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Abstract Background Higher consumption of sugary beverages (SB) has been associated with type 2 diabetes (T2D), but whether these associations are modified by physical activity remains unclear. This study aimed to examine the associations of SB intake, including sugar-sweetened beverages (SSB), artificially sweetened beverages (ASB), and natural juices (NJ) with the risk of incident T2D, and the potential role of physical activity. Methods We included 153,862 diabetes-free participants in the UK Biobank who completed both the International Physical Activity Questionnaire at recruitment (2006–2010) and at least one 24-h dietary recall questionnaire in 2009–2012. We assessed the associations of each SB with the risk of incident T2D using Cox proportional hazard models, and explored the interactions between each SB and physical activity. Results During a median follow-up of 11.8 years, 6631 participants developed incident T2D. Participants consuming more SSB and ASB (comparing > 2 to 0 unit/d) had a higher hazard of T2D (hazard ratio [HR]: 1.17, 95% confidence interval [CI]: 1.05–1.31 for SSB; 1.54, 1.37–1.74 for ASB), while medium intake of NJ showed an inverse association (HR> 0–1 vs. 0 unit/d: 0.87, 95% CI: 0.82–0.92; HR> 1–2 vs. 0 unit/d: 0.88, 95% CI: 0.81–0.97) with incident T2D. No significant interactions between physical activity and SSB/ASB were found (P-interaction=0.204 for SSB, 0.926 for ASB), but the protective association of medium NJ intake with T2D was stronger among participants with higher level of physical activity (P-interaction = 0.043). Conclusions Higher intake of SSB and ASB was related to higher risks of T2D. Medium NJ intake was associated with a lower risk of T2D, particularly among individuals with higher physical activity level. These findings emphasized the importance of healthy beverage intake and adequate physical activity in diabetes prevention.

BACKGROUND: The global nutrition transition is associated with increased consumption of ultra-processed snack foods and sugar-sweetened beverages (UPF/SSB), contributing to the double burden of child obesity and undernutrition. METHODS: This cross-sectional study describes the prevalence of maternal and child UPF/SSB consumption and the factors associated with frequent consumption in a convenience sample of 749 children ages 6 months through 6 years and their mothers participating in a community-based child oral health program in five informal settlement communities in Mumbai, India. Mothers were interviewed regarding maternal and child oral health and nutrition characteristics, including consumption of beverages and foods associated with tooth decay-milk, soda, tea with sugar, sweets, and chips/biscuits-using standardized questionnaires. Spearman correlations were used to assess for associations between various social factors and the frequency of maternal and child consumption of the five food categories. Chi-square tests were used to assess differences in child consumption patterns by age groups. RESULTS: Though reported soda consumption was low among both mothers and children, nearly 60% of children consumed sweets and chips/biscuits daily, four to five times the rate of mothers. Factors associated with childrens frequent consumption of UPF/SSB included lower maternal education level, frequent maternal consumption of UPF/SSB, greater number of household members, greater amount of money given to the child, and closer proximity to a store. CONCLUSION: Our findings demonstrate social factors that may promote UPF/SSB consumption. The nutritional dangers of sugary drinks and non-nutritious snacks for mothers and young children should be addressed across maternal-child health, education, and social service programs. Early childhood nutrition interventions should involve the entire family and community and emphasize the need to limit childrens consumption of unhealthy foods and beverages from an early age.

Adequate water intake is essential for human health. Sugary beverage taxes are a best buy policy to reduce obesity and diet-related non-communicable diseases. Food-based dietary guidelines (FBDGs) promote healthy dietary patterns. The study purpose was to evaluate national FBDGs for countries with sugary beverage tax legislation (2000–2023) to promote water and discourage sugary beverage consumption. We developed a coding framework to conduct a content analysis of FBDG documents, and used six indicators to identify messages and images to assign healthy hydration recommendation (HHR) scores from 0–12 to compare FBDGs across countries and six regions. Results showed 93 countries with sugary beverage tax legislation of which 58 countries (62%) had published FBDGs (1998–2023). Of 58 FBDGs reviewed, 48 (83%) had complementary recommendations that encouraged water and discouraged sugary beverages. Of 93 countries, 13 (14%) had the highest HHR scores (11–12); 22, (24%) had high HHR scores (9–10); 20 (21%) had medium HHR scores (4–8); 3 (3%) had low HHR scores (0–3); and 35 (38%) countries had no FBDGs. To reduce health risks for populations, governments must ensure policy coherence to optimize sugary beverage tax impacts by developing FBDGs that encourage water and discourage sugary beverages complementary to national policies. [ABSTRACT FROM AUTHOR]

Background: Previous studies show social inequality in tooth loss, but the underlying pathways are not well understood. The aim was to investigate the mediated proportion of sugary beverages (SBs) and diabetes and the association between educational level and tooth loss, and to investigate whether the indirect effect of SBs and diabetes varied between educational groups in relation to tooth loss. Methods: Data from 47,109 Danish men and women aged 50 years or older included in the Danish Diet, Cancer and Health Study was combined with data from Danish registers. Using natural effect models, SBs and diabetes were considered as mediators, and tooth loss was defined as having <15 teeth present. Results: In total, 10,648 participants had tooth loss. The analyses showed that 3% (95% confidence interval 2–4%) of the social inequality in tooth loss was mediated through SBs and diabetes. The mediated proportion was mainly due to differential exposure to SBs and diabetes among lower educational groups. Conclusions: The findings show that SBs and diabetes to a minor degree contribute to tooth-loss inequalities. The explanation indicates that individuals in lower educational groups have higher consumption of SBs and more often suffer from diabetes than higher educational groups. [ABSTRACT FROM AUTHOR]

