Caloric Soft Drinks Research Articles

Evolution of beverage portion sizes consumed in Brazil between 2008 and 2018.

To describe the evolution of beverage portion sizes consumed in Brazil between 2008 and 2018. Data from the dietary surveys of 2008-2009 and 2017-2018 Brazilian Household Budget Surveys, conducted with 34,003 and 46,164 individuals, respectively, were used to analyze the portion size of beverages. Food consumption data were used to group beverages according to nutritional characteristics, type and size of portions into eight groups: high-calorie soft drinks, fruit refreshments, alcoholic beverages, coffee/tea, fruit juices, milk and milk substitutes and ultra-processed milk-based beverages. The two-day food record and recall were considered to analyze the consumed portions. Comparisons between the surveys were done using Chi-Square tests and linear regression models. Between 2008 and 2018, the average portion consumed showed a significant increase for the group of alcoholic beverages (+29%), flavored juices (+11%), caloric soft drinks (+8%), milk and milk substitutes (+6%) and fruit juices (+5%); and reduction for the coffee/tea group (-11%). Analyzes by age group showed that among individuals between 20 and 40 years of age, the soft drinks and alcoholic beverage groups showed the greatest increase in portion size, +12 and +44%, respectively. The beverage portion sizes consumed in Brazil between 2008 and 2018 increased for the group of alcoholic beverages, flavored juices, caloric soft drinks, milk and milk substitutes, and fruit juices.

Association Between Sugar-Sweetened Beverage Intake and Mortality Risk in Women: The California Teachers Study

BackgroundThe evidence linking sugar-sweetened beverage (SSB) intake and mortality risk is conflicting, and associations between various SSB subtypes and mortality remain unclear. ObjectiveTo examine the association between baseline SSB intake, subtypes of SSB intake, and mortality risk in women. DesignProspective cohort study. Participants/settingParticipants of the California Teachers Study (n = 100,314; median age = 53 years) free of cardiovascular disease, cancer, and diabetes at baseline (1995-1996) were followed from 1995 to 2015. Baseline SSB intake was defined as caloric soft drinks (regular soft drinks, not diet soda), sweetened bottled waters or teas, and fruit drinks; and was derived from a self-administered food frequency questionnaire. Main outcome measureMortality was ascertained via annual linkage with state- and nationwide mortality records and the National Death Index over 20 years. Statistical analysisMultivariable-adjusted Cox proportional hazards models were used to generate hazard ratios (HRs) and 95% CIs for assessing associations between SSB intake and mortality. Rare/never consumers were the comparator group. ResultsThere were a total of 14,143 deaths over 20 years (30.5% from cardiovascular disease; 29.2% from cancer). In women who consumed ≥ 7 servings/week of SSBs at baseline (4% of participants), the multivariable-adjusted HRs were not significant for all-cause, cardiovascular disease-specific, or cancer-specific mortality. Consuming ≥ 7 servings/week of baseline caloric soft drink was associated with a higher risk of all-cause (HR = 1.26, 95% CI 1.10 to 1.46; P for trend = 0.02) and cancer-specific (HR = 1.33, 95% CI 1.08 to 1.63; P for trend = 0.08) mortality. In secondary analyses, consuming ≥ 1.5 c/day of baseline SSBs was associated with all-cause mortality (HR = 1.12, 95% CI 1.02 to 1.24; P for trend = 0.01). ConclusionsAlthough the baseline frequency of total SSB intake was not significantly associated with mortality, consuming ≥ 7 servings/week of caloric soft drinks was associated with higher risk of all-cause and cancer-specific mortality. Findings support public health efforts to reduce caloric soft drink consumption.

Soft Drink Consumption in Young Mexican Adults Is Associated with Higher Total Body Fat Percentage in Men but Not in Women.

A high consumption of soft drinks (SDs) has been linked with the development of anthropometric and metabolic alterations. We evaluate the association between SD consumption and some anthropometric and metabolic variables. This study is an observational study, using a sample of 394 university students, of which 158 were men (40.1%) and 238 women (59.9%), between 18 and 30 years. An SD intake questionnaire provided the consumption of different SDs. The participants’ weight, height, and waist and hip circumferences were collected. Metabolic biomarkers were analyzed. The average intake of caloric SDs (CSDs) was 1193.6 ± 1534.8 mL/week and 84.5 ± 115.02 mL/week for non-caloric SDs (NCSDs). Sex differences were found in the amount of SD consumption and these statistical differences were driven by those men subjects with a high total body fat percentage (TBF%). In men, correlations were found between the intake of CSDs and the body mass index, waist and hip circumferences, TBF%, and visceral fat percentage. In woman, a correlation was found with glucose and triglycerides. The prediction model revealed that the intake of CSDs predicts TBF% and low-density lipoprotein only in men. A high amount of CSD consumption in men was associated with a high TBF%, and this may be predictive of future development of metabolic abnormalities.

