they would receive a complementary drink (valued at <$5AUD) based on their selections following the completion of a brief questionnaire. Baseline results indicated that SSBs and waters were the most and least popular choices, respectively. For both males and females, there was a significant decrease in SSB selection (p < 0.001) and significant increase in ASB and water selection (p < 0.001) following the addition of warning labels to high-sugar drinks. The decreased selection of SSBs and increased selection of waters was maintained in Round 3 when HSR labels were added to all drinks. 100% fruit juice selection decreased with the addition of a warning label for females only (p < 0.01), but increased following the addition of a 4-star HSR label, for both males (p < 0.05) and females (p < 0.001). Warning labels reduced young adults' selection of SSBs and promoted substitution to water. The HSR reinforced this effect for the least healthy drinks. Increased water selection may be further enhanced by ensuring that warning label thresholds and HSR algorithms align to present consistent messaging.
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Affiliation(s)
- Caroline Miller
- Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, Australia; School of Public Health, The University of Adelaide, Adelaide, Australia.
| | - Kerry Ettridge
- Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, Australia; School of Psychology, The University of Adelaide, Adelaide, Australia
| | - Simone Pettigrew
- Food Policy, The George Institute for Global Health, Sydney, Australia
| | - Gary Wittert
- Freemasons Foundation Centre for Men's Health, Faculty of Health Sciences, University of Adelaide, Adelaide, Australia; Centre for Nutrition and GI Diseases, South Australian Health and Medical Research Institute Adelaide, Australia
| | - Melanie Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Australia; School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - John Coveney
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - David Roder
- Cancer Epidemiology and Population Health, University of South Australia, Australia
| | - Jane Martin
- Obesity Policy Coalition and Alcohol and Obesity Policy, Cancer Council Victoria, Melbourne, Australia
| | - Aimee Brownbill
- Foundation for Alcohol Research and Education, Canberra, Australia
| | - Joanne Dono
- Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, Australia; School of Psychology, The University of Adelaide, Adelaide, Australia
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Abstract
Over 45 jurisdictions globally have implemented sweetened beverage taxes. Researchers and policymakers need to assess whether and how these taxes change beverage demand and supply, their intended and unanticipated health, economic and equity impacts. Lessons from such evaluations can maximise the policies' success and impact on non-communicable disease prevention globally. We discuss key theoretical, design and methodological considerations to help policymakers, funders and researchers commission and conduct rigorous evaluations of these policies and related disease prevention efforts. We encourage involving the perspectives of various stakeholders on what evaluations are needed given the specific context, what data and methods are appropriate, readily available or can be collected within time and budget constraints. A logic model /conceptual system map of anticipated implications across sectors and scales should help identify optimal study design, analytical techniques and measures. These models should be updated when synthesising findings across diverse methods and integrating findings across subpopulations using similar methods.
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Affiliation(s)
- Shu Wen Ng
- Carolina Population Center, University of North Carolina at Chapel Hill, CB #8120, 137 East Franklin Street, Chapel Hill, NC, 27516, USA.
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, CB#7461, UNC-Chapel Hill, Chapel Hill, NC, 27599-7461, USA.
| | - M Arantxa Colchero
- Center for Health Systems Research, Instituto Nacional de Salud Pública, Universidad No 655 Colonia Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, CP, 62100, Cuernavaca, Morelos, Mexico
| | - Martin White
- Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
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An R, Zheng J, Xiang X. Projecting the Influence of Sugar-Sweetened Beverage Warning Labels and Restaurant Menu Labeling Regulations on Energy Intake, Weight Status, and Health Care Expenditures in US Adults: A Microsimulation. J Acad Nutr Diet 2021:S2212-2672(21)00330-0. [PMID: 34689957 DOI: 10.1016/j.jand.2021.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 04/01/2021] [Accepted: 05/04/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Accurate, readily accessible, and easy-to-understand nutrition labeling is a promising policy strategy to address poor diet quality and prevent obesity. OBJECTIVE This study projected the influence of nationwide implementation of sugar-sweetened beverage (SSB) warning labels and restaurant menu labeling regulations. DESIGN A stochastic microsimulation model was built to estimate the influences of SSB warning labels and menu labeling regulations on daily energy intake, body weight, body mass index, and health care expenditures among US adults. PARTICIPANTS/SETTING The model used individual-level data from the National Health and Nutrition Examination Survey, Medical Expenditure Panel Survey, and other validated sources. STATISTICAL ANALYSES PERFORMED The model was simulated using the bootstrapped samples, and the means and associated 95% CIs of the policy effects were estimated. RESULTS SSB warning labels and restaurant menu labeling regulations were estimated to reduce daily energy intake by 19.13 kcal (95% CI 18.83 to 19.43 kcal) and 33.09 kcal (95% CI 32.39 to 33.80 kcal), body weight by 0.92 kg (95% CI 0.90 to 0.93 kg) and 1.57 kg (95% CI 1.54 to 1.60 kg), body mass index by 0.32 (95% CI 0.31 to 0.33) and 0.55 (95% CI =0.54 to 0.56), and per-capita health care expenditures by $26.97 (95% CI $26.56 to $27.38) and $45.47 (95% CI $44.54 to $46.40) over 10 years, respectively. The reduced per-capita health care expenditures translated into an annual total medical cost saving of $0.69 billion for SSB warning labels and $1.16 billion for menu labeling regulations. No discernable policy effect on all-cause mortality was identified. The policy effects could be heterogeneous across population subgroups, with larger effects in men, non-Hispanic Black adults, and younger adults. CONCLUSIONS SSB warning labels and menu labeling regulations could be effective policy leverage to prevent weight gains and reduce medical expenses attributable to adiposity.
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Boelsen-Robinson T, Jerebine A, Kurzeme A, Gilham B, Huse OT, Blake MR, Backholer K, Chung A, Peeters A. Evaluating the implementation and customer acceptability of a sugar-sweetened beverage reduction initiative in thirty Australian aquatic and recreation centres. Public Health Nutr 2021; 24:5166-5175. [PMID: 34085621 PMCID: PMC11082803 DOI: 10.1017/s1368980021002421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 05/05/2021] [Accepted: 05/21/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To assess the feasibility of implementation and customer perspectives of a sugar-sweetened beverage (SSB) reduction initiative across YMCA Victoria aquatic and recreation centres. DESIGN Two data sources were used to assess implementation and customer acceptability. Photo audits were used to assess the type of drinks available for purchase 6 months prior to initiative implementation and 6 months after, in thirty centres. Change in the range of SSB targeted for removal, non-targeted SSB, as well as drinks classified as 'red' (limit), 'amber' (choose carefully) and 'green' (best choice), was reported. Customer surveys were conducted in three centres to assess acceptability and awareness of the initiative. Inductive and deductive thematic analysis was used to analyse customers' perspectives of the initiative. SETTING 30 aquatic and recreation centres in Victoria, Australia. PARTICIPANTS 806 customers. RESULTS At post-implementation, 87 % of centres had removed targeted SSB. 'Red' drinks reduced by an average of 4·4 drink varieties compared to pre-implementation (11·9 varieties) and 'green' drinks increased by 1·4 varieties (3·2 varieties pre-implementation). Customers were largely unaware of the SSB-reduction initiative (90 %) but supported YMCA Victoria in continuing the initiative (89 %), with many believing it would support children in making healthier choices. CONCLUSIONS Implementation of an initiative that limited SSB availability across a large number of aquatic and recreation centres was feasible and considered acceptable by customers. Customers frequently mentioned the importance of protecting children from consuming SSB.