Abstract Background The global nutrition transition is associated with increased consumption of ultra-processed snack foods and sugar-sweetened beverages (UPF/SSB), contributing to the double burden of child obesity and undernutrition. Methods This cross-sectional study describes the prevalence of maternal and child UPF/SSB consumption and the factors associated with frequent consumption in a convenience sample of 749 children ages 6 months through 6 years and their mothers participating in a community-based child oral health program in five informal settlement communities in Mumbai, India. Mothers were interviewed regarding maternal and child oral health and nutrition characteristics, including consumption of beverages and foods associated with tooth decay—milk, soda, tea with sugar, sweets, and chips/biscuits—using standardized questionnaires. Spearman correlations were used to assess for associations between various social factors and the frequency of maternal and child consumption of the five food categories. Chi-square tests were used to assess differences in child consumption patterns by age groups. Results Though reported soda consumption was low among both mothers and children, nearly 60% of children consumed sweets and chips/biscuits daily, four to five times the rate of mothers. Factors associated with children’s frequent consumption of UPF/SSB included lower maternal education level, frequent maternal consumption of UPF/SSB, greater number of household members, greater amount of money given to the child, and closer proximity to a store. Conclusion Our findings demonstrate social factors that may promote UPF/SSB consumption. The nutritional dangers of sugary drinks and non-nutritious snacks for mothers and young children should be addressed across maternal–child health, education, and social service programs. Early childhood nutrition interventions should involve the entire family and community and emphasize the need to limit children’s consumption of unhealthy foods and beverages from an early age.

Objective: To explore the associations between the consumption of three categories of ultra-processed food (sugary beverages, sweet, and salty snacks) and body mass index (BMI) among Chilean university students. Methods: We conducted a multi-center, descriptive study among 2,039 students from 6 Chilean universities. Food consumption was surveyed using a validate food survey. That height and body weight were objectively measured to calculate BMI for determining weight status, and also, tobacco use and physical activity were measured. Results: An intake equal to or higher than 1 serving of sugary beverage a day was associated with greater odds of obesity in university students (OR:1.32 [95% CI: 1.00, 1.74]), 2 servings/day (OR: 1.30 [95% CI: 1.04, 1.50]), and 3 servings/day (OR: 1.39 [95% CI: 1.05, 1.80]). Neither consumption of sweet nor salty snacks (≥1 servings/day) related to differential odds of obesity: (OR: 0.83 [95% CI: 0.42, 1.64]) and (OR: 1.79 [95% CI: 0.93, 3.41]), respectively. Conclusion: In a sample of Chilean university students, consumption of sugary beverages, and not consumption of sweet or salty snacks, was associated with obesity. [ABSTRACT FROM AUTHOR]

Background Sugar-sweetened beverage (SSB) taxes are recognised as an effective intervention to prevent obesity. More countries are adopting SSB taxes, but the process of the adoption is politically complex. Objective This study aimed to analyse how public participation processes influenced the South African tax. Methods We conducted a content analysis of documents associated with the process of adopting the tax. Records were identified utilising the Parliamentary Monitoring Group database, including draft bills, meeting minutes and written submissions. The records were categorised and then inductively coded to identify themes and arguments. Results We identified six cross-cutting themes advanced by stakeholders: economic considerations, impact on the vulnerable, responsiveness of an SSB tax to the problem of obesity, appropriateness of an SSB tax in South Africa, procedural concerns, and structure of the tax. Stakeholder views and arguments about the tax diverged based on their vested interests. The primary policymaker was most responsive to arguments concerning the economic impact of a tax, procedural concerns and the structure of the tax, reducing the effective rate to address industry concerns. Conclusion Both supportive and opposing stakeholders influenced the tax. Economic arguments had a significant impact. Arguments in South Africa broadly echoed arguments advanced in many other jurisdictions.

OBJECTIVES: To examine associations of maternal consumption of 100% juice and sugar-sweetened beverages (SSBs) in the third trimester of pregnancy with infant weight status at 6 and 12 months. METHODS: We studied 379 mother-infant dyads from Rise & SHINE, a prospective cohort study. Exposures were maternal consumption of 100% juice and SSBs in the third trimester. Outcome measures were infant weight-for-length (WFL) z-scores at 6 and 12 months and rapid infant weight gain (RIWG; change in weight-for-age z-score ≥0.67) from birth to 6 and 12 months. RESULTS: Mean (SD) maternal age was 32.8 (5.1) years; 71.7% reported household income ≥$50,000. In the third trimester, nearly daily or daily consumption of 100% juice and SSBs was 25.9% and 16.6%, respectively. Mean (SD) WFL z-scores at 6 and 12 months were 0.35 (0.96) and 0.50 (0.98). RIWG was present in 30.2% and 36.6% of infants from birth to 6 months and birth to 12 months, respectively. In multivariable models, 100% juice consumption was associated with higher WFL z-score at 6 months (b = 0.26; 95% confidence interval [CI]: 0.03, 0.49) and higher odds of RIWG from birth to 6 months (adjusted odds ratio [aOR] = 2.09; 95%CI: 1.23, 3.56) and birth to 12 months (aOR = 1.85; 95%CI: 1.04, 3.28). 100% juice consumption was not associated with WFL z-score at 12 months and SSB consumption was not associated with any of the outcomes. CONCLUSIONS: Consumption of 100% juice, but not SSBs, in the third trimester of pregnancy is associated with infant weight status at 6 months and RIWG. [ABSTRACT FROM AUTHOR]