Sugar-Sweetened Beverage Intake and Cardiovascular Disease Risk in the California Teachers Study.

BackgroundSugar‐sweetened beverage (SSB) consumption has been associated with cardiometabolic risk. However, the association between total and type of SSB intake and incident cardiovascular disease (CVD) end points such as myocardial infarction, stroke, and revascularization is limited.Methods and ResultsWe examined the prospective association of baseline SSB consumption with incident CVD in 106 178 women free from CVD and diabetes mellitus in the CTS (California Teachers Study), a cohort of female teachers and administrators, followed since 1995. SSBs were defined as caloric soft drinks, sweetened bottled waters or teas, and fruit drinks, and derived from a self‐administered food frequency questionnaire. CVD end points were based on annual linkage with statewide inpatient hospitalization records. Cox proportional hazards models were used to assess the association between SSB consumption and incident CVD. A total of 8848 CVD incident cases were documented over 20 years of follow‐up. After adjusting for potential confounders, we observed higher hazard ratios (HRs) for CVD (HR, 1.19; 95% CI, 1.06–1.34), revascularization (HR, 1.26; 95% CI, 1.04–1.54]), and stroke (HR, 1.21; 95% CI, 1.04–1.41) in women who consumed ≥1 serving per day of SSBs compared with rare/never consumers. We also observed a higher risk of CVD in women who consumed ≥1 serving per day of fruit drinks (HR, 1.42; 95% CI, 1.00–2.01 [P trend=0.021]) and caloric soft drinks (HR, 1.23; 95% CI, 1.05–1.44 [P trend=0.0002]), compared with rare/never consumers.ConclusionsConsuming ≥1 serving per day of SSB was associated with CVD, revascularization, and stroke. SSB intake might be a modifiable dietary target to reduce risk of CVD among women.

Sugar-sweetened beverages and colorectal cancer risk in the California Teachers Study.

BackgroundThe association between sugar-sweetened beverage (SSB) consumption and colorectal cancer (CRC) risk remains unclear and published data are limited.MethodsThe analytic cohort included 99,798 women, free of cancer at baseline, from the California Teachers Study, a 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. SSB consumption constituted caloric soft drinks, sweetened bottled waters and teas, and fruit drinks, derived from a self-administered food frequency questionnaire. Consumption was divided into four categories: Rare or never, >rare/never to <1 serving/week, ≥1 serving/week to <1 serving/day, and ≥1 serving/day. CRC endpoints were based on annual linkage with California Cancer Registry, defined as first diagnosis of CRC, and classified following the Surveillance, Epidemiology, and End Results Program coding system. Multivariable-adjusted Cox proportional hazards models were used to generate hazard ratios (HR) and 95% confidence intervals (CI) for assessing the association between SSB consumption and incident CRC.ResultsA total of 1,318 incident CRC cases were identified over 20 years of follow-up (54.5% proximal colon and 45.5% distal colorectum). Compared with rare/never consumers, the multivariable-adjusted HRs (95% CI) were 1.14 (0.86, 1.53) for total CRC; 1.11 (0.73, 1.68) for proximal colon; and 1.22 (0.80, 1.86) for distal colorectum cancers among women consuming ≥ 1 serving/day of SSBs.ConclusionSSBs were not significantly associated with CRC risk. The biological effects of high SSB consumption make it important to continue to evaluate whether SSBs are associated with CRC. Additionally, future studies should further assess SSBs in large, racial/ethnically diverse cohorts of males and females, and, if feasible, address changes in SSB consumption over time.

Beverage Consumption among Adults in the Balearic Islands: Association with Total Water and Energy Intake.

