How does the Kids SIPsmartER Program Impact the Sugar-Sweetened Beverage Intake of Students: An Investigation beyond Total Treatment Effect in Randomized Controlled Trial.

Sugar-sweetened beverages, milk intake, and obesity in children and adolescents

P117 Factors Associated with Sugar-Sweetened Beverage Consumption Among Children and Adolescents in the United States by Race/Ethnicity: NHANES 2011-2016

BackgroundDespite excessive consumption of sugar-sweetened beverages (SSB), little is known about behavioral interventions to reduce SSB intake among adults, particularly in medically-underserved rural communities. This type 1 effectiveness-implementation hybrid RCT, conducted in 2012–2014, applied the RE-AIM framework and was designed to assess the effectiveness of a behavioral intervention targeting SSB consumption (SIPsmartER) when compared to an intervention targeting physical activity (MoveMore) and to determine if health literacy influenced retention, engagement or outcomes.MethodsGuided by the Theory of Planned Behavior and health literacy strategies, the 6 month multi-component intervention for both conditions included three small-group classes, one live teach-back call, and 11 interactive voice response calls. Validated measures were used to assess SSB consumption (primary outcome) and all secondary outcomes including physical activity behaviors, theory-based constructs, quality of life, media literacy, anthropometric, and biological outcomes.ResultsTargeting a medically-underserved rural region in southwest Virginia, 1056 adult participants were screened, 620 (59 %) eligible, 301 (49 %) enrolled and randomized, and 296 included in these 2015 analyses. Participants were 93 % Caucasian, 81 % female, 31 % ≤ high-school educated, 43 % < $14,999 household income, and 33 % low health literate. Retention rates (74 %) and program engagement was not statistically different between conditions. Compared to MoveMore, SIPsmartER participants significantly decreased SSB kcals and BMI at 6 months. SIPsmartER participants significantly decreased SSB intake by 227 (95 % CI = −326,−127, p < 0.001) kcals/day from baseline to 6 months when compared to the decrease of 53 (95 % CI = −88,−17, p < 0.01) kcals/day among MoveMore participants (p < 0.001). SIPsmartER participants decreased BMI by 0.21 (95 % CI = −0.35,−0.06; p < 0.01) kg/m2 from baseline to 6 months when compared to the non-significant 0.10 (95 % CI = −0.23, 0.43; NS) kg/m2 gain among MoveMore participants (p < 0.05). Significant 0–6 month effects were observed for about half of the theory-based constructs, but for no biological outcomes. Health literacy status did not influence retention rates, engagement or outcomes.ConclusionsSIPsmartER is an effective intervention to decrease SSB consumption among adults and is promising for translation into practice settings. SIPsmartER also yielded small, yet significant, improvements in BMI. By using health literacy-focused strategies, the intervention was robust in achieving reductions for participants of varying health literacy status.Trial registrationClinicaltrials.gov; ID: NCT02193009.

High consumption of alcoholic and sugar sweetened beverages (SSBs) remains a public health problem among the young adults. This study assessed the knowledge, attitude and consumption pattern of alcohol and SSBs among the undergraduate students. A pretested, self-administered questionnaire was used to obtain information on the socio-demographic characteristic, knowledge, attitude and consumption pattern of the students regarding the negative social and health implications of excessive consumption of alcohol and SSBs from 376 undergraduate students from the University of Ibadan. Data was analyzed using descriptive statistics and chi square at P<0.05 was considered significant. The mean age of the students was 22.5±2.3 years. Large proportion (83.0% and 86.7%) had adequate knowledge of the health implications of excessive consumption of alcohol and SSBs respectively. Majority (85.4%) had positive attitude towards intake of alcoholic drinks while 83.5% had negative attitude towards the intake of SSBs. Majority (83.0%) of the respondents considered high intake of alcoholic drinks as dangerous to health while only 32.5% considered regular consumption of SSBs as dangerous to health. Majority (75.0%, 63.3% and 79.3%) of the respondents abstained from intake of beers, alcoholic wines and spirits respectively. Significant relationship was observed between the knowledge of social and health implication of excessive consumption of alcohol and the abstinence of the participants (p<0.05). A significant relationship was also observed between frequent consumption of SSBs by the respondents and being overweight (P<0.05). Knowledge of the undergraduate students on the social and health implication of excessive consumption of alcohol and sugar sweetened beverages was adequate. Majority had negative attitude towards alcohol intake but positive attitude towards the intake of sugar sweetened beverages. Frequent consumption of sugar sweetened beverages could contribute to being overweight. Nutrition education to encourage healthful dietary practices regarding the intake of sugar sweetened beverages should be intensified. Key words : Knowledge, Attitude, Consumption pattern, Sugar Sweetened Beverages, Alcoholic drink