Sugar-sweetened beverage (SSB) taxes are recognised as an effective intervention to prevent obesity. More countries are adopting SSB taxes, but the process of the adoption is politically complex. This study aimed to analyse how public participation processes influenced the South African tax. We conducted a content analysis of documents associated with the process of adopting the tax. Records were identified utilising the Parliamentary Monitoring Group database, including draft bills, meeting minutes and written submissions. The records were categorised and then inductively coded to identify themes and arguments. We identified six cross-cutting themes advanced by stakeholders: economic considerations, impact on the vulnerable, responsiveness of an SSB tax to the problem of obesity, appropriateness of an SSB tax in South Africa, procedural concerns, and structure of the tax. Stakeholder views and arguments about the tax diverged based on their vested interests. The primary policymaker was most responsive to arguments concerning the economic impact of a tax, procedural concerns and the structure of the tax, reducing the effective rate to address industry concerns. Both supportive and opposing stakeholders influenced the tax. Economic arguments had a significant impact. Arguments in South Africa broadly echoed arguments advanced in many other jurisdictions. [ABSTRACT FROM AUTHOR]

Summary: Sugary beverage consumption is associated with many health risks. This study used a proof‐of‐concept media campaign typology to examine U.S. beverage campaigns that promoted healthy beverages and encouraged or discouraged sugary beverages. We used a three‐step systematic scoping review to identify, organize, analyze, and synthesize evidence. Step 1 used Preferred Reporting Items for Systematic Review and Meta‐Analysis Extension for Scoping Reviews (PRISMA‐ScR) guidelines to search four electronic databases and gray literature through 2021. Step 2 categorized relevant media campaigns using a media campaign typology. Step 3 examined campaign evaluation outcomes. We identified 280 campaigns organized into six campaign typology categories. The media landscape was dominated by corporate marketing campaigns for branded sugary beverages (65.8%; n = 184) followed by public awareness (9.6%; n = 27), public policy (8.2%; n = 23), social marketing (7.1%; n = 20), corporate social responsibility (5.7%; n = 16), and countermarketing (3.6%; n = 10) campaigns. Evaluations for 20 unique campaigns implemented over 30 years (1992–2021) across 14 states showed reduced sugary beverage or juice and increased water or low‐fat milk sales and intake. Positive short‐term cognitive and mid–term retail and behavioral changes were reported. There was limited evidence for long‐term policy, social norm, and population health outcomes. Future research is needed to use media campaigns in strategic communications to reduce sugary beverage health risks for Americans. [ABSTRACT FROM AUTHOR]

PurposeThe role of consumption of added sugars in cancers of the upper aerodigestive tract (UADT) is unclear. We examined associations between sugary beverages and susceptibility to UADT cancer as well as overall survival among UADT cancer patients.MethodsThe association between dietary added sugar and susceptibility to UADT cancers or overall survival among 601 UADT cancer cases was evaluated using data from a population-based case-control study conducted in Los Angeles County. Unconditional logistic regression was used to estimate odds ratios and 95 % confidence intervals (CI) for cancer susceptibility, and Cox regression was used to estimate hazards ratios (HRs) with 95 % CIs for survival, adjusting for relevant confounders.ResultsA total of 248 deaths were observed during follow-up (median 12.1 years). A positive association was observed with consumption of grams of sugar from beverages, including soft drinks and fruit juices, and poorer survival among UADT cancer cases (aHR, Q4 vs. Q1:1.88; 95 % CI 1.29, 2.72; p for trend = 0.002), as well as servings of sugary beverages (aHR, Q4 vs. Q1: 95 % CI 1.97, 95 % CI 1.32-2.93). This was due largely to consumption of sugars from soft drinks. Particularly, high consumption of sugary beverages was associated with poorer survival among esophageal cancer cases, driven by squamous cancers. No association was observed between sugary beverages and cancer susceptibility.ConclusionThese findings suggest that consumption of sugary beverages may decrease survival associated with UADT cancers. Additional studies should be conducted to examine survival among cancer patients consuming high amounts of added or refined sugars. Such studies may highlight prognostic factors for UADT cancers.

Objective: To promote healthy beverage consumption among 9–12 grade students (ages 14–18) by means of a 4-week curriculum promoting increased awareness of drinks containing added sugar and the association between sugar-sweetened beverage consumption and health risks. Design: Quasi-experimental pre–post design. Setting: High schools in Northern California with at least 50% of students eligible for free or reduced-price meals. Method: A 4-lesson version of the Rethink Your Drink high school curriculum was piloted in three high schools in two northern California counties. Two high schools in the same area served as comparison sites. A survey of beverage-related knowledge, behaviours, perceptions and self-efficacy was administered to intervention and comparison students before and after the intervention. Focus groups with students and an online survey and semi-structured interviews with teachers were conducted following the intervention. Results: Intervention students reported significantly greater frequency of reading Nutrition Facts labels and understanding of beverage choice influences and decreased consumption of diet soda than comparison students. A decrease of 0.26 times per day in consumption of sugar-sweetened beverages relative to the comparison group was not significant. Conclusion: The intervention resulted in some positive outcomes, but improvements in targeted beverage consumption were not significant. Students and teachers want shorter, more engaging and experiential curricula that build on previous learning. Findings point to actionable recommendations for improvement of high school healthy beverage curricula and suggest the need for reinforcement using a multi-level approach. [ABSTRACT FROM AUTHOR]