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Affiliation(s)
- Tara Boelsen-Robinson
- School of Public Health and Preventive Medicine,
Monash University, Melbourne,
Australia
- Deakin University, Geelong, Global Obesity Centre, Institute for
Health Transformation, Geelong, VIC3220, Australia
| | | | | | - Beth Gilham
- Deakin University, Geelong, Global Obesity Centre, Institute for
Health Transformation, Geelong, VIC3220, Australia
| | - Oliver T Huse
- Deakin University, Geelong, Global Obesity Centre, Institute for
Health Transformation, Geelong, VIC3220, Australia
| | - Miranda R Blake
- Deakin University, Geelong, Global Obesity Centre, Institute for
Health Transformation, Geelong, VIC3220, Australia
| | - Kathryn Backholer
- Deakin University, Geelong, Global Obesity Centre, Institute for
Health Transformation, Geelong, VIC3220, Australia
| | - Alexandra Chung
- School of Public Health and Preventive Medicine,
Monash University, Melbourne,
Australia
- Deakin University, Geelong, Global Obesity Centre, Institute for
Health Transformation, Geelong, VIC3220, Australia
| | - Anna Peeters
- Deakin University, Geelong, Global Obesity Centre, Institute for
Health Transformation, Geelong, VIC3220, Australia
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Ertuglu LA, Afsar B, Yildiz AB, Demiray A, Ortiz A, Covic A, Kanbay M. Substitution of Sugar-Sweetened Beverages for Other Beverages: Can It Be the Next Step Towards Healthy Aging? Curr Nutr Rep 2021; 10:399-412. [PMID: 34595722 DOI: 10.1007/s13668-021-00372-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2021] [Indexed: 12/25/2022]
Abstract
PURPOSE OF REVIEW With the prolongation of life expectancy, the gap between lifespan and "health span," the disease-free lifespan, has been widening due to the massive burden of age-related chronic diseases and research on healthy aging has been gaining momentum. A growing body of evidence suggests that diet is a strong determinant of healthy aging and consumption of sugar-sweetened beverages (SSB), a major source of added sugars, predicts poor health outcomes in the aging population, including cardiovascular disease, diabetes, and cancer. Evidence further supports a link between sugar-sweetened beverages-triggered pathological processes and biologic factors of aging, including inflammaging, oxidative stress, and alterations in intestinal microbiota. At present, substitution of sugar-sweetened beverages with healthier alternative beverage remains the most robust strategy to limit the deleterious effects of sugar-sweetened beverages on health worldwide and may help achieve healthy longevity. The purpose of this review is to provide an overview of mechanisms by which sugar-sweetened beverages consumption may impact the physiological aging process and how a simple intervention of beverage replacement may promote healthy aging. RECENT FINDINGS Recent findings indicate that SSB are associated with accelerated aging phenotype and activate various adverse biological processes such as chronic inflammation, oxidative stress, insulin resistance, and gut dysbiosis. Replacing SSB with healthier beverages may be a reasonable option to reduce the burden of chronic disease in the aging population and even prolong life and healthspan.
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Affiliation(s)
- Lale A Ertuglu
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Baris Afsar
- Division of Nephrology, Department of Internal Medicine, Suleyman Demirel University School of Medicine, Isparta, Turkey.
| | - Abdullah B Yildiz
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Atalay Demiray
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Alberto Ortiz
- Department of Medicine, School of Medicine, IIS-Fundacion Jimenez Diaz, Universidad Autonoma de Madrid, Madrid, Spain
| | - Adrian Covic
- Department of Nephrology, Grigore T. Popa' University of Medicine, Iasi, Romania
| | - Mehmet Kanbay
- Division of Nephrology, Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
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Hosseinpour-Niazi S, Aghayan M, Mirmiran P, Azizi F. Does weight change modify the association between the consumption of sugar-sweetened beverages and 100% fruit juice and the risk of metabolic syndrome? Clin Nutr 2021; 40:5261-5268. [PMID: 34534895 DOI: 10.1016/j.clnu.2021.08.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 08/02/2021] [Accepted: 08/21/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND & AIMS This study aimed to determine the prospective relationship between the consumption of sugar-sweetened beverages (SSBs) and 100% fruit juice and metabolic syndrome (MetS) and to investigate whether weight change can modify this association in a representative sample of the population of Tehran, Iran. METHODS In this 8.9-year follow-up study, the consumption of SSBs and 100% fruit juice by 1915 individuals, who participated in Tehran Lipid and Glucose Study (TLGS), was examined using a validated food frequency questionnaire. The MetS was defined according to the Joint Interim Statement. Participants were categorized as those who lost weight (≥-2%), those with weight stability (-1.9%-1.9%), and those who gained weight (≥2%). The Cox regression model was used to determine the relationship between the consumption of SSBs and 100% fruit juice and the risk of MetS and weight gain ≥2%. Also, the modifying effect of weight change including weight loss, weight stability and weight gain on the relationship between SSBs and 100% fruit juice consumption and the incidence of MetS was assessed. RESULTS There was no significant association between the consumption of SSBs and the risk of MetS in the crude model; however, after adjustments for confounders, a significant positive association was found between the consumption of SSBs and the risk of MetS (HR: 1.33; 95% CI: 1.07-1.66). Also, no significant association was observed between the consumption of 100% fruit juice and the risk of MetS in the crude model. However, after adjustments for the potential confounders, 100% fruit juice was inversely associated with the MetS risk (HR: 0.78; 95% CI: 0.63-0.95). The consumption of SSBs and 100% fruit juice was positively associated with weight gain (≥2% during the follow-up). Nevertheless, after adjustments for lifestyle and dietary factors, there was no significant association between the consumption of SSBs and weight gain. On the other hand, the consumption of 100% fruit juice was positively associated with the increased risk of weight gain (HR: 1.41; 95% CI: 1.20-1.65). Among participants with weight loss, the first, second and third tertiles of 100% fruit juice reduced the risk of MetS by 29% (HR: 0.71; 95% CI: 0.51-0.99), 47% (HR: 0.53; 95% CI: 0.37-0.75) and 35% (HR: 0.65; 95% CI: 0.46-0.92), respectively. CONCLUSION Although 100% fruit juice reduced the risk of MetS, its consumption must be limited due to its positive effect on weight gain. On the other hand, the consumption of 100% fruit juice reduced the risk of MetS, depending on the individual's weight change. Also, high consumption of SSBs was associated with the incidence of MetS.
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Affiliation(s)
- Somayeh Hosseinpour-Niazi
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Aghayan
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvin Mirmiran
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Itria A, Borges SS, Rinaldi AEM, Nucci LB, Enes CC. Taxing sugar-sweetened beverages as a policy to reduce overweight and obesity in countries of different income classifications: a systematic review. Public Health Nutr 2021;:1-11. [PMID: 34218837 DOI: 10.1017/S1368980021002901] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To evaluate the potential impact of sugar-sweetened beverage (SSB) taxes on overweight and obesity prevalence in countries of different income classifications. DESIGN Systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO number CRD42020161612). Five databases (Cochrane Library, Embase, LILACS (via Virtual Health Library) and MEDLINE (via PubMed), and Web of Science were searched, from January 2009 to December 2019. Articles that reported changes in purchases, sales, intake, body weight, BMI, overweight and/or obesity prevalence due to a tax on or price change in SSB were included. SETTING Studies conducted in countries of different income classifications. PARTICIPANTS The search yielded 8349 articles of which 21 met inclusion criteria. RESULTS Among the sixteen studies selected, only two did not show that consumption, sales and purchase decreased as the price of SSB increased. In eight of the thirteen studies selected, a positive effect of an SSB tax on decreasing overweight and obesity prevalence was expected. It is estimated that a 20 % taxation on SSB would result in a greater decrease in the prevalence of overweight and obesity compared to a 10 % rate. Studies with no significant effect of taxing on sales, purchases, consumption and prevalence of obesity were from high-income countries, while significant effects of taxing on reducing purchase, consumption and/or obesity prevalence were found in studies from upper-middle- and middle-income countries. CONCLUSION A high SSB tax might be an effective fiscal policy to decrease purchase and consumption of SSB and reduce overweight/obesity prevalence, especially if the tax were specific for beverage volume.
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Duffy EW, Taillie LS, Richter APC, Higgins ICA, Harris JL, Hall MG. Toddler milk perceptions and purchases: the role of Latino ethnicity. Public Health Nutr 2021; 24:2911-2919. [PMID: 33472718 PMCID: PMC8255274 DOI: 10.1017/s1368980021000264] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 01/07/2021] [Accepted: 01/18/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Toddler milk (i.e. a nutrient-fortified milk-based drink marketed for children 12-36 months old) is increasingly being marketed in the USA despite not being recommended for young children. There is evidence of targeted toddler milk marketing to Latinos in the USA. This study aimed to explore toddler milk perceptions and behaviours among Latino and non-Latino parents. DESIGN An online survey assessed toddler milk perceptions, behaviours and interpretations of nutrition-related claims. Multivariable logistic and linear regression explored socio-demographic correlates of parent reported past purchases and perceived healthfulness. SETTING Online. PARTICIPANTS National convenience sample of 1078 US parents of children aged 2-12 years (48 % Latino). RESULTS About half of parents (51 %) had previously purchased toddler milk and few (11 %) perceived toddler milk as unhealthy. Latino parents were more likely to have purchased toddler milk than non-Latino parents (P < 0·001), but there were no differences in perceived product healthfulness (P = 0·47). Compared to parents born in the USA, parents living in the USA 10 years or less were more likely to have purchased toddler milk (P < 0·001) and perceive toddler milk as healthier (P = 0·002). Open-ended interpretations of claims were primarily positive, suggesting 'health halo' effects. CONCLUSIONS Common misperceptions about toddler milk healthfulness suggest stronger labelling regulations are needed. Greater reported purchases by Latino parents and recent immigrants warrant further investigation.
