The Relationship between Self-Reported Exposure to Sugar-Sweetened Beverage Promotions and Intake: Cross-Sectional Analysis of the 2017 International Food Policy Study.

Hannah Forde,Jean Adams,Stephen Sharp,Louis Levy,Felix Greaves,Lana Vanderlee,David Hammond,Martin White

doi:10.3390/nu11123047

Abstract

Sugar-sweetened beverage (SSB) consumption is independently associated with several non-communicable diseases, so policymakers are increasingly implementing measures, such as marketing regulation, to reduce intake. To help understand how such measures work, this study examined the association between SSB consumption and self-reported exposure to SSB promotions, both overall and by type of promotion, and whether these relationships vary between the UK, USA, Canada, Mexico, and Australia. Cross-sectional analysis of the online 2017 International Food Policy Study was performed (n = 15,515). Participants were grouped into 5265 (34%) non-, 5117 (33%) low-, and 5133 (33%) high-SSB consumers. Multinomial logistic regression models examined whether SSB consumption varied by exposure to total SSB promotion and by type: traditional, digital, recreational environment, and functional environment. Multiplicative interactions were included to investigate international variations. An additional unit of total self-reported SSB promotion exposure increased the likelihood of participants being low SSB consumers (relative risk ratio (RRR) = 1.08, 95% confidence interval (CI) = 1.06–1.10) and high SSB consumers (RRR = 1.13, 95% CI = 1.11–1.16). Only exposure to traditional and digital promotion increased the likelihood of participants being SSB consumers, though this may be explained by degree of exposure, which was not measured in this study. Some evidence illustrated international variation in these relationships.

Highlights

In 2017, 11 million deaths worldwide were attributable to dietary risk factors [1]
No respondents reported exposure to all 15 types of promotion. Among those reporting exposure to Sugar-sweetened beverage (SSB) promotions, there was a median value of 3 exposures; 9322 (60%) reported exposure to traditional promotions, 5565 (36%) to digital promotions, 4363 (28%) to promotions in the recreational environment, and 5265 (34%) to promotions in the functional environment
We found some evidence that the strength of association between self-reported exposure to digital promotions, traditional promotions, and promotions in the recreational environment and SSB consumption varied between countries in the study

Summary

Introduction

In 2017, 11 million deaths worldwide were attributable to dietary risk factors [1]. High consumption of sugars [2,3] is a known risk factor for non-communicable diseases (NCDs), such as overweight [4]and type II diabetes [5], cardio-metabolic risks [6], poor oral health [7], and overall mortality [8].Sugar sweetened beverages (SSBs) are a substantial source of dietary sugar and the greatest source of dietary sugar for young people in many countries worldwide [9,10,11,12,13]. In 2017, 11 million deaths worldwide were attributable to dietary risk factors [1]. High consumption of sugars [2,3] is a known risk factor for non-communicable diseases (NCDs), such as overweight [4]. Type II diabetes [5], cardio-metabolic risks [6], poor oral health [7], and overall mortality [8]. Consumption of SSBs is associated with several NCDs, independent of effects mediated by obesity [14,15]. Many attribute the scale of global SSB consumption at least in part to successful marketing [16,17]

Results

Discussion

Conclusion