Background and Aims: Metabolic syndrome (MetS) is an important determinant of cardiometabolic disease development, with excessive sugar intake as one of the key modifiable risk factors. However, evidence on the association between sugar-sweetened beverages (SSB), their replacement by low/no caloric beverages (LNCB), and MetS development is still limited., Methods and Results: Data from participants' of Lifelines (n = 58 220), NQPlus (n = 1094) and Feel4Diabetes (n = 342) were prospectively analysed. Dose-response associations were investigated using restricted cubic spline analyses (Lifelines). Cox proportional hazard regression analysis with robust variance was used to quantify associations between intakes of SSB, fruit juices (FJ) and LNCB and MetS incidence; data were pooled using random-effects models. Associations were adjusted for demographic, lifestyle and other dietary factors. In Lifelines, NQPlus, and Feel4Diabetes, 3853 (7 %), 47 (4 %), and 39 (11 %) participants developed MetS, respectively. Pooled analyses showed that each additional serving of SSB was associated with a 6 % higher risk of MetS (95%CI 1.02-1.10). A J-shaped association was observed for FJ and MetS, with a significant inverse association at moderate intake levels (IPR 0.89, 95 % CI 0.82-0.96). LNCB intake was not associated with MetS (IPR 1.59, 95%CI 0.74-2.43), but findings across studies were inconsistent (I 2 94 %, p-value <0.01). Replacing SSB with FJ or LNCB did not show any associations with MetS incidence., Conclusion: SSB intake was adversely associated with MetS incidence. A J-shaped association was observed between FJ and MetS. For LNCB, results were inconsistent across studies and therefore findings must be interpreted cautiously., Competing Interests: Declaration of competing interest SSM-M has received recent research funding for epidemiological studies on dairy products and cardiometabolic diseases from the Dutch Dairy Association and the Danish Dairy Research Foundation. JCGH is a member of Dupont/IFF and Mars Scientific Advisory Boards and has received honorariums from the International Sweeteners Association together with AR. JCGH and JAH are also conducting the SWITCH trial funded by the American Beverage Association. JCGH and AR have received an honorarium from Unilever, the International Sweeteners Association, and Nestlé. In the past, EJMF has received an unrestricted grant from Friesland Campina and the European Beer Institute and conducted a study on added sugar and individual sugars partly funded by Kenniscentrum Suiker en Gezondheid (2011). Other authors have no conflicts of interest to be disclosed., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: The associations between specific types of sugary beverages and major chronic respiratory diseases remain relatively unexplored., Objectives: This study aimed to investigate the associations of sugar-sweetened beverages (SSBs), artificially sweetened beverages (ASBs), and natural juices (NJs) with chronic obstructive pulmonary disease (COPD), asthma, and asthma-chronic obstructive pulmonary disease overlap syndrome (ACOS)., Methods: This prospective cohort study included 210,339 participants from the UK Biobank. Sugary beverage intake was measured in units (glasses/cans/cartons/250 mL) through 24-h dietary questionnaires. Logistic regression and Cox proportional hazards models were used to analyze the prevalence and incidence, respectively. Quantile G-computation was used to estimate the joint associations and relative contributions of the 3 types of sugary beverages., Results: Over a median follow-up of 11.6 y, 3491 participants developed COPD, 4645 asthma, and 523 ACOS. In prevalence analysis, certain categories of SSB and NJ consumption were associated with increased asthma prevalence, while high ASB consumption (>2 units/d) was linked to higher risks of all 3 outcomes. In incidence analysis, high SSB consumption (>2 units/d) was associated with incident COPD (hazard ratio [HR]: 1.53; 95% confidence interval [CI]: 1.19, 1.98) and asthma (HR: 1.22; 95% CI: 0.98, 1.52). Dose‒response relationships were observed for ASB consumption with all 3 outcomes (continuous HR: 1.98; 95% CI: 1.36, 2.87, for COPD; continuous HR: 1.65; 95% CI: 1.24, 2.20, for asthma; and continuous HR: 2.84; 95% CI: 1.20, 6.72, for ACOS). Moderate NJ consumption (>0-1 unit/d) was inversely associated with COPD (HR: 0.89; 95% CI: 0.82, 0.97), particularly grapefruit and orange juice. Joint exposure to these beverages (per unit increase) was associated with COPD (HR: 1.15; 95% CI: 1.02, 1.29) and asthma (HR: 1.16; 95% CI: 1.06, 1.27), with ASBs having greater positive weights than SSBs., Conclusions: Consumption of SSBs and ASBs was associated with increased risks of COPD, asthma, and potentially ACOS, whereas moderate NJ consumption was associated with reduced risk of COPD, depending on the juice type., Competing Interests: Conflict of interest The authors report no conflicts of interest., (Copyright © 2024 American Society for Nutrition. Published by Elsevier Inc. All rights reserved.)

Abstract Background Taxes on sugary beverages are an emerging strategy to improve health by reducing consumption and raising revenues to support community wellbeing. However, taxes may have unintended consequences, and perceptions of these consequences may affect attitudes towards this policy. Methods In June 2017, the Seattle City Council passed an ordinance imposing a tax on sugary beverages, effective January 1, 2018. Between October and December 2017, we recruited 851 adults in Seattle to complete a survey (telephone or online) about support for the tax and their perceptions of tax-related health and economic impacts. We first analyzed data for the full sample. We then tested for differences in participants’ responses by household income level (

The consumption of sugar-sweetened beverages (SSB) and 100% juice before age 12 months is discouraged. We examine racial/ethnic differences in SSB and 100% juice consumption when infants were 6- and 12-months old and examine links between fathers’ and infants’ beverage consumption. Participants were from a longitudinal cohort of infants and their parents (recruited 2016–2018), followed from birth until the child was 24 months. In 2020, we analyzed data collected when infants were 6- (N = 352 infants and 168 fathers) and 12-months (N = 340 infants and 152 fathers) old. Based on maternal report, 13% of infants consumed 100% juice at 6 months and 31% at 12 months. Two percent of infants consumed SSB at 6 months and 7% at 12 months. In models adjusting for income and education, Black/African American (Black/AA) and Hispanic infants were 5–6 times as likely at 6 months and 3 times as likely at 12 months to consume 100% juice compared with non-Hispanic white and Asian infants. At 12 months, Black/AA and Hispanic infants were 6–7 times as likely to consume SSB than non-Hispanic white and Asian infants after adjusting for covariates. In unadjusted models, infants were more likely to consume 100% juice and SSB at 12 months when their fathers were high consumers (>12times/month) of the beverage; effects were no longer significant after adjusting for income, race/ethnicity, education and maternal beverage consumption. Results highlight the need to implement culturally responsive interventions promoting healthy beverage consumption in infants prior to birth and should concurrently target fathers, in addition to mothers.