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Affiliation(s)
- Emily W Duffy
- Department of Nutrition and Carolina Population Center, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Lindsey Smith Taillie
- Department of Nutrition and Carolina Population Center, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Ana Paula C Richter
- Department of Health Behavior and Carolina Population Center, University of North Carolina at Chapel Hill Gillings School of Global Public Health, 123 W. Franklin St., Suite 210, Chapel Hill, NC27516, USA
| | - Isabella CA Higgins
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jennifer L Harris
- University of Connecticut Rudd Center for Food Policy & Obesity, Hartford, CT, USA
| | - Marissa G Hall
- Department of Health Behavior and Carolina Population Center, University of North Carolina at Chapel Hill Gillings School of Global Public Health, 123 W. Franklin St., Suite 210, Chapel Hill, NC27516, USA
- UNC Lineberger Comprehensive Cancer Center, School of Medicine, CB #7295, Chapel Hill, NC27599, USA
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24
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Papies EK. The Psychology of Desire and Implications for Healthy Hydration. Ann Nutr Metab 2021; 76 Suppl 1:31-36. [PMID: 33774627 DOI: 10.1159/000515025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 11/03/2020] [Indexed: 11/19/2022]
Abstract
This article discusses the cognitive mechanisms underlying the motivation to consume sugar-sweetened beverages (SSBs) and outlines implications for developing healthy hydration habits. While the detrimental health consequences of consuming SSBs are well understood, the psychological processes underlying the motivation to consume them are understudied. To address this gap, the current article applies a grounded cognition theory of desire and motivated behaviour, which can be used as a framework to understand and potentially change the motivation for SSBs and healthier alternatives, such as water. The grounded cognition theory of desire argues that people represent foods and drinks through potentially rewarding simulations, or re-experiences, of consuming them. These simulations, in turn, can increase desire and motivated behaviour. In line with this theory, research on eating behaviour shows that people think about attractive food in terms of what it feels like to eat it and in terms of relevant eating situations and that these simulations predict the desire to eat. Similarly, emerging research on SSBs shows that people represent these beverages in terms of the sensory and rewarding experiences of drinking them, more so than water, and especially if they consume them often. These simulations, in turn, predict the desire for sugary drinks and actual consumption. This has implications for attempts to increase healthy hydration: in order to facilitate healthy choices, the immediate pleasure to be gained from consuming a healthy beverage should be emphasized, rather than its long-term benefits. Repeatedly facilitating healthy drink choices in similar situations can ultimately contribute to the development of healthy hydration habits.
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Xie L, Atem F, Gelfand A, Delclos G, Messiah SE. Association between asthma and sugar-sweetened beverage consumption in the United States pediatric population. J Asthma 2021; 59:926-933. [PMID: 33625285 DOI: 10.1080/02770903.2021.1895210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES United States (US) youth consume an average of 10 teaspoons of added sugar from sugar-sweetened beverages (SSB) on any given day. Few population-based studies have examined the association between SSB consumption and asthma in children and adolescents. This study aimed to examine the association between SSB consumption and asthma in the US pediatric population. DESIGN Analytical cross-sectional study. SETTING AND PARTICIPANTS A total of 9,938 children aged 2-to-17 years old who participated in the 2011-2016 National Health and Nutrition Examination Surveys. SSB consumption was categorized into 3 groups based on the caloric intake from 24-hour food recall data as follows: 1) no consumption (0 kcal/day); 2) moderate consumption (1-499 kcal/day); and 3) heavy consumption (≥ 500 kcal/day). The primary outcome of interest was self-reported current asthma condition. RESULTS Asthma prevalence estimates were significantly higher in heavy (16.4%) and moderate (11.0%) SSB consumers versus non-consumers (7.5%) (p < 0.05 for both comparisons). The adjusted odds of asthma were twice that among children with heavy SSB consumption (aOR 2.01, 95% confidence interval [CI] 1.31-3.08) versus non-SSB consumers. The odds of asthma were higher among those who consumed fruit drinks (aOR 2.51, 95% CI 1.55-4.08), non-diet soft drinks (aOR 1.89, 95% CI 1.23-2.89) and sweet tea (aOR 1.87, 95% CI 1.13-3.09) compared to nondrinkers. The effect was independent of obesity status (p-interaction = 0.439). CONCLUSIONS Findings here suggest a dose-response relationship between SSB intake and asthma diagnosis, therefore controlling SSB consumption may potentially improve pulmonary health risk in the US pediatric population.
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Affiliation(s)
- Luyu Xie
- University of Texas Health Science Center, School of Public Health, Dallas Campus, Dallas, TX, USA.,Center for Pediatric Population Health, Children's Health System of Texas and University of Texas Health Science Center, Dallas, TX, USA
| | - Folefac Atem
- University of Texas Health Science Center, School of Public Health, Dallas Campus, Dallas, TX, USA.,Center for Pediatric Population Health, Children's Health System of Texas and University of Texas Health Science Center, Dallas, TX, USA
| | - Andrew Gelfand
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - George Delclos
- University of Texas Health Science Center, School of Public Health, Houston Campus, Houston, TX, USA
| | - Sarah E Messiah
- University of Texas Health Science Center, School of Public Health, Dallas Campus, Dallas, TX, USA.,Center for Pediatric Population Health, Children's Health System of Texas and University of Texas Health Science Center, Dallas, TX, USA
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26
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Zenk SN, Li Y, Leider J, Pipito AA, Powell LM. No long-term store marketing changes following sugar-sweetened beverage tax implementation: Oakland, California. Health Place 2021; 68:102512. [PMID: 33517072 DOI: 10.1016/j.healthplace.2021.102512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 12/05/2020] [Accepted: 01/08/2021] [Indexed: 11/30/2022]
Abstract
Globally, more than 45 countries have implemented sugar-sweetened beverage (SSB) taxes; however, little is known about effects on marketing practices. For the 2017 Oakland, California, 1 cent per ounce SSB tax, this study evaluated long-term changes in beverage price promotions, depth of sale, and interior and exterior advertising at stores, collected via in-person audits at two time points (pre-tax and 24-months post-tax). Overall, based on difference-in-differences estimation, relative to the comparison site, no significant pre-post tax changes were found in the odds of price promotions, exterior or interior advertising, or sale depth for SSBs or untaxed beverages. As additional SSB taxes are considered these findings suggest that SSB taxes may not have long-term effects on store marketing practices.
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Affiliation(s)
- Shannon N Zenk
- National Institute of Nursing Research, National Institutes of Health, 9000 Rockville Pike, Building 31, Room 5B05, Bethesda, MD, USA.
| | - Yu Li
- Health Policy and Administration Division, School of Public Health, University of Illinois Chicago, 1603 W Taylor St, Chicago, IL, 60612, USA.
| | - Julien Leider
- Institute for Health Research and Policy, University of Illinois Chicago, 1747 W Roosevelt Rd, Chicago, IL, 60608, USA.
| | - Andrea A Pipito
- Institute for Health Research and Policy, University of Illinois Chicago, 1747 W Roosevelt Rd, Chicago, IL, 60608, USA.
| | - Lisa M Powell
- Health Policy and Administration Division, School of Public Health, University of Illinois Chicago, 1603 W Taylor St, Chicago, IL, 60612, USA; Institute for Health Research and Policy, University of Illinois Chicago, 1747 W Roosevelt Rd, Chicago, IL, 60608, USA.
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27
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Duffy EW, Hall MG, Dillman Carpentier FR, Musicus AA, Meyer ML, Rimm E, Smith Taillie L. Nutrition Claims on Fruit Drinks Are Inconsistent Indicators of Nutritional Profile: A Content Analysis of Fruit Drinks Purchased by Households With Young Children. J Acad Nutr Diet 2021; 121:36-46.e4. [PMID: 32978105 PMCID: PMC7752796 DOI: 10.1016/j.jand.2020.08.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 07/30/2020] [Accepted: 08/05/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND Fruit drinks are the most commonly consumed sugar-sweetened beverage among young children. Fruit drinks carry many nutrition-related claims on the front of package (FOP). Nutrition-related claims affect individuals' perceptions of the healthfulness of products and purchase intentions, often creating a "health halo" effect. OBJECTIVE The aims of this study were to describe the prevalence of FOP nutrition-related claims on fruit drinks purchased by households with young children and to examine the association between claims and the nutritional profile of fruit drinks. DESIGN The sample included 2059 fruit drinks purchased by households with children 0 to 5 years old participating in Nielsen Homescan in 2017. FOP labels were obtained from 2 databases that contain bar code-level information on all printed material on product labels. A codebook was used to code for presence of FOP nutrition-related claims. The coded claims data were linked by bar code with Nutrition Facts label data. Claim type prevalence was calculated, and the association between claim types and median calories and total grams of sugar per 100 mL was analyzed using Wilcoxon rank-sum tests. The percentages of products containing noncaloric sweeteners (NCSs) with and without each claim type were also calculated and compared. RESULTS Almost all (97%) fruit drinks sampled had at least 1 nutrition-related FOP claim. Implied natural claims such as "natural flavors" were the most common (55% of products), followed by claims about the presence of juice or nectar (49%). Claims about vitamin C (33%), sugar (29%), and calories (23%) were also common. Fruit drinks with vitamin C, juice or nectar, fruit or fruit flavor, and overt natural claims were higher in calories and sugar and less likely to contain NCSs compared with products without these claims. Fruit drinks with calorie, sugar, NCS, implied natural, and other claims were lower in calories and sugar and more likely to contain NCSs compared with products without these claims. CONCLUSIONS Claims are prevalent on fruit drinks purchased by households with young children. This is concerning given prior research demonstrating that claims can mislead consumers. Regulatory actions such as requiring a warning or disclosure on drinks that contain added sugars or NCSs should be considered.