The paper seeks to describe beverage consumption and examine the association between beverage consumption and total water intake and total energy intake of the adult population in the Balearic Islands. Beverage consumption, total water intake, and total energy intake were obtained by using two 24-h diet recalls from a cross-sectional nutritional survey carried out in the Balearic Islands (n = 1386). The contribution of beverages to total water intake and total energy intake were also assessed. Beverages accounted for 65–71% of total water intake and 29–35% of it provided by drinking water. Food moisture contributed 31–37% of total water intake. The mean daily total water intake from all sources was around 2.2 L for men and 1.9 L for women and slightly lower than the proposed adequate intake (AI) recommendations of the European Food Safety Authority (EFSA). The mean total energy intake was 2222 kcal/day and beverages contributed 10.3% of total energy intake for men and 9.5% for women. Energy intake from beverages varied with age. In both sexes, milk was the main beverage contributed to total energy intake. The energy contribution of caloric soft drinks was 1.8% for men and 1.2% for women and energy intake from these beverages was significantly higher among younger adults. Water was the main beverage in the diet, followed by milk and hot beverages. Beverages were mainly consumed in the main meal times (breakfast, lunch, and dinner) in both sexes. The main findings of this study indicate that consumption of sugar-sweetened beverages (caloric soft drinks and commercial fruit juice) is higher among young adults, consumption of alcoholic beverages is higher among males aged 26 and older, and TWI (total water intake) is lower than the EFSA recommendations. These findings may be used to develop effective, healthy eating and drinking policies and campaigns.

Water Intake in a Sample of Greek Adults Evaluated with the Water Balance Questionnaire (WBQ) and a Seven-Day Diary

Awareness on the importance of hydration in health has created an unequivocal need to enrich knowledge on water intake of the general population and on the contribution of beverages to total water intake. We evaluated in the past water intake in a sample of Greek adults using two approaches. In study A, volunteers completed the Water Balance Questionnaire (WBQ), a food frequency questionnaire, designed to evaluate water intake (n = 1092; 48.1% males; 43 ± 18 years). In study B, a different population of volunteers recorded water, beverage, and food intake in seven-day diaries (n = 178; 51.1% males; 37 ± 12 years). Herein, data were reanalyzed with the objective to reveal the contribution of beverages in total water intake with these different methodologies. Beverage recording was grouped in the following categories: Hot beverages; milk; fruit and vegetable juices; caloric soft drinks; diet soft drinks; alcoholic drinks; other beverages; and water. Total water intake and water intake from beverages was 3254 (SE 43) mL/day and 2551 (SE 39) mL/day in study A; and 2349 (SE 59) mL/day and 1832 (SE 56) mL/day in study B. In both studies water had the highest contribution to total water intake, approximately 50% of total water intake, followed by hot beverages (10% of total water intake) and milk (5% of total water intake). These two approaches contribute information on water intake in Greece and highlight the contribution of different beverages; moreover, they point out differences in results obtained from different methodologies attributed to limitations in their use.

Beverage Consumption Habits and Association with Total Water and Energy Intakes in the Spanish Population: Findings of the ANIBES Study.

Background: Inadequate hydration is a public health issue that imposes a significant economic burden. In Spain, data of total water intake (TWI) are scarce. There is a clear need for a national study that quantifies water and beverage intakes and explores associations between the types of beverages and energy intakes. Methods: The Anthropometry, Intake and Energy Balance Study ANIBES is a national survey of diet and nutrition conducted among a representative sample of 2285 healthy participants aged 9–75 years in Spain. Food and beverage intakes were assessed in a food diary over three days. Day and time of beverage consumption were also recorded. Results: On average, TWI was 1.7 L (SE 21.2) for men and 1.6 L (SE 18.9) for women. More than 75% of participants had inadequate TWI, according to European Food Safety Authority (EFSA) recommendations. Mean total energy intake (EI) was 1810 kcal/day (SE 11.1), of which 12% was provided by beverages. Water was the most consumed beverage, followed by milk. The contribution of alcoholic drinks to the EI was near 3%. For caloric soft drinks, a relatively low contribution to the EI was obtained, only 2%. Of eight different types of beverages, the variety score was positively correlated with TWI (r = 0.39) and EI (r = 0.23), suggesting that beverage variety is an indicator of higher consumption of food and drinks. Conclusions: The present study demonstrates that well-conducted surveys such as the ANIBES study have the potential to yield rich contextual value data that can emphasize the need to undertake appropriate health and nutrition policies to increase the total water intake at the population level promoting a healthy Mediterranean hydration pattern.

Ten-year beverage intake trends among US preschool children: rapid declines between 2003 and 2010 but stagnancy in recent years.