Objectives: The unresolved issue of the relationship between sex differences in tea, coffee, and beverage consumption and malignancy risk prompted our study in 2022. Methods: Logistic proportional hazards models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) in our investigation of the associations between cancer risk and tea, coffee, and beverage consumption. Results: Our findings revealed that frequent consumption of white tea significantly reduced the occurrence of malignant tumours, but this effect was detected only in the fully adjusted model for males (OR: 0.736, 95% CI: 0.095-5.704). The amount of sugar added to coffee was associated with an increased risk of malignancy in a dose-dependent manner (P for trend = 0.001), with significance observed for both men (P for trend = 0.049) and women (P for trend = 0.005) in the final model. Notably, individuals who consumed more than 2100 ml of sugary beverages daily had a statistically significant reduction in malignancy risk (OR: 0.219, 95% CI: 0.052-0.917). Interestingly, the intake of sugary beverages had a protective effect on cancer incidence, with a significant effect on males (P for trend = 0.031) but not females (P for trend = 0.096) in the final model. Conclusions: Our study highlights the substantial impact of regular white tea consumption on reducing the risk of malignant tumours in males. This study first reported that the potential protective effect of consuming sugary beverages is predominantly observed in males, and a correlation between the amount of sugar added to coffee and a heightened risk of malignancy., Competing Interests: Competing Interests: The authors have declared that no competing interest exists., (© The author(s).)

• California regulates the provision of sugar-sweetened beverages and juice by child care facilities. • California working households with preschool-age children increased their juice purchases right after the regulation became effective. • However, such offsetting increase disappears after 1 year. • We find no increases in the purchases of sugary substitutes. • Regulating the consumption of sugary drinks in child care facilities may be an effective policy to lower children's preferences for sugary drinks. Excessive sugar intake is associated with higher risk for a range of diseases in children, including childhood obesity. To reduce sugar intake in children, California regulates the provision of sugar-sweetened beverages and juice by child care facilities. The regulation may reduce the consumption of beverages high in sugar in the short run and weaken their preferences for sugary drinks in the long run. Whether these objectives are achieved depends on how parents respond to the regulation by providing sugary drinks at home. Using detailed scanner data on grocery purchases, we find that affected California households increased their juice purchases right after the regulation became effective. However, this increase disappears after 1 year. Moreover, we do not find an increase in the purchases of sugary substitutes. Our findings suggest that parents provide more juice for their children after child care facilities limit their provision of sugary beverage, but such offsetting behavior disappears after 1 year. Regulating the consumption of sugary drinks in child care facilities may be an effective policy to lower children's preferences for sugary drinks. [ABSTRACT FROM AUTHOR]

Overconsumption of sugary drinks is linked with obesity. These beverages have been the target of recent public health policies, and, simultaneously, some firms have altered their pricing of such beverages, including charging the same price for all beverage sizes ("any‐size‐same‐price" pricing). We compare the effect of any‐size‐same‐price pricing versus standard pricing on soft drink beverage size choices and further explore the effect of this firm lever under different health‐related policy situations. Overall, we show that any‐size‐same‐price pricing increases consumers' focus on the value of getting a good financial deal and thereby increases beverage size selections. Further, the allure of any‐size‐same‐price pricing prevents calorie postings from successfully reducing choice of larger sizes as occurs under standard pricing. However, a more graphic health intervention can reduce the appeal of larger sizes under any‐size‐same‐price pricing. Finally, the findings are not moderated by diet versus nondiet beverage selections, indicating that consumers do not perceive the value of larger sizes under any‐size‐same‐price pricing to come from getting more calories. We conclude by discussing how this work can improve the design of public health nutrition policies. This article is part of the issue "Transformative Consumer Research": Davis & Pechmann (2019): https://doi.org/10.1002/jcpy.1139 [ABSTRACT FROM AUTHOR]

Consumption of added sugar is associated with weight gain and metabolic syndrome, but most importantly with cardiovascular disease (CVD) morbidity and mortality. Sugarsweetened beverages (SSBs) in the form of soft drinks or sodas constitute a major source of added sugar with its attendant ill effects on health. Of particular concern is the rising consumption of soft drinks among young people. The World Health Organization (WHO) recommends the reduction of free sugars to <10% of total energy intake due to their potential implications in dental caries, weight gain and CVD consequences, however, adherence to this recommendation is generally very low. Noncaloric drinks in the form of artificially sweetened beverages (ASBs) (diet sodas) are popular as alternatives to SSBs. However, these sweeteners may also have various negative, albeit at a lesser degree, health outcomes, including weight gain, obesity, metabolic syndrome, type II diabetes, and CV events. Finally, substantially lower health risks are incurred from 100% fruit juice consumption compared with SSBs. All these issues are herein reviewed and measures are discussed to lessen the consequences of such an unhealthy dietary behavior. [ABSTRACT FROM AUTHOR]

The frequent consumption of sugary beverages is associated with many health risks. This study examined how persuasive appeals and graphics were used in different media campaigns to encourage and discourage sugary beverages and water in the United States (U.S.) The investigators developed a codebook, protocol and systematic process to conduct a qualitative content analysis for 280 media campaigns organized into a typology with six categories. SPSS version 28.0 was used to analyze rational and emotional appeals (i.e., positive, negative, coactive) for campaign slogans, taglines and graphic images (i.e., symbols, colors, audiences) for 60 unique campaigns across the typology. Results showed that positive emotional appeals were used more to promote sugary beverages in corporate advertising and marketing (64.7%) and social responsibility campaigns (68.8%), and less to encourage water in social marketing campaigns (30%). In contrast, public awareness campaigns used negative emotional appeals (48.1%), and advocacy campaigns combined rational (30%) and emotional positive (50%) and negative appeals (30%). Public policy campaigns used rational (82.6%) and positive emotional appeals (73.9%) to motivate support or opposition for sugary beverage tax legislation. Chi-square analyses assessed the relationships between the U.S. media campaign typology categories and graphic elements that revealed three variables with significant associations between the campaign typology and race/ethnicity (χ 2 (103) = 32.445, p = 0.039), content (χ 2 (103) = 70.760, p < 0.001) and product image (χ 2 (103) = 11.930, p = 0.036). Future research should examine how positive persuasive appeals in text and graphics can promote water to reduce sugary beverage health risks.