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Affiliation(s)
- Emily W Duffy
- University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC
| | - Marissa G Hall
- Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC
| | | | - Aviva A Musicus
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Michele L Meyer
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Eric Rimm
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Lindsey Smith Taillie
- University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC.
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Erzse A, Christofides N, Stacey N, Lebard K, Foley L, Hofman K. Availability and advertising of sugar sweetened beverages in South African public primary schools following a voluntary pledge by a major beverage company: a mixed methods study. Glob Health Action 2021; 14:1898130. [PMID: 33910480 PMCID: PMC8288764 DOI: 10.1080/16549716.2021.1898130] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 02/28/2021] [Indexed: 10/31/2022] Open
Abstract
Background: Towards the end of the 2017 school year, a prominent beverage company in South Africa pledged to remove their sugar-sweetened beverages (SSBs) and advertisements from primary schools in order to contribute to the realization of a healthy school environment.Objectives: To assess the availability and advertising of the company's beverages in public primary schools in Gauteng province following their voluntary pledge to remove the products, and to explore perceptions of school staff regarding SSB availability in schools and processes related to the implementation of the pledge.Methods: In 2019, we conducted a representative survey of public sector primary (elementary) schools in Gauteng province, South Africa. A random sample of schools was drawn, with schools stratified by whether or not they charge fees. This was a proxy for the socioeconomic status of the locale and student body. At each school, the availability of beverages and presence of advertising or not was assessed by an observational audit tool and differences across fee status assessed by Pearson χ 2 test. Semi-structured interviews were conducted with a purposive sample of school officials. Data from the interviews were coded and thematic analysis conducted.Results: Two years following a voluntary pledge, the company's carbonated SSBs were available for sale in 54% (CI: 45-63%) of schools with tuck shops and advertised in 31% (CI: 25-39%). Qualitative interviews revealed a complex landscape of actors within schools, which, combined with indifference or resistance to the pledge, may have contributed to the continued availability of SSBs.Conclusions: Though we were unable to examine SSB availability before and after the pledge, our findings provide some preliminary evidence that voluntary pledges by commercial entities are not sufficient to remove SSBs and advertisements from schools. Mandatory regulations coupled with in-depth engagement with schools may be an avenue to pursue in the future.
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Affiliation(s)
- Agnes Erzse
- SAMRC/Centre for Health Economics and Decision Science, PRICELESS, Faculty of Health Sciences, University of Witwatersrand School of Public Health, Johannesburg, South Africa
| | - Nicola Christofides
- Faculty of Health Sciences, University of Witwatersrand School of Public Health, Johannesburg, South Africa
| | - Nicholas Stacey
- SAMRC/Centre for Health Economics and Decision Science, PRICELESS, Faculty of Health Sciences, University of Witwatersrand School of Public Health, Johannesburg, South Africa
| | - Kelsey Lebard
- SAMRC/Centre for Health Economics and Decision Science, PRICELESS, Faculty of Health Sciences, University of Witwatersrand School of Public Health, Johannesburg, South Africa
| | - Louise Foley
- MRC Epidemiology Unit, University of Cambridge, UK
| | - Karen Hofman
- SAMRC/Centre for Health Economics and Decision Science, PRICELESS, Faculty of Health Sciences, University of Witwatersrand School of Public Health, Johannesburg, South Africa
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Zhang YB, Chen JX, Jiang YW, Xia PF, Pan A. Association of sugar-sweetened beverage and artificially sweetened beverage intakes with mortality: an analysis of US National Health and Nutrition Examination Survey. Eur J Nutr 2021; 60:1945-55. [PMID: 32945955 DOI: 10.1007/s00394-020-02387-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 09/10/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE Current evidence on the associations between sugar-sweetened beverage (SSB) intakes and mortality is inconsistent, whereas the evidence on artificially sweetened beverages (ASBs) was sparse. We aimed to investigate the associations of SSB and ASB intakes with mortality in a nationally representative sample of US adults. METHODS Participants from the National Health and Nutrition Examination Survey (NHANES, 1999-2014; n = 31,402) were linked to the US mortality registry by the end of 2015. SSB and ASB intakes were collected using 24-h dietary recalls. Cox proportional hazard regression models were used to assess the associations of intakes of SSBs, ASBs, and added sugar from SSBs with mortality with adjustment for demographic, lifestyle, comorbidity, and dietary factors. RESULTS After a mean follow-up of 7.9 years, 3878 deaths were identified. The multivariate-adjusted hazard ratios (95% confidence intervals) associated with each additional serving/d of SSB were 1.05 (1.01-1.09) for all-cause mortality and 1.11 (1.03-1.21) for heart disease mortality. Hazard ratios (95% confidence intervals) comparing the extreme quintiles of added sugar intakes from SSBs were 1.22 (1.05-1.42) for all-cause mortality and 1.45 (1.06-1.97) for heart disease mortality. No significant relationship was found between SSB intakes and cancer mortality or between high ASB intakes and mortality. Substituting one serving/d of SSB by an equivalent amount of ASBs, unsweetened coffees and teas, and plain water was associated with a 4-7% lower risk of all-cause mortality. CONCLUSION Higher SSB intakes were associated with higher risks of all-cause mortality and heart disease mortality. High ASB intakes were not significantly associated with mortality. ASBs, unsweetened coffees and teas, and plain water might be optional alternatives for reducing SSB intakes.
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McNaughton SA, Pendergast FJ, Worsley A, Leech RM. Eating occasion situational factors and sugar-sweetened beverage consumption in young adults. Int J Behav Nutr Phys Act 2020; 17:71. [PMID: 32493366 PMCID: PMC7271392 DOI: 10.1186/s12966-020-00975-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 05/19/2020] [Indexed: 02/04/2023] Open
Abstract
Background Young adulthood represents an influential transitional period marked by poor dietary habits and excess weight gain. Sugar-sweetened beverages (SSB) are a major source of excess caloric intake among young adults, yet little is known about the correlates of SSB consumption. This study examines the individual and situational correlates of SSB consumption, using real-time assessment of Australian young adults’ eating occasions. Methods Dietary, sociodemographic and health behaviour data were collected during the Measuring EAting in Everyday Life (MEALS) study (n = 675 adults, 18–30 y). Participants reported all foods and beverages consumed over 3–4 non-consecutive days using a real-time Smartphone food diary application (“FoodNow”). For every eating occasion, food and beverage intake was recorded along with situational characteristics (eating location, purchase location, presence of others and activities while eating). A beverage occasion was defined as any eating occasion where a beverage was consumed and a SSB occasion was defined as any eating occasion where a SSB was consumed. Multilevel logistic regression was used to examine individual and situational characteristics with SSB intake at beverage occasions (i.e. factors associated with choosing a SSB over other non-alcoholic beverages) and to examine factors associated with consuming a SSB at any occasion where food and/or beverages were consumed. Results Thirty-five percent of participants consumed SSBs during the recording period (n = 237). Of the 2185 beverage eating occasions reported by SSB consumers, 481 (20%) contained a SSB. SSB were rarely consumed on their own (i.e. other foods were present). Having a lower than tertiary education (odds ratio [95% confidence interval]: 1.53 [1.16, 2.01]; p < 0.01); eating in a café/restaurant, compared to at home (3.02 [1.58, 5.78]; p < 0.001), and purchasing beverages from a convenience outlet, compared to a supermarket/grocery store (4.58 [2.85, 7.38]; p < 0.001) were associated with SSB intake at beverage eating occasions. Similar associations were also found when all food and/or beverage eating occasions were examined. Conclusion In this study, SSB were often consumed with other foods and intake was associated with individual and situational factors. Further studies are needed to confirm these findings and explore how SSB are consumed in relation to their accompanying foods.