It has been previously reported that total energy intake among US preschool children (ages 2-5 years) decreased between 2003-2004 and 2009-2010. However, little is known about how intakes of beverages among US preschoolers (ages 2-5 years) changed from 2003-2004 to 2011-2012. This paper examines changes in intakes of key beverages during this period, as well as how eating location (at home or away from home) and source (store vs. others) may have contributed to these changes. Cross-sectional day one dietary data among children ages 2-5 years from the National Health and Nutrition Examination Survey 2003-2004, 2005-2006, 2007-2008, 2009-2010 and 2011-2012 were used. Survey-weighted mean intakes by survey year, eating location and source were computed for total sugar-sweetened beverages (SSBs), milks, 100% juice, low/no-calorie beverages, 10 key beverages, total beverages and total foods. Means were compared using two-tailed z-tests with Bonferroni corrections (α < 0.05). Between 2003-2004 and 2011-2012, among 2-5 year olds, total caloric intake fell by 132 kcal d(-1) , with intakes of beverages falling by 55 kcal d(-1) . Decreases in intakes of total SSBs (-57 kcal d(-1) ), fruit-flavoured or juice drinks containing <100% juice (juice drinks) (-37 kcal d(-1) ), caloric soft drinks (-13 kcal d(-1) ) and >1% fat, low-sugar milk (-42 kcal d(-1) ) were among the major changes. By eating location, total beverage intake at home fell by 73 kcal d(-1) . By source, total beverage intake from stores fell by 106 kcal d(-1) . Changes in intakes occurred primarily between 2003-2004 and 2009-2010, as there were no significant differences in beverage intakes between 2009-2010 and 2011-2012. Intakes of total calories (+49 kcal d(-1) ) and calories from foods (+53 kcal d(-1) ) trended upward between 2009-2010 and 2011-2012, but changes were not significant. These findings suggest improvements in the diets of preschoolers between 2003-2004 and 2009-2010, of which stores were a major contributor.

Beverage consumption habits “24/7” among British adults: association with total water intake and energy intake

BackgroundVarious recommendations exist for total water intake (TWI), yet it is seldom reported in dietary surveys. Few studies have examined how real-life consumption patterns, including beverage type, variety and timing relate to TWI and energy intake (EI).MethodsWe analysed weighed dietary records from the National Diet and Nutrition Survey of 1724 British adults aged 19–64 years (2000/2001) to investigate beverage consumption patterns over 24 hrs and 7 days and associations with TWI and EI. TWI was calculated from the nutrient composition of each item of food and drink and compared with reference values.ResultsMean TWI was 2.53 L (SD 0.86) for men and 2.03 L (SD 0.71) for women, close to the European Food Safety Authority “adequate Intake” (AI) of 2.5 L and 2 L, respectively. However, for 33% of men and 23% of women TWI was below AI and TWI:EI ratio was <1 g/kcal. Beverages accounted for 75% of TWI. Beverage variety was correlated with TWI (r 0.34) and more weakly with EI (r 0.16). Beverage consumption peaked at 0800 hrs (mainly hot beverages/ milk) and 2100 hrs (mainly alcohol). Total beverage consumption was higher at weekends, especially among men. Overall, beverages supplied 16% of EI (men 17%, women 14%), alcoholic drinks contributed 9% (men) and 5% (women), milk 5-6%, caloric soft drinks 2%, and fruit juice 1%.In multi-variable regression (adjusted for sex, age, body weight, smoking, dieting, activity level and mis-reporting), replacing 100 g of caloric beverages (milk, fruit juice, caloric soft drinks and alcohol) with 100 g non-caloric drinks (diet soft drinks, hot beverages and water) was associated with a reduction in EI of 15 kcal, or 34 kcal if food energy were unchanged. Using within-person data (deviations from 7-day mean) each 100 g change in caloric beverages was associated with 29 kcal change in EI or 35 kcal if food energy were constant. By comparison the calculated energy content of caloric drinks consumed was 47 kcal/100 g.ConclusionsTWI and beverage consumption are closely related, and some individuals appeared to have low TWI. Energy from beverages may be partly compensated. A better understanding of interactions between drinking and eating habits and their impact on water and energy balance would give a firmer basis to dietary recommendations.