Background: The extent to which physical activity attenuates the detrimental effects of sugar (SSBs)- or artificially-sweetened beverages (ASBs) on the risk of cardiovascular disease is unknown., Methods: We used Cox proportional-hazards models to calculate hazard ratios and 95% confidence interval [HR (CI)] between SSB or ASB intake and physical activity with cardiovascular disease risk among 65,730 women in the Nurses' Health Study (1980-2016) and 39,418 men in the Health Professional's Follow-up Study (1986-2016), who were free from chronic diseases at baseline. SSBs and ASBs were assessed every 4-years and physical activity biannually., Results: A total of 13,269 cardiovascular events were ascertained during 3,001,213 person-years of follow-up. Compared with those that never/rarely consumed SSBs or ASBs, HR and 95% CI for cardiovascular disease for participants consuming ≥2 servings/day were 1.21 (95% CI,1.12 to 1.32; P -trend<0.001) and 1.03 (95% CI, 0.97 to 1.09; P -trend=0.06), respectively. In the joint analyses, for participants meeting and not meeting physical activity guidelines (<7.5 vs ≥7.5 MET-h/week) as well as consuming ≥2 servings/day of SSBs or ASBs, the HRs for cardiovascular disease were 1.15 (95% CI, 1.08 to 1.23) and 0.96 (95% CI, 0.91 to 1.02), and 1.47 (95% CI, 1.37 to 1.57) and 1.29 (95% CI, 1.22 to 1.37) respectively, compared with participants who met physical activity guidelines and never/rarely consumed these beverages. Similar patterns were observed when coronary heart disease and stroke were analyzed., Conclusions: Our findings suggest that among physically active participants, higher SSB intake, but not ASBs, is associated with a higher cardiovascular risk. Our results support current recommendations to limit the intake of SSB and maintain adequate physical activity levels.

Objective: To assess potential misperceptions among parents regarding the healthfulness of sugary drinks for their children.Design: Online survey of parents. Participants identified the categories and specific brands of sugary drinks they provided for their children. They also indicated their perceptions of sugary drink categories and brands as healthy options for children, perceived importance of on-package claims in purchase decisions and their concerns about common sugary drink ingredients.Setting: Online market research panel.Subjects: Parents (n 982) of 2- to 17-year-olds, 46 % non-white or Hispanic.Results: Ninety-six per cent of parents provided on average 2·9 different categories of sugary drinks for their children in the past month. Flavoured waters, fruit drinks and sports drinks were rated as the healthiest sugary drink categories. Across all categories and brands, parents who purchased specific products rated them as significantly healthier than those who did not (P<0·05). Over half of parents reported concern about caffeine, sugar and artificial sweeteners in sugary drinks that their children consume and approximately one-third reported that on-package ingredient claims were important in their purchase decisions.Conclusions: Nearly all parents provide sugary drinks for their children and many believe that some sugary drinks are healthy options for children, particularly flavoured waters, fruit drinks and sports drinks. Furthermore, many parents rely upon on-package claims in their purchase decisions. Given excessive consumption of added sugar by children in the home, there is a continuing need to address parents' misperceptions about the healthfulness of many sugary drink products. [ABSTRACT FROM AUTHOR]

Bisphenol A (BPA) was determined in sugary carbonated, non-carbonated and milk-based beverages, through HLPC-fluorescence detection and confirmed by LC-MS/MS, in a selection of brands that are mostly consumed by Italian children. The daily intake was determined through the WHO budget method (BM). BPA was found at detectable levels in 57% of carbonated beverages, in 50% of non-carbonated and in 100% of milk-based beverages. The median concentrations were 1.24 µg l–1(range = < LOD–4.98 µg l–1) in canned carbonated beverages and 0.18 µg l–1(< LOD–1.78 µg l–1) in non-canned carbonated beverages. In non-carbonated beverages, median concentrations were 0.80 µg l–1(< LOD–2.79 µg l–1) and 0.18 µg l–1(< LOD–3.58 µg l–1), respectively, for canned and non-canned beverages; in milk-based products the BPA median concentration was 3.60 µg l–1(1.00–17.65 µg l–1). BPA daily intake from sugary drink consumption in children ranged from 0.008 to 1.765 µg kg–1bw day–1. The median exposure values for the ‘best’ and ‘worst’ cases were 0.16% and 0.47% respectively of the EFSA t-TDI for BPA (4 µg kg–1bw day–1), and 10.59% and 35.30% of the t-TDI when the maximum levels were considered. [ABSTRACT FROM PUBLISHER]

Beverages contribute substantially to daily energy and nutrient intakes. However, little is known about the co-development of beverage consumption throughout adolescence. This study aimed to investigate the presence of naturally occurring sub-groups of girls and boys following distinct trajectories of various types of beverage consumption (i.e. sugary beverages, tea and coffee, water, and milk) throughout adolescence. During the Monitoring Activities for Teenagers to Comprehend their Habits study, data were collected from 744 Canadian youths followed for six years (2013-2019). The participants were asked yearly (start-age 10-11 years old) to report how many times they consumed sugary beverages, tea and coffee, water, and milk in a week. Trajectories of beverage consumption were identified from age 11 to 18 using a person-centred approach, namely group-based multi-trajectory modelling. For girls, three different groups were identified: 'Water consumers' (62.7%), 'High beverage consumers' (20.9%), and 'Water and milk consumers' (16.4%). For boys, four different groups were identified: 'Water consumers' (39.1%), 'Water and milk consumers' (30.5%), 'Sugary drinks, coffee and tea consumers' (20.1%), and 'High beverage consumers' (10.4%). This study illustrates the complexity of beverage consumption patterns in adolescence. Various types of public health messaging and interventions may be required to promote healthier beverage consumption patterns among all adolescents. [ABSTRACT FROM AUTHOR]