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Affiliation(s)
- Sarah A McNaughton
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.
| | - Felicity J Pendergast
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Anthony Worsley
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Rebecca M Leech
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
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Kashino I, Kochi T, Imamura F, Eguchi M, Kuwahara K, Nanri A, Kurotani K, Akter S, Hu H, Miki T, Kabe I, Mizoue T. Prospective association of soft drink consumption with depressive symptoms. Nutrition 2020; 81:110860. [PMID: 32791444 DOI: 10.1016/j.nut.2020.110860] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 04/10/2020] [Accepted: 04/19/2020] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Consumption of soft drinks has become a serious public health issue worldwide. However, prospective evidence is limited regarding the relationship between soft drink consumption and depression, especially in Asia. The aim of this study was to investigate the prospective association between soft drink consumption and the development of depressive symptoms. METHODS We evaluated an occupational cohort of 935 adults in Japan (2012-2016), who were free from depressive symptoms at baseline and attended a 3-y follow-up assessment. Soft drink consumption was assessed using a self-administered diet history questionnaire. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression scale. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated from multivariate logistic regression analysis controlling for sociodemographic, lifestyle, dietary, and occupational covariates. RESULTS Over the 3-y study period, 16.9% (158 cases) of the study participants reported depressive symptoms. Higher soft drink consumption was associated with higher odds of depressive symptoms. The multivariable-adjusted OR was 1.91 (95% CI, 1.11-3.29; Ptrend = 0.015) when comparing soft drink consumption of ≥4 cups/wk with consumption of <1 cup/wk. CONCLUSION The present results suggested that greater consumption of soft drinks would increase the likelihood of exhibiting depressive symptoms.
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Affiliation(s)
- Ikuko Kashino
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.
| | - Takeshi Kochi
- Department of Health Administration, Furukawa Electric Corporation, Tokyo, Japan
| | - Fumiaki Imamura
- Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, United Kingdom
| | - Masafumi Eguchi
- Department of Health Administration, Furukawa Electric Corporation, Tokyo, Japan
| | - Keisuke Kuwahara
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan; Teikyo University Graduate School of Public Health, Tokyo, Japan
| | - Akiko Nanri
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan; Department of Food and Health Sciences, International College of Arts and Sciences, Fukuoka Women's University, Fukuoka, Japan
| | - Kayo Kurotani
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan; Department of Nutritional Epidemiology and Shokuiku, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Shamima Akter
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Huan Hu
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takako Miki
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Isamu Kabe
- Department of Health Administration, Furukawa Electric Corporation, Tokyo, Japan
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
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Lee G, Han JH, Maeng HJ, Lim S. Three-Month Daily Consumption of Sugar-Sweetened Beverages Affects the Liver, Adipose Tissue, and Glucose Metabolism. J Obes Metab Syndr 2020; 29:26-38. [PMID: 32045514 PMCID: PMC7118004 DOI: 10.7570/jomes19042] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 08/26/2019] [Accepted: 10/04/2019] [Indexed: 12/19/2022] Open
Abstract
Background Growing evidence suggests links between sugar-sweetened beverages (SSBs) and metabolic disorders. We investigated the effects of SSBs commonly consumed by adolescents and their relationships to glucose metabolism and fatty liver. Methods We treated 7-week old male C57BL/6 mice with water (control) or one of three different SSBs, carbonated soda (Coca-Cola), sweetened milk coffee (Maxwell), or chocolate-added cocoa (Choco-Latte), for 13 weeks (n=10 in each group). Half of the animals were fed a regular chow diet and the other half a high-fat diet (40% fat). Body composition and biochemical variables were investigated at the end of treatment. Histology of the liver and adipose tissue, as well as molecular signaling related to glucose and lipid metabolism, were also evaluated. Results During the 13-week treatment, mice treated with chocolate-added cocoa or sweetened milk coffee showed significantly greater increases in body weight compared with controls, especially when fed a high-fat diet. Fasting glucose level was higher in the three SSB-treated groups compared with the control group. Lipid droplets in the liver, fat cell size, and number of CD68-positive cells in adipose tissue were greater in the SSB-treated groups than in the control group. SSB treatments increased the expression of genes related to inflammatory processes in the liver and adipose tissue. Phosphorylation of AKT and glycogen synthase kinase in muscle was significantly reduced in SSB-treated groups. Conclusion Daily consumption of SSBs over 3 months lead to metabolic impairment and weight gain and may contribute to development of metabolic diseases.
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Affiliation(s)
- Ghayoung Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Ji Hye Han
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Hyo Jin Maeng
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Soo Lim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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Cuadrado C, Dunstan J, Silva-Illanes N, Mirelman AJ, Nakamura R, Suhrcke M. Effects of a sugar-sweetened beverage tax on prices and affordability of soft drinks in Chile: A time series analysis. Soc Sci Med 2019; 245:112708. [PMID: 31862547 PMCID: PMC7267770 DOI: 10.1016/j.socscimed.2019.112708] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 11/19/2019] [Accepted: 11/27/2019] [Indexed: 01/15/2023]
Abstract
Chile is one of several countries that recently implemented a fiscal policy to reduce soft drink (SD) intake and obesity. In 2014 the government increased the existing ad-valorem tax on high-sugar SD by 5% and decreased by 3% the tax on low-sugar SD, based on a 6.25gr/100 ml sugar threshold. This study aims to evaluate the tax modification passed-on to consumers through prices, and to calculate changes in affordability of SDs. We analysed nationally representative consumer price index data of 41 soft drinks within 6 beverage categories between 2009 and 2016. Price change post-tax implementation was estimated for different categories (carbonates, juices, concentrates, waters and energy-sport drinks), using time-series analyses. In addition, changes in affordability were evaluated by estimating the changes in prices relative to wages. The price of carbonates increased by 5.60% (CI 95% 3.18–8.03%) immediately after the tax was implemented. A sustained increase in the prices of concentrates was observed after the implementation. Unexpectedly, a smaller increase was also seen for the price of bottled water – a category that saw no tax change. There were no effects for juices and energy-sports drinks. There was a reduction in affordability for carbonates, concentrates and waters. Overall, the fiscal policy was effective in increasing prices and there are some signs of reduced affordability. Results varied substantially among categories directly affected by the tax policy. While for carbonates the price increase exceeded the tax change (‘over-shifting’), in other categories subject to a tax cut, a price reduction was expected but the opposite occurred. As the effect of the tax on prices differed between categories, the effects of the tax policy on consumption patterns are likely to be mixed. Our findings underline the need to better understand and anticipate price setting behaviour of firms in response to a tax. Chile implemented a tax policy on soft drinks (SD) to promote healthier diets in 2014. It consists in a 5% tax increase on high-sugar SD and 3% reduction on low-sugar SD. Using consumer price index data we estimate policy impact on SD price/affordability. Overall, the policy was effective to increase prices and reduce affordability. Results varied substantially among SD categories, with some counterintuitive effects.
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Affiliation(s)
| | | | | | | | - Ryota Nakamura
- Centre for Health Economics, University of York, UK; Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Japan
| | - Marc Suhrcke
- Centre for Health Economics, University of York, UK; Luxembourg Institute of Socio-economic Research, Luxembourg
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Mosites E, Seeman S, Fenaughty A, Fink K, Eichelberger L, Holck P, Thomas TK, Bruce MG, Hennessy TW. Lack of in-home piped water and reported consumption of sugar-sweetened beverages among adults in rural Alaska. Public Health Nutr 2020; 23:861-8. [PMID: 31547892 DOI: 10.1017/S1368980019002477] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To assess whether a community water service is associated with the frequency of sugar-sweetened beverages (SSB) consumption, obesity, or perceived health status in rural Alaska. DESIGN We examined the cross-sectional associations between community water access and frequency of SSB consumption, body mass index categories, and perceived health status using data from the 2013 and 2015 Alaska Behavioral Risk Factor Surveillance System (BRFSS). Participants were categorized by zip code to 'in-home piped water service' or 'no in-home piped water service' based on water utility data. We evaluated the univariable and multivariable (adjusting for age, household income and education) associations between water service and outcomes using log-linear survey-weighted generalized linear models. SETTING Rural Alaska, USA. SUBJECTS Eight hundred and eighty-seven adults, aged 25 years and older. RESULTS In unadjusted models, participants without in-home water reported consuming SSB more often than participants with in-home water (1·46, 95 % CI: 1·06, 2·00). After adjustment for potential confounders, the effect decreased but remained borderline significant (1·29, 95 % CI: 1·00, 1·67). Obesity was not significantly associated with water service but self-reported poor health was higher in those communities without in-home water (1·63, 95 % CI: 1·05, 2·54). CONCLUSIONS Not having access to in-home piped water could affect behaviours surrounding SSB consumption and general perception of health in rural Alaska.