Sugar-sweetened beverage (SSB) consumption may increase risk for unnecessary weight gain. To develop interventions discouraging consumption, more insight is needed about cognitive and environmental predictors related to the decrease in SSB consumption. The present paper aims (1) to describe the relationship between potential cognitive determinants of change (attitudes, subjective norms, perceived behavioural control and intentions) and perceived environmental factors (family food rule and home availability of SSB) with changes in SSB consumption between baseline and 4-month follow-up and (2) to study whether the relationships between the environmental factors and SSB consumption are mediated by the cognitive determinants. Information on possible predictors and SSB intake at baseline and 4-month follow-up was provided by 348 Dutch adolescents (aged 12-13 years) through online questionnaires that were completed at school. Multilevel logistic regression and mediation analyses were used to determine direct and indirect associations between predictors and behaviour. The present results show that a high perceived behavioural control to decrease intake at baseline was associated with a decrease in consumption of SSB between baseline and follow-up (OR = 0.53). Low availability and a stricter family food rule were associated with a decrease in SSB consumption between baseline and follow-up (OR = 2.39, 0.54). The association between availability and decrease in SSB consumption was for 68 % mediated by perceived behavioural control to drink less. In conclusion, interventions to decrease SSB intake should focus on improving attitudes and perceived behavioural control to reduce intake, and on limiting home availability and stimulating stricter family food rules regarding SSB consumption.

Sugar-sweetened beverages (SSBs) consumption has risen significantly, which may lead to various health problems. Studies about the association between SSBs and attention-deficit/hyperactivity disorder (ADHD) in children are rare and inconsistent. We have used the two-stage cluster sampling method to select 6541 students aged 6-12. We further investigated their basic information and SSB intake. Teachers' questionnaires and parents' questionnaires were used to evaluating the hyperactive behaviors in children. We examined the associations between SSB consumption and hyperactivity index (HI) by adopting the censored least absolute deviation (CLAD) estimator. Then, we further evaluated the impacts of sex and age on the association between SSB intake and hyperactivity. Children who weekly drank SSB two or more times were associated with 0.05 (0.04, 0.07) and 0.04 (0.02, 0.06) higher scores of ln (HI+1) reported by teachers and parents, respectively, compared to non-consumers children (p for trend < 0.05). A stronger association between SSB intake and hyperactivity occurred in girls and old children. (p for interaction < 0.05). SSB intake has a positive correlation with the risk of hyperactivity in children, and the frequency of SSB consumption and hyperactivity have a dose-response relationship.

Introduction: Previous observational studies have shown a positive association between sugar-sweetened beverage (SSB) consumption and cardiovascular disease (CVD) risk, but many have been relatively short-term. Objective: To determine the association of SSB consumption over a 20-year period and incident CVD in a large prospective cohort of middle-aged women. Methods: Data are from the California Teachers Study, a US based longitudinal cohort comprised of 133,477 female teachers and administrators who were active or recently retired members of the California State Teachers Retirement System in 1995. After excluding those with a history of CVD and type 2 diabetes mellitus at baseline, our analytic sample was 107,905. SSB consumption constituted regular soft drinks, sweetened bottled waters and teas, and fruit drinks (other than fruit juice) and was derived from a self-administered Block95 food frequency questionnaire. SSB consumption was divided into four categories: Rare or never, &gt;rare/never to &lt;1 serving per week, ≥1 serving per week to &lt;1 serving per day, and ≥1 serving per day. CVD endpoints were based on annual linkage with statewide hospitalization records, defined as first occurrence of myocardial infarction, coronary artery bypass grafting (CABG) or stroke following the International Statistical Classification of Diseases 9 th and 10 th Revision coding system. Cox proportional hazards models were used to assess the association between SSB consumption and incident CVD, after adjusting for potential confounders and mediators. Results: Of a total of 8,946 CVD incident cases over 20 years, the majority were strokes (5,728). In an age-adjusted model, we observed increased hazard ratios (HR) for CVD (HR 1.24 [95% CI 1.11, 1.38]), CABG (HR 1.39 [95% CI 1.13, 1.71]), and stroke (HR 1.21 [95% CI 1.05, 1.39]) events in women who consumed ≥1 serving/day vs those who rarely/never consumed SSBs. Our fully adjusted model included age, smoking, alcohol intake, physical activity, multivitamin and aspirin use, menopausal status, hormone replacement therapy, oral contraceptive use, history of hypertension, body mass index, fruit and vegetable intake, and total energy intake. This model slightly attenuated the hazard for CVD (HR 1.20 [95% CI 1.07, 1.35]), CABG (HR 1.25 [95% CI 1.00, 1.06]), and stroke (HR 1.18 [1.01, 1.37]) in women who consumed ≥1 serving/day in comparison to women that rarely/never consumed SSBs. Conclusions: If this finding is replicated, SSB consumption might be a modifiable dietary target to reduce risk of CVD among women.