Abstract: Consumption of sugar-sweetened beverages (SSBs) increased greatly from the late 1970s to the early part of this decade. Although recent data show that consumption of SSB may now be declining, consumption levels still remain much higher than recommended. Using data from the National Health and Nutrition Examination Survey, we assessed trends in intakes of SSB and levels of chronic disease biomarkers from 1999 to 2010 and examined the associations of SSB intake and biomarkers of chronic disease risk. We hypothesized that SSB intake will decrease and biomarkers of chronic disease risk will improve, therefore indicating that high intake of SSB is associated with greater chronic disease risk. Univariate analysis showed that from 1999 to 2010, SSB consumption decreased (P for trend = .0026), high-density lipoprotein increased (P for trend < .0001), low-density lipoprotein decreased (P for trend = .0007), and C-reactive protein decreased (P for trend = .0096). Using multivariate analysis, we showed that higher intakes of SSB were associated with lower high-density lipoprotein (P for trend < .0001), in an unadjusted model and all models with increasing numbers of covariates, and higher C-reactive protein (P for trend < .05), in an unadjusted model and in models with age, race/ethnicity, sex, education level, and poverty income ratio adjustments. We conclude that SSB consumption is associated with biomarkers of chronic disease risk, independent of demographic and lifestyle factors. [Copyright &y& Elsevier]

Highlights: [•] Only one in ten participants ate adequate fruit and vegetables. [•] Two in three participants exhibited two or more of the four risk behaviours studied. [•] Participants most commonly intended to change fruit, vegetable and fat intake. [Copyright &y& Elsevier]

While no solid, structured studies were found to support specific recommendations of water consumption, the main problem seems to be the excessive intake of sugary beverages. The recommended figure of 1-1.5 mL of water per kcal of energy intake is a reference value that must consider weather, physical activity, and dietary variations. At ages up to six months, all water must come from maternal milk, of which an intake of 100-190 mL/kg/day is recommended; at ages 6-12 months, 800-1000 mL/day, considering milk and a gradual introduction of water. Children aged 2-3 years old must have 1,300 mL/day, and those aged 4-8 years old, 1,600 mL/day. Females aged 9-13 years old must consume 1,900 mL/day while the water intake of males must be 2,100 mL/day. For those aged 14 years old or more, adult recommendations apply. [ABSTRACT FROM AUTHOR]

Abstract: Consumption of sugary beverages has been identified as a contributor to childhood obesity. Studies have established the importance of specific parenting practices to children''s beverage consumption; however, no study has examined multiple operationalizations of parenting to better understand where to focus future interventions. The present study examined the relationship between children''s sugary beverage consumption and a parenting model that included household food rules, parent modeling of food rules, parent-mediated behaviors, and parent support. Baseline data from Project MOVE/me Muevo were used. Participants included 541 children, aged 5 to 8 years old, and their parents. Parents completed a 45-minute self-administered survey in Spanish or English, providing information about their child''s dietary intake, as well as their parenting practices. Children''s sugary beverage consumption included nondiet soda, noncarbonated sugary drinks, and sport drinks. Household food rules and parent modeling of food rules were assessed with seven items each. Parent-mediated behaviors consisted of four behaviors. Parent support was assessed with five items. Parent support and parent-mediated behaviors, including total screen time and eating at fast-food restaurants at least weekly, were associated with greater consumption of sugary beverages in children. No other parenting variables were significant. Encouraging caregivers to promote healthy dietary behaviors and provide healthy choices, limiting children''s television and computer use, and reducing fast-food consumption can contribute to reductions in sugary beverage consumption among children. [Copyright &y& Elsevier]

Abstract: Certain beverages contribute energy, protein, vitamins, and minerals. North American adolescents have shifted their beverage intake from predominantly milk to predominantly sugary beverages. Intake of these sugary beverages, in sufficient quantity, may increase the risk of bone fractures, may contribute to obesity, and may lead to tooth decay. This study evaluated the effectiveness of a school-nutrition education program (Fluids Used Effectively for Living) on nutrition knowledge, attitude, and self-reported behavior of grade 9 students in Saskatchewan, Canada. Two classes of grade 9 students, 1 (n = 33) in a high school in Saskatoon (n = 33) and 1 (n = 24) in a large high school in Prince Albert, Saskatchewan, received the peer educator intervention. Two other classes in the 2 cities (n = 24 and n = 24, respectively) were controls. Six sessions of Fluids Used Effectively for Living nutrition education were delivered by using 2 peer educator models (multiple and single), and the intervention was delivered in a 45-minute weekly class session over a 6-week period. After the intervention, students in these 2 peer educator classes decreased their sugary beverage intake significantly, which was sustained for 3 months. Students in the control self-taught class increased their juice intake at the end of the year. The significant decrease of juice and sugary beverage intakes in the single model peer educator class disappeared after Bonferroni correction. Carbonated sugary beverage intake of students in the control self-taught classes declined, but it was not sustainable at the 3-month follow-up. A peer educator school-based nutrition education approach can lead to a decrease in sugary beverage intake in high school children. [Copyright &y& Elsevier]