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Wong THT, Buyken AE, Brand-Miller JC, Louie JCY. Is there a soft drink vs. alcohol seesaw? A cross-sectional analysis of dietary data in the Australian Health Survey 2011-12. Eur J Nutr 2019; 59:2357-2367. [PMID: 31489466 DOI: 10.1007/s00394-019-02084-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Accepted: 08/28/2019] [Indexed: 12/13/2022]
Abstract
PURPOSE Previous studies in older Australians have reported higher alcohol intake in those with low added sugar intake, yet the relationship between energy in liquid form [alcoholic beverages vs. sugar-sweetened beverages (SSB)] and measures of obesity has not been evaluated. We aimed to assess the association between the energy derived from SSB and alcoholic beverages, and to model the association between the substitution of SSB with alcoholic beverages and waist circumference. METHODS In this cross-sectional analysis, dietary data from the Australian Health Survey 2011-12 were analyzed. Participants with implausible dietary intake were excluded by applying the Goldberg cut-off. Usual SSB intake of adults ≥ 19 years old was estimated using the Multiple Source Method and participants were classified into zero-, low- or high-SSB consumers according to their usual SSB intake. Energy from alcoholic beverages in the three SSB consumption groups was compared using multivariable general linear models. A substitution model was used to assess the association between the replacement of SSB with alcoholic beverages and waist circumference. RESULTS Zero-SSB consumers made up 33% of the included participants. In all age groups, zero-SSB consumers had significantly higher energy intakes from alcoholic beverages than low- and high-SSB consumers. Low- and high-SSB consumers had similar consumption of alcoholic beverages. Substituting SSB intake with alcoholic beverage intake was not associated with significant differences in waist circumference in most age groups. CONCLUSIONS Australian adults who avoid SSB are common but consume substantially more energy in the form of alcoholic beverages. An increase in alcoholic beverage intake could be an 'unintended consequence' of strictly discouraging SSB consumption.
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Affiliation(s)
- Tommy H T Wong
- School of Biological Sciences, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
| | - Anette E Buyken
- Faculty of Natural Sciences, Institute of Nutrition, Consumption and Health, Paderborn University, Paderborn, Germany
| | - Jennie C Brand-Miller
- Charles Perkins Centre, The University of Sydney, Sydney, Australia.,School of Life and Environmental Sciences, The University of Sydney, Sydney, Australia
| | - Jimmy Chun Yu Louie
- School of Biological Sciences, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China.
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Abstract
PURPOSE OF REVIEW Various policies to reduce sugar-sweetened beverages (SSBs) consumption in children have been implemented. Here, we review the evidence on whether these policies are effective in reducing SSB intake and whether a reduction in SSB intake results in a concomitant reduction in child obesity. We also highlight ethical concerns with such efforts. RECENT FINDINGS The evidence supporting relationship between SSB consumption and child body mass index (BMI) is consistently small and lacks causality. The effects of policies are unclear; taxation has no clear relationship to SSB purchasing, innovative marketing outlets make it difficult to examine the effects of restricting marketing on SSB consumption, and there is no evidence that reducing SSB availability in schools decreases consumption. Research studies with rigorous and reproducible study designs are needed to examine whether reducing SSB consumption reduces child obesity, and to identify implementable policies that not only reduce SSB consumption but also child weight.
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Affiliation(s)
- Shabnam R Momin
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Street, Houston, TX, 77030, USA.
| | - Alexis C Wood
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Street, Houston, TX, 77030, USA
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Tovar A, Vadiveloo M, Østbye T, Benjamin-Neelon SE. Maternal predictors of infant beverage consumption: results from the Nurture cohort study. Public Health Nutr 2019; 22:2591-7. [PMID: 31106724 DOI: 10.1017/S1368980019000934] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The goal of the present study was to estimate prevalence and maternal risk factors for infant beverage consumption. DESIGN Observational birth cohort. SETTING Central North Carolina, USA. PARTICIPANTS Mothers 20-36 weeks pregnant were surveyed every 3 months through their infant's first year (n 666) on their sociodemographics and infant's consumption frequency of 100 % fruit and vegetable juices and sugar-sweetened-beverages (SSB). Repeated-measure models, using a compound symmetry covariance structure, were used to assess the association of sociodemographic and maternal predictors with introducing juice and SSB separately and explored interaction terms with time to determine how the effects of the predictors change over time. RESULTS On average, mothers were 28 years old, 72 % were non-Hispanic Black and 59 % were low-income. We found time by race, income, education, maternal age and breast-feeding duration interactions for both juice and SSB consumption. At approximately 6-7 months of age through 12 months of age, being Black, having a lower income (≤$US 20 000 v. >$US 20 000 per year) and education (less than high-school degree v. high-school degree or higher), being younger (<26 years v. ≥26 years) and breast-feeding for fewer than 26 weeks were each associated with introduction of both juice and SSB consumption. CONCLUSIONS Future efforts are needed to raise awareness on the importance of national recommendations of limiting juice and SSB for infants, together with decreasing disparities in unhealthy beverage intake early in life.
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Madsen KA, Falbe J, Olgin G, Ibarra-Castro A, Rojas N. Purchasing patterns in low-income neighbourhoods: implications for studying sugar-sweetened beverage taxes. Public Health Nutr 2019; 22:1807-14. [PMID: 30915943 DOI: 10.1017/S1368980019000375] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The present study aimed to determine the store types from which people in low-income neighbourhoods purchase most sugar-sweetened beverages (SSB) and to identify associations between purchasing location and demographic characteristics. DESIGN Street-intercept surveys of passers-by near high foot-traffic intersections in 2016. Participants completed a beverage frequency questionnaire and identified the type of store (e.g. corner store, chain grocery) from which they purchased most SSB. SETTING Eight low-income neighbourhoods in four Bay Area cities, California, USA.ParticipantsSample of 1132 individuals who reported consuming SSB, aged 18-88 years, who identified as African-American (41 %), Latino (29 %), White (17 %) and Asian (6 %). RESULTS Based on surveys in low-income neighbourhoods, corner stores were the primary source from which most SSB were purchased (28 %), followed by discount stores (18 %) and chain groceries (16 %). In fully adjusted models, those with lower education were more likely to purchase from corner stores or discount groceries than all other store types. Compared with White participants, African-Americans purchased more frequently from corner stores, discount groceries and chain groceries while Latinos purchased more frequently from discount groceries. CONCLUSIONS The wide range of store types from which SSB were purchased and demographic differences in purchasing patterns suggest that broader methodological approaches are needed to adequately capture the impact of SSB taxes and other interventions aimed at reducing SSB consumption, particularly in low-income neighbourhoods.
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Blake MR, Lancsar E, Peeters A, Backholer K. Sugar-sweetened beverage price elasticities in a hypothetical convenience store. Soc Sci Med 2019; 225:98-107. [PMID: 30822609 DOI: 10.1016/j.socscimed.2019.02.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 01/30/2019] [Accepted: 02/12/2019] [Indexed: 11/30/2022]
Abstract
An increase in sugar-sweetened beverage (SSB) prices has been suggested to reduce SSB intake to improve population health. Using a discrete choice experiment, we tested the effect of price changes on beverage choices in an online hypothetical convenience store setting amongst 1,008 Australian adults in May to June 2016. From this we calculated pre-packaged beverage price elasticities overall and for health policy-target consumer subgroups; and identified consumer subgroups likely to be most reactive to beverage price changes. Using mixed logit analysis, we found similar price elasticities for age, gender and income groups. More frequent SSB consumers tended to be less sensitive to SSB price changes. Latent class analysis revealed five consumer groups, none of which fit the desirable policy-target of highly price sensitive, frequent SSB consumers. An improved understanding of responsiveness to beverage price changes and consumer preferences could improve predictions of whose health is likely to benefit most from pricing interventions.
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Affiliation(s)
- Miranda R Blake
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Deakin University, Geelong, Global Obesity Centre, Institute for Health Transformation, Australia.
| | - Emily Lancsar
- Department of Health Services Research and Policy, Research School of Population Health, Australian National University, Canberra, Australia; Centre for Health Economics, Monash University, Clayton, Australia.
| | - Anna Peeters
- Deakin University, Geelong, Global Obesity Centre, Institute for Health Transformation, Australia.
| | - Kathryn Backholer
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Deakin University, Geelong, Global Obesity Centre, Institute for Health Transformation, Australia.