Determinants and patterns of soft drink consumption in young adults: a qualitative analysis

To explore knowledge, attitudes and behaviours regarding caloric soft drinks in a group of young adults attending university and to identify opportunities for a health promotion intervention aimed at reducing consumption. In-depth, semi-structured focus groups segmented by gender. Sydney, Australia. Undergraduate University of Sydney students aged 18-30 years (n 35). Social and environmental cues, intrinsic qualities of beverages and personal health beliefs were identified as important influences on consumption. Social cues included settings in which alcohol is usually consumed, socialising with friends, and family influences. Environmental cues included purchasing of fast foods, and ready availability, preferential pricing and promotion of caloric beverages. Reinforcing intrinsic qualities of caloric soft drinks included taste, sugar and caffeine content, and their association with treats and rewards. Major gender differences as well as variations in individual readiness for behaviour change were observed. Raising awareness of the sugar content of various beverages and the potential health impacts associated with their consumption was considered important. The findings provide new insights with important implications for policy and practice, and suggest that there is considerable scope for promoting awareness in this group. Carefully designed social marketing campaigns highlighting the health issues and addressing social and environmental cues relating to caloric soft drink consumption are required. There is a need for gender-differentiated intervention programmes which are both informational and appealing to young adults. Further research is warranted, particularly to investigate beverage consumption relating to fast-food meal deals and young adults' consumption patterns in more depth.

The Relationship Between Caloric Beverage Consumption and Body Mass Index in Turkish University Students

The goal of this study was to correlate caloric beverage consumption (amount and type) and body mass index (BMI) in Turkish university students. Subjects (600 men and 593 women) were recruited from 3 public and 3 private universities in Ankara, Turkey. In each subject, socio demographic information was reviewed, a 3-day 24-hour dietary record was evaluated, body weight and height were measured, and BMI was calculated. Multi variate regression models were used to determine the independent relationship of caloric beverage consumption with BMI. The younger male subjects drank significantly more total caloric beverages than did the younger female subjects did. Caloric soft drinks were the beverage of choice among subjects, after which fluid milk, fruit drinks, and 100% fruit juices were preferred. No significant associations were noted between the BMI of the subjects and their intake of caloric beverages. Caloric beverage consumption accounted for 1% or less of the explained variance in BMI.

Sugar intake, soft drink consumption and body weight among British children: Further analysis of National Diet and Nutrition Survey data with adjustment for under-reporting and physical activity

We investigated associations between body mass index (BMI) and intake of non-milk extrinsic sugars (NMES) and caloric soft drinks using weighed 7-day food records, nutrient intakes, BMI measurements and 7-day physical activity (PA) diaries from the UK National Dietary and Nutritional Survey of Young People (n=1,294 aged 7–18 years). NMES and caloric soft drinks (excluding 100% fruit juice) were quantified by their contribution to energy intake. BMI z-scores were calculated from UK reference curves and International Obesity Task Force (IOTF) cut-off values were used to define overweight.The BMI z-score was weakly inversely correlated with percentage energy from NMES after adjustment for under-reporting and dieting (r=–0.06, P=0.03). The percentage of energy from soft drinks was not associated with the BMI z-score or PA. After excluding under-reporters and dieters, the heaviest children (top quintile: Q5 of BMI z-scores) consumed more total energy (+1,220 kJ/day) than those in the lowest quintile (Q1), but only 60 kJ (5%) was from soft drinks.In logistic regression (adjusted for age and gender, under-reporting, and dieting), overweight was positively associated with energy intake (MJ) (odds ratio [OR]=1.58, confidence interval [CI]=1.42–1.77) and sedentary activity (h) (OR=1.11, CI=1.01–1.23), and inversely associated with moderate/vigorous activity (h) (OR=0.71, CI=0.58–0.86). In the macronutrient model, high fat and protein intake (top tertile vs lowest tertile, g/day) were positively associated with overweight (OR>2.5, P<0.001) while starch had less impact (OR=1.60, CI=1.0–2.55, P<0.05). Top tertile intakes of caloric soft drinks were weakly associated with overweight (OR=1.39, CI=0.96–2.0, P=0.08), while other sources of NMES showed no association (OR=0.81, CI=0.52–1.27, P=0.4). Risk associated with caloric soft drinks appeared non-linear with an increase in odds only for very high consumers (top quintile, mean 870 kJ/day; OR=1.67, CI=1.04–2.66, P=0.03). These data are not consistent with any specific role for NMES or caloric soft drinks in obesity among British children and adolescents, but point instead to a general role of overeating and physical inactivity. Evidence of successful interventions is urgently needed but these must use reliable measurements of exposure (diet and PA) and outcome (BMI z-score, body fat, waist circumference) and have a sufficient timescale.