Abstract
BackgroundWe sought to explore the perceptions of the socio-cultural contexts and health concerns of consuming sugar-sweetened beverages (SSB) among Indian adults working or studying at a post-secondary institution in Karnataka, India.MethodsWe completed a qualitative study, including 24 semi-structured interviews between 2017 and 2018 at the University of Agricultural Sciences, Dharwad, Karnataka, India. Data were analyzed using thematic content analysis.ResultsOne over-arching theme emerged, westernization and changing perceptions of food, sugar, and health. Participants discussed SSB and associated health concerns in the broad context of westernization and overall economic development in India. Three sub-themes regarding the health perceptions of consuming SSB were: healthy drinks are clean and natural; hydration and energy; and moderation and body weight. Hygienically-prepared beverages were a consistent concern among participants. Juices and beverages, such as tea or coffee, sweetened with jaggery were viewed positively due to their naturalness and lack of processed sugar. Participants perceived SSB as providing hydration and energy, particularly in hot weather. Lastly, if consumed in moderation, SSB were thought to have no direct adverse health consequences. Though some participants noted excessive, ‘addictive’ consumption would contribute to weight gain and diabetes.ConclusionPerceived health concerns of SSB reflect dominant health issues in India, namely, food insecurity, food safety, and increasingly, diabetes. Policymakers tend to prioritize acute challenges over long-term concerns. As such, the capacity of any policy to address chronic nutritional concerns related to SSB are likely to be muted in the absence of improvements to food safety and security.
Highlights
We sought to explore the perceptions of the socio-cultural contexts and health concerns of consuming sugar-sweetened beverages (SSB) among Indian adults working or studying at a post-secondary institution in Karnataka, India
Sugar, SSB, and associated health concerns were often discussed in the broad context of westernization, poverty, urbanization, as well as overall economic development in India
These issues influenced health perceptions of SSB by way of economic development in terms of purchasing power and who consumes SSB, cultural values associated with food and beverages, and the changing health issues in the country, which were attributed to westernization
Summary
We sought to explore the perceptions of the socio-cultural contexts and health concerns of consuming sugar-sweetened beverages (SSB) among Indian adults working or studying at a post-secondary institution in Karnataka, India. Organizations and researchers expressing health concerns frequently cite sugarsweetened beverage (SSB) intake as being associated with weight gain and incident diabetes, though these studies have been mostly conducted with American populations [2, 3]. The World Health Organization (WHO) has recommended policies, such as taxation, to address SSB intake in all countries in order to address a global increase in weight-related non-communicable diseases, such as Type 2 Diabetes [1]. India has not yet implemented any SSB tax to date, though consumption of sugar and SSB has been identified as a health concern in India, among young people [6]; the importance of understanding local social, political, economic, and cultural contexts prior to considering SSB taxation as a viable intervention has been emphasized [7, 8]. Biomedical models of disease, such as those for diabetes, developed within a western context may not align with individual perceptions or needs in low- or middle-income countries [9]
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