Associations of sugar-sweetened beverage knowledge, self-efficacy, and perceived benefits and barriers with sugar-sweetened beverage consumption in adolescents: A structural equation modeling approach

Food Purchasing Behaviors and Sugar-Sweetened Beverage Consumption among Canadian Secondary School Students in the COMPASS Study

Objectives: To examine factors at individual, household, school, and school neighborhood levels that are associated with sugar-sweetened beverage (SSB) consumption among children in urban Lebanon and Tunisia – two contexts undergoing a nutrition transition with high child obesity rates. Methods: Two-stage cluster-randomized, cross-sectional school surveys recruited representative samples of children in grades 4-6 in 2022 in Greater Beirut, Lebanon (n=2,125), and in 2020 in Greater Tunis, Tunisia (n=2,465). Data on eating habits and dietary intake of children on the previous school day (including intake of SSB) and on household socio-demographics and school characteristics were collected through questionnaires administered to children, parents and school directors. Density of food outlets in school neighborhoods (defined by an 800m road network buffer around schools) was assessed using geospatial methods. Crude and adjusted multi-level logistic regression models assessed factors associated with SSB consumption. Results: In both settings, around 36% of children consumed SSB on the previous day. SSB consumption was associated with consuming sweets [Adjusted OR (95%CI): 1.6 (1.2-2.1) in Beirut and 3.1 (2.1-4.4) in Tunis] and salted snacks [1.3 (1.1-1.6) in Beirut and 1.7 (1.2-2.5) in Tunis], and attending schools with high neighborhood density of unhealthy food retailers [3.9 (2.0-7.3) in Beirut and 1.8 (1.1-3.1) in Tunis]. In Tunis, SSB consumption was also associated with consuming fast-food ≥1 time/week, eating in front of a screen ≥2 days/week, buying food from stores in/around schools and attending private schools. In Beirut, it was associated with male sex, low nutrition knowledge, and attending schools without a health or nutrition educator. Conclusions: In these urban middle-income nutrition transition settings, density of unhealthy food outlets in school neighborhoods, along with ultra-processed food consumption behaviors were consistently associated with SSB intake in schoolchildren, whereas other factors spanning the socio-ecological model were differentially associated with SSB intake across contexts. These results provide insights for contextually adapted interventions to improve schoolchildren’s diets. Funding Sources: International Development Research Centre – Canada.

Background: Findings on the association of sugar sweetened beverages (SSB) and fructose intakes with gout and hyperuricemia have been conflicting.Objective: We aimed to perform a systematic review and meta-analysis on studies that examined the association of SSB and fructose consumption with gout and hyperuricemia in adults.Methods: We searched PubMed, Scopus and Google Scholar up to Aug 2017 for all relevant published papers assessing SSB and fructose intakes and risk of gout and hyperuricemia. After excluding non-relevant papers, 10 studies remained in our systematic. Meta-analysis on SSB consumption and risk of gout was done on three effect sizes from cohort studies and five effect sizes from case-control studies. For risk of hyperuricemia, the meta-analysis was done on six effect sizes from cross-sectional studies. All analyses were performed on ORs or RRs.Results: We found an overall significant positive association between SSB consumption and risk of gout in both cohort (summary effect size: 1.35; 95% CI: 1.18–1.55) and case-control studies (summary effect size: 1.33; 95% CI: 1.06–1.66). Meta-analysis on cross-sectional studies revealed that SSB consumption was associated with 35% greater odds of hyperuricemia (summary effect size: 1.35; 95% CI: 1.19–1.52). No evidence of between-study heterogeneity as well as publication bias was found. Although the studies on fructose intake and risk of gout and hyperuricemia were included in our systematic review, we did not perform met-analysis on these studies due to insufficient number of publications.Conclusion: We found that SSB consumption was significantly associated with increased risk of gout and hyperuricemia in adult population. Further studies are needed to examine the association between dietary fructose intake and risk of gout and hyepruricemia.

We examined the associations between mothers' child‐feeding practices and children's sugar‐sweetened beverage (SSB) intake among 6‐year‐olds using data from the Year 6 Follow‐Up of Infant Feeding Practices Study II (n=1350). The outcome variable was child's SSB intake. The exposure variables were 4 child‐feeding practices of mothers (set limits on sweets or junk foods; regulating child's favorite food intake to prevent overconsumption; pressuring their child eat enough; and pressuring their child to “clean the plate”). We used multivariate logistic regression and controlled for child and maternal characteristics. Analyses were stratified on child weight status. Consuming SSB 蠅1 time/day at age 6 years was observed among 17.1% of underweight/normal weight children and 23.2% of overweight/obese children. The adjusted odds for consuming SSB 蠅1 time/day (vs. no SSB intake) were significantly lower in children with mothers who set limits on sweets/junk foods (odds ratio (OR)=0.29 for underweight/normal weight children; OR=0.16 for overweight/obese children). SSB intake was higher among underweight/normal weight children whose mothers tried to keep them from eating too much of favorite foods (OR=2.03). Mothers' tendency to pressure their children to consume more food or “clean the plate” was not associated with child's SSB intake. SSBs were commonly consumed by young children and mothers' reported attempts to restrict children's intake of foods was associated with child's SSB intake. Future studies can investigate the impact of alternative child feeding practices on reducing children's SSB intake.

Difference in Sugar-Sweetened Beverage Consumption before and during the COVID-19 Pandemic among Korean Adolescents

Associations among sugar sweetened beverage intake, visceral fat, and cortisol awakening response in minority youth

Total Sugar-Sweetened Beverage Intake Among US Adults Underreported When Using One Question Instead of Four Questions to Assess Intake