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Asgari-Taee F, Zerafati-Shoae N, Dehghani M, Sadeghi M, Baradaran HR, Jazayeri S. Association of sugar sweetened beverages consumption with non-alcoholic fatty liver disease: a systematic review and meta-analysis. Eur J Nutr 2018; 58:1759-1769. [PMID: 29761318 DOI: 10.1007/s00394-018-1711-4] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 05/07/2018] [Indexed: 12/13/2022]
Abstract
PURPOSE The relationship between consumption of sugar sweetened beverages (SSB) and NAFLD has been reported in several epidemiological studies, but the results are inconsistent. The present systematic review and meta-analysis of observational studies was carried out to assess the relationship between sugar sweetened beverages consumption and NAFLD. METHODS Online databases were searched systematically through December, 2016 for studies investigating association between SSB consumption and NAFLD but limited to observational studies in human. Pooled odds ratio (OR) and 95% confidence intervals were calculated using Der-Simonian and Laird method while random effects meta-analysis was used, taking into account conceptual heterogeneity. Heterogeneity was assessed with the Cochran Q statistic and quantified with the I2 statistic. RESULTS Of the 1015 identified articles, 42 were reviewed in depth and six studies (four cross-sectional, one case-control, and one cohort) met the criteria for inclusion in our systematic review with 6326 participants and 1361 cases of NAFLD in both men and women. Finally, four cross-sectional studies were included in the meta-analysis. Higher intake of SSBs (highest compared to lowest categories) was significantly associated with NAFLD, with a 40% increased Odds of NAFLD after adjusting for important potential confounders (pooled odds ratio 1.40; 95% CI 1.07, 1.82). There was no evidence for significant heterogeneity across studies [P = 0.226 (Q statistics), I2 = 31.0%]. A significant positive association between SSB consumption and NAFLD was observed consistently in a sensitivity analysis [range of summary ORs 1.39-1.49]. There was no evidence of publication bias for the association between SSB and NAFLD. CONCLUSIONS This meta-analysis supports a positive significant association between higher consumption of SSB and NAFLD in both men and women. These findings strengthen the evidence that intake of SSBs should be limited to reduce fatty liver disease.
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Affiliation(s)
- Farzaneh Asgari-Taee
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Nahid Zerafati-Shoae
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohsen Dehghani
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Masoumeh Sadeghi
- Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Hamid R Baradaran
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
| | - Shima Jazayeri
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
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Abstract
PURPOSE OF REVIEW Obesity has grown at an alarming rate in children and adolescents. Concurrently, consumption on sugar-sweetened beverages (SSBs) also rose significantly. This review provides an overview of obesity and type 2 diabetes mellitus (T2DM) related to SSBs and current policies restricting SSBs in schools, school-based interventions, and taxation on reducing SSB intake and obesity. We also discuss challenges of and future steps for these initiatives. RECENT FINDINGS Clinical and epidemiological studies suggest a strong association between SSB intake and obesity and T2DM. School food policies have been initiated at federal, state, and local levels. School-based interventions have shown positive effects on SSB intake and obesity reduction. Taxation on SSBs is promising in combating obesity and in generating revenue. Challenges towards compliance and implementation of the policies and programs exist. The relationship between SSB and obesity and T2DM is a complex problem which requires comprehensive solutions. Continued efforts in restricting SSBs in schools are needed. Intervention programs should be tailored to age, gender, language, and culture and involve participation from families and local communities. Taxation can reduce SSB consumption by direct economic incentive, earmarking revenues to support healthy foods, and sending negative message. However, a higher tax rate may be necessary to have a measurable effect on weight.
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Affiliation(s)
- Yilin Yoshida
- Department of Health Management and Informatics, School of Medicine, University of Missouri-Columbia, CE707 CS&E Bldg., One Hospital Drive, Columbia, MO 65212, USA
- Missouri Cancer Registry and Research Center, University of Missouri-Columbia, Columbia, MO, USA
| | - Eduardo J. Simoes
- Department of Health Management and Informatics, School of Medicine, University of Missouri-Columbia, CE707 CS&E Bldg., One Hospital Drive, Columbia, MO 65212, USA
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Gollust SE, Tang X, White JM, French SA, Runge CF, Rothman AJ. Young adults' responses to alternative messages describing a sugar-sweetened beverage price increase. Public Health Nutr 2017; 20:46-52. [PMID: 27465661 PMCID: PMC10261550 DOI: 10.1017/s1368980016001816] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 05/31/2016] [Accepted: 06/06/2016] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Many jurisdictions in the USA and globally are considering raising the prices of sugar-sweetened beverages (SSB) through taxes as a strategy to reduce their consumption. The objective of the present study was to identify whether the rationale provided for an SSB price increase affects young adults' behavioural intentions and attitudes towards SSB. DESIGN Participants were randomly assigned to receive one of eight SSB price increase rationales. Intentions to purchase SSB and attitudes about the product and policy were measured. SETTING A forty-six-item cross-sectional Internet survey. SUBJECTS Undergraduate students (n 494) at a large US Midwestern university. RESULTS Rationale type was significantly associated with differences in participants' purchasing intentions for the full sample (F 7,485=2·53, P=0·014). Presenting the rationale for an SSB price increase as a user fee, an effort to reduce obesity, a strategy to offset health-care costs or to protect children led to lower SSB purchasing intentions compared with a message with no rationale. Rationale type was also significantly associated with differences in perceptions of soda companies (F 7,485=2·10, P=0·043); among low consumers of SSB, messages describing the price increase as a user fee or tax led to more negative perceptions of soda companies. CONCLUSIONS The rationale attached to an SSB price increase could influence consumers. However, these message effects may depend on individuals' level of SSB consumption.
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Affiliation(s)
- Sarah E Gollust
- Division of Health Policy and Management, University of Minnesota School of Public Health, 420 Delaware Street SE, MMC 729, Minneapolis, MN 55455, USA
| | - Xuyang Tang
- Division of Health Policy and Management, University of Minnesota School of Public Health, 420 Delaware Street SE, MMC 729, Minneapolis, MN 55455, USA
| | - James M White
- Department of Agricultural Economics, University of Wisconsin River Falls, River Falls, WI, USA
| | - Simone A French
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
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Park S, Akinbami LJ, McGuire LC, Blanck HM. Association of sugar-sweetened beverage intake frequency and asthma among U.S. adults, 2013. Prev Med 2016; 91:58-61. [PMID: 27496394 PMCID: PMC5050122 DOI: 10.1016/j.ypmed.2016.08.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 06/20/2016] [Accepted: 08/01/2016] [Indexed: 01/02/2023]
Abstract
OBJECTIVES Sugar-sweetened beverage (SSB) intake among U.S. adults is associated with obesity and type 2 diabetes. An association between SSB intake and asthma has been shown among U.S. children and Australian adults, but scant published information exists for U.S. adults. We examined associations between SSB intake and current asthma among U.S. adults, and the role of obesity in this association. METHODS We analyzed 2013 Behavioral Risk Factor Surveillance System data for 146,990 adults (≥18years) from 23 states and the District of Columbia. We used multivariable logistic regression to estimate associations between current asthma and frequency (none, <1 time/day, once/day, ≥2 times/day) of SSB intake (soda, fruit drink, sweet tea, and sports/energy drink). SSB intake was measured using two questions. Covariates included age, sex, race/ethnicity, education, and smoking. Obesity, based on self-reported height and weight, was assessed as an effect modifier. RESULTS Overall, 9.1% of adults reported current asthma: 8.5% of adults who did not consume SSBs had current asthma vs 12.1% of adults who consumed SSBs ≥2 times/day. There was no difference in asthma prevalence with SSB intake <1 time/day (8.7%) or once/day (8.7%). Among non-obese adults, the odds of having current asthma were higher among those who consumed SSBs ≥2 times/day (aOR=1.66, 95%CI=1.39, 1.99) than non-SSB consumers. However, SSB intake frequency was not associated with asthma among obese adults. CONCLUSIONS Frequent SSB consumption was associated with asthma among non-obese adults. Research on asthma prevention should further consider the potential adverse effects of high SSB intake among U.S. adults.
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Affiliation(s)
- Sohyun Park
- Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Lara J Akinbami
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA
| | - Lisa C McGuire
- Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Heidi M Blanck
- Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Shearrer GE, Daniels MJ, Toledo-Corral CM, Weigensberg MJ, Spruijt-Metz D, Davis JN. Associations among sugar sweetened beverage intake, visceral fat, and cortisol awakening response in minority youth. Physiol Behav 2016; 167:188-193. [PMID: 27660033 DOI: 10.1016/j.physbeh.2016.09.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Revised: 09/16/2016] [Accepted: 09/17/2016] [Indexed: 01/12/2023]
Abstract
CONTEXT Abdominal adiposity has long been associated with excess caloric intake possibly resulting from increased psychosocial stress and associated cortisol dysfunction. However, the relationship of sugar-sweetened beverage (SSB) intake specifically with cortisol variability and visceral adipose tissue (VAT) is unknown. OBJECTIVE To examine the relationships between SSB intake, VAT, and cortisol response in minority youth. DESIGN A cross-sectional analysis. SETTING The University of Southern California. PARTICIPANTS 60 overweight/obese Non-Hispanic Black and Hispanic adolescents ages 14-18years. MAIN OUTCOME MEASURES VAT via Magnet Resonance Imaging (MRI), cortisol awakening response (CAR) via multiple salivary samples, and SSB intake via multiple 24-hour diet recalls. SSB intake was divided into the following: low SSB consumers (<1 servings per day), medium SSB consumers (≥1-<2 servings per day), high SSB consumers (≥2 servings per day). Analysis of covariance were run with VAT and CAR as dependent variables and SSB intake categories (independent variable) with the following a priori covariates: sex, Tanner stage, ethnicity, caloric intake, and body mass index. RESULTS The high SSB intake group exhibited a 7% higher VAT compared to the low SSB intake group (β=0.25, CI:(0.03, 0.33), p=0.02). CAR was associated with VAT (β=0.31, CI:(0.01,0.23), p=0.02). The high SSB intake group exhibited 22% higher CAR compared to the low SSB intake group (β=0.30, CI:(0.02,0.48), p=0.04). CONCLUSION This is the first study exploring the relationship between SSB, VAT, and CAR. SSB consumption appears to be independently associated greater abdominal adiposity and higher morning cortisol variability in overweight and obese minority youth. This study highlights potential targets for interventions specifically to reduce SSB intake in a minority youth population.