Background: Few studies have investigated the association between sugar intake and insulin dynamics in children, and none have examined this association in overweight Latino youth. Objective: We aimed to examine the relation between dietary components, especially sugar intake, and insulin dynamics in overweight Latino youth. Design: We examined 63 overweight Latino children aged 9-13 y. Dietary intake was determined by 3-d records, and body composition was measured with dual-energy X-ray absorptiometry. Insulin sensitivity (SI), acute insulin response (AIR), and disposition index (an index of β cell function) were measured by using a frequently sampled intravenous-glucose-tolerance test and minimal modeling. Hierarchical regression analysis ascertained the potential independent relation between insulin dynamics and dietary components. Results: The relation between macronutrient intake and any variable related to insulin dynamics was not significant. However, higher total sugar intake, although not related to SI, was significantly associated with lower AIR (β = -0.296, P = 0.045) and lower β cell function (β = -0.421, P = 0.043), independent of the covariates age, sex, body composition, Tanner stage, and energy intake. Sugar-sweetened beverage intakes trended toward inverse association with lower AIR (β = -0.219, P = 0.072) and β cell function (β = -0.298, P = 0.077). Conclusions: In overweight Latino children, higher intakes of sugar and sugar-sweetened beverages were associated with lower AIR and disposition index, which suggested that these children already have early signs of poor β cell function. These results emphasize the need for early nutritional interventions to reduce daily sugar intake in overweight Latino children and potentially reduce their risk for type 2 diabetes. [ABSTRACT FROM AUTHOR]

Adolescence represents a critical transition phase during which individuals acquire eating behaviours that can track into adulthood. This study aims to characterise trends in eating behaviours throughout adolescence by investigating the presence of sub-groups of individuals presenting distinct trajectories of vegetable and fruit, sugary beverage, breakfast and fast-food consumption. Data from 744 MATCH study Canadian participants followed from 11 to 18 Years old (2013–2019) were included in the analyses. Participants reported how often they ate breakfast and consumed vegetables and fruits, sugary beverages and fast foods. Trajectories of eating behaviours over seven years were identified using group-based multi-trajectory modelling. For girls, three different groups were identified, namely 'stable food intake with a decline in daily breakfast consumption' (39.9%), 'moderate food intake and worsening in overall eating behaviours' (38.0%) and 'stable high food intake' (22.1%). For boys, five different groups were identified, namely 'low food intake with stable daily breakfast consumption' (27.3%), 'breakfast-skippers and increasing fast food intake' (27.1%), 'low food intake with a decline in daily breakfast consumption' (23.9%), 'high food intake with worsening of eating behaviours' (13.3%) and 'average food intake with consistently high breakfast consumption' (8.4%). Eating behaviours evolve through various distinct trajectories and sub-group-specific strategies may be required to promote healthy eating behaviours among adolescents. [ABSTRACT FROM AUTHOR]

Interventions to discourage sugary beverages and encourage water consumption have produced modest and unsustainable behavioral changes to reduce obesity and noncommunicable disease risks. This systematic scoping review examined media campaigns to develop a typology to support healthy hydration nonalcoholic beverage behaviors. Our three-step methodology included the following: (1) review and summarize expert-recommended healthy beverage guidelines; (2) review six English-language electronic databases guided by PRISMA to describe existing campaign types by issue, goal and underlying theory; and (3) develop a media campaign typology to support policies, systems and environments to encourage healthy hydration behaviors. Results showed no international consensus for healthy beverage guidelines, though we describe expert-recommended healthy beverage guidelines for the United States. Of 909 records identified, we included 24 articles describing distinct media campaigns and nine sources that defined models, schemes or taxonomies. The final media campaign typology included: (1) corporate advertising, marketing or entertainment; (2) corporate social responsibility, public relations/cause marketing; (3) social marketing; (4) public information, awareness, education/ health promotion; (5) media advocacy/countermarketing; and (6) political or public policy. This proof-of-concept media campaign typology can be used to evaluate their collective impact and support for a social change movement to reduce sugary beverage health risks and to encourage healthy hydration behaviors.

Background: Taxes on sugary beverages are an emerging strategy to improve health by reducing consumption and raising revenues to support community wellbeing. However, taxes may have unintended consequences, and perceptions of these consequences may affect attitudes towards this policy.Methods: In June 2017, the Seattle City Council passed an ordinance imposing a tax on sugary beverages, effective January 1, 2018. Between October and December 2017, we recruited 851 adults in Seattle to complete a survey (telephone or online) about support for the tax and their perceptions of tax-related health and economic impacts. We first analyzed data for the full sample. We then tested for differences in participants' responses by household income level (< 260% Federal Poverty Level [FPL], ≥ 260% FPL) and across race/ethnicities using chi-square tests. Analyses used population weights and adjusted for multiple comparisons, using the Holm-Bonferroni Sequential Correction (p < 0.01).Results: A majority of participants supported the sugary beverage tax (59%; 95% Confidence Interval [CI]: 55, 63%) and believed that the tax would improve public health (56%; CI: 52, 60%). Most participants believed that the tax would not negatively affect small businesses (52%; CI: 48, 56%) nor result in job loss (66%; CI: 62, 70%). Most participants also perceived that the tax would not negatively impact their own finances (79%; CI: 75, 82%). However, fewer lower-income (48%; CI: 42, 53%), versus higher-income participants (61%; CI: 55, 66%), perceived that the tax would improve public health, would not result in job loss (lower-income: 58%; CI: 53, 64%; higher-income: 71%; CI: 66, 75%) and would not negatively affect their own finances (lower-income: 68%; CI: 62, 73%; higher-income: 85%; CI: 81, 88%). Compared to non-Hispanic Whites, (82%; CI: 79, 86%), a smaller proportion of non-Hispanic Blacks (63%; 95% CI: 48, 75%), and Hispanics (67%; 95% CI: 51, 79%), perceived that the tax would have negative consequences for their own family finances.Conclusions: A majority of respondents supported the sugary beverage tax in Seattle. Lower-income participants were more concerned about potential financial consequences. Further evaluation of the extent to which unintended consequences occur is needed. [ABSTRACT FROM AUTHOR]