Determinants of soft drink consumption among children and adolescents in developed countries - a systematic review.

Abstract

Soft drinks are a major component of daily caloric and sugar intake. This is especially true for children and adolescents. The WHO as well as many other institutions currently recommend to increase research on the determinants of soft drink consumption. We submit a current systematic review on this topic. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, we included all quantitative observational studies that comprise samples from developed countries in the age range 0-18 years and are listed in PubMed, Sociological Abstracts and the Social Sciences Citation Index. Publication period was not limited. The second and the last author screened all 10,392 hits independently with both reviewers being blinded. Interrater reliability (agreement and Cohen's kappa) was 97%/0.73 for the selection of titles, 91%/0.83 for abstracts and 91%/0.80 for full texts. Results of 43 included studies, published between 2001 and 2017, show that children and adolescents consuming soft drinks tend to be older, male and of lower social status. Important contextual factors promoting consumption include constant availability at home, at schools or elsewhere as well as restrictions by parents and rules concerning drinks during meals or generally at home. The association between media consumption and soft drink consumption is particularly striking. Other factors in the food environment (choice of food and alternative drinks at home, having meals together, motivation, knowledge about nutrition and healthy eating) are of minor importance. When introducing interventions parents should play a major role because they serve as physical and social gatekeepers for this early risk factor of juvenile obesity.