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Affiliation(s)
- G E Shearrer
- Department of Nutrition, University of Texas, Austin, TX, United States.
| | - M J Daniels
- Department of Statistics & Data Sciences, University of Texas, Austin, TX, United States; Department of Integrative Biology, University of Texas, Austin, TX, United States
| | - C M Toledo-Corral
- Department of Public Health, California State University, Los Angeles, CA, United States
| | - M J Weigensberg
- Department of Pediatrics, Institute for Integrative Health, University of Southern California Keck School of Medicine, CA, Unites States
| | - D Spruijt-Metz
- Center for Economic and Social Research, University of Southern California, CA, Unites States
| | - J N Davis
- Department of Nutrition, University of Texas, Austin, TX, United States
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Song HJ, Paek YJ, Choi MK, Yoo KB, Kang JH, Lee HJ. Gender Differences in the relationship between carbonated sugar-sweetened beverage intake and the likelihood of hypertension according to obesity. Int J Public Health 2016; 62:573-581. [PMID: 27450984 DOI: 10.1007/s00038-016-0855-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 06/24/2016] [Accepted: 07/08/2016] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES The aim of the present study was to investigate the association between hypertension and carbonated sugar-sweetened beverages (SSB) intake according to gender and obesity. METHODS The study used data from 2007, 2008 and 2009 Korea National Health and Nutrition Examination Surveys. A total of 9869 subjects (men = 3845 and women = 6024) were included. SSB intakes were calculated from food frequency questionnaires. Odds ratios (ORs) and 95 % confidence interval (CI) for hypertension were assessed using survey logistic regression and multivariable adjusted models. RESULTS A total of 14.5 % of individuals were classified as having hypertension. The likelihood of hypertension in the third, fourth and fifth quintiles for SSB intake increased to OR 1.00, 1.20 and 1.42 respectively, after adjusting for confounding factors. Compared to the participants in the lowest tertile for SSB intake, participants in the third tertile showed an increased likelihood of hypertension with ORs (CI) of 2.00 (1.21-3.31) and 1.75 (1.23-2.49) for obese women and non-obese men, respectively. CONCLUSIONS The present study showed gender differences in the relationship between carbonated SSB intake and the hypertension according to obesity.
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Affiliation(s)
- Hong Ji Song
- Department of Family Medicine, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Seoul,, Korea
| | - Yu Jin Paek
- Department of Family Medicine, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Seoul,, Korea
| | - Min Kyu Choi
- Department of Family Medicine, Kangnam Sacred Heart Hospital, College of Medicine Hallym University, Seoul, Korea
| | - Ki-Bong Yoo
- Department of Healthcare Management, Eulji University, Seongnam-si, Korea
| | - Jae-Heon Kang
- Department of Family Medicine, Seoul Paik Hospital, College of Medicine, Inje University, Seoul, Korea
| | - Hae-Jeung Lee
- Department of Food and Nutrition, Gachon University, Seongnam-si, Korea.
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Davy BM, Jahren AH, Hedrick VE, You W, Zoellner JM. Influence of an intervention targeting a reduction in sugary beverage intake on the δ13C sugar intake biomarker in a predominantly obese, health-disparate sample. Public Health Nutr 2017; 20:25-9. [PMID: 27297740 DOI: 10.1017/S1368980016001439] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Controversy exists surrounding the health effects of added sugar (AS) and sugar-sweetened beverage (SSB) intakes, primarily due to a reliance on self-reported dietary intake. The purpose of the current investigation was to determine if a 6-month intervention targeting reduced SSB intake would impact δ13C AS intake biomarker values. DESIGN A randomized controlled intervention trial. At baseline and at 6 months, participants underwent assessments of anthropometrics and dietary intake. Fasting fingerstick blood samples were obtained and analysed for δ13C value using natural abundance stable isotope MS. Statistical analysis included descriptive statistics, correlational analyses and multilevel mixed-effects linear regression analysis using an intention-to-treat approach. SETTING Rural Southwest Virginia, USA. SUBJECTS Adults aged ≥18 years who consumed ≥200 kcal SSB/d (≥837 kJ/d) were randomly assigned to either the intervention (n 155) or a matched-contact group (n 146). Participants (mean age 42·1 (sd 13·4) years) were primarily female and overweight (21·5 %) or obese (57·0 %). RESULTS A significant group by time difference in δ13C value was detected (P<0·001), with mean (sd) δ13C value decreasing in the intervention group (pre: -18·92 (0·65) ‰, post: -18·97 (0·65) ‰) and no change in the comparison group (pre: -18·94 (0·72) ‰, post: -18·92 (0·73) ‰). Significant group differences in weight and BMI change were also detected. Changes in biomarker δ13C values were consistent with changes in self-reported AS and SSB intakes. CONCLUSIONS The δ13C sugar intake biomarker assessed using fingerstick blood samples shows promise as an objective indicator of AS and SSB intakes which could be feasibly included in community-based research trials.
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Ruff RR, Zhen C. Estimating the effects of a calorie-based sugar-sweetened beverage tax on weight and obesity in New York City adults using dynamic loss models. Ann Epidemiol 2015; 25:350-7. [PMID: 25659449 DOI: 10.1016/j.annepidem.2014.12.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 12/27/2014] [Indexed: 12/21/2022]
Abstract
PURPOSE Sugar-sweetened beverages (SSBs) contribute to weight gain and increase the risk of obesity. In this article, we determine the effects of an innovative SSB tax on weight and obesity in New York City adults. METHODS Dynamic weight loss models were used to estimate the effects of an expected 5800-calorie reduction resulting from an SSB tax on weight and obesity. Baseline data were derived from the New York City Community Health Survey. One, five, and 10-year simulations of weight loss were performed. RESULTS Calorie reductions resulted in a per-person weight loss of 0.46 kg in year 1 and 0.92 kg in year 10. A total of 5,531,059 kg was expected to be lost over 10 years when weighted to the full New York City adult population. Approximately 50% of overall bodyweight loss occurred within the first year, and 95% within 5 years. Results showed consistent but nonsignificant decreases in obesity prevalence. CONCLUSIONS SSB taxes may be viable strategies to reduce obesity when combined with other interventions to maximize effects in the population.
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Affiliation(s)
- Ryan Richard Ruff
- Department of Epidemiology & Health Promotion, New York University College of Dentistry, New York University Global Institute of Public Health, New York.
| | - Chen Zhen
- Food and Nutrition Policy Research Program, RTI International, Research Triangle Park, NC
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Kumar GS, Park S, Onufrak S. Association between reported screening and counseling about energy drinks and energy drink intake among U.S. adolescents. Patient Educ Couns 2014; 94:250-254. [PMID: 24176609 DOI: 10.1016/j.pec.2013.09.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Revised: 09/13/2013] [Accepted: 09/27/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVE Possible adverse health consequences of excessive energy drink (ED) consumption have led to recommendations by the American Academy of Pediatrics discouraging ED intake by youth. However, limited information on ED counseling by health care providers exists. METHODS Data was obtained from the 2011 YouthStyles Survey administered to youth aged 12-17 (n=815). The outcome variable was ED consumption (none vs. ≥1 time/week) and exposure variables were screening and counseling about ED (if doctor/nurse asked about ED consumption and if doctor/nurse recommended against ED consumption). RESULTS Approximately 8.5% of youth consumed energy drinks weekly, 11.5% reported being asked by their doctor/nurse about frequency of ED consumption, and 11.1% were advised by their doctor/nurse against ED intake. Multivariable logistic regression analysis revealed that the odds for drinking ED ≥1 time/week was significantly higher in youth who were asked how often they drank ED by their doctor/nurse (odds ratio=2.46) vs. those who were not asked. CONCLUSION About 1 in 9 youth reported receiving counseling discouraging ED consumption from their doctor/nurse, and a greater proportion of youth who were screened about ED also reported ED consumption. PRACTICE IMPLICATIONS Efforts by health care providers to educate youth about potential harms of consuming ED are needed.
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Affiliation(s)
- Gayathri Suresh Kumar
- Epidemic Intelligence Service, Office of Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Sohyun Park
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Stephen Onufrak
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
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