Carbonated Soft Drink Consumption Research Articles

Labels, taxes, and food reformulation: A tale of sugar in carbonated soft drinks in Ecuador

Abstract The prevalence of obesity has increased significantly worldwide, including in low- and middle-income countries. In Ecuador, a middle-income country, the government has implemented two policies to improve the quality of its population’s diet: (1) a traffic-light (TL) nutritional labeling requirement for processed foods and (2) a special tax scheme for drinks with a high sugar content (HSC). This study examines changes in carbonated soft drink (CSD) sugar formulation and its associated impacts on sugar consumption after the implementation of these two policies. Sugar content in soft drinks was obtained from the National Agency for Health Regulation, Control, and Surveillance (ARCSA) and directly from the labels of carbonated soft drinks sold in the country. CSD monthly purchase data from January 2013 to December 2019 were obtained from the Kantar World Panel (Ecuador). Mixed reactions followed the introduction of the TL in the sugar content reformulation of CSD. In contrast, the implementation of the HSC tax scheme was followed by extensive efforts to reformulate CSD as all brands studied decreased their sugar content. We also found evidence that CSD consumption reduced significantly after the HSC tax scheme was imposed. Overall, sugar consumption linked to CSD decreased after the implementation of these two policies. Still, most of this decrease is related to reformulation activities observed after the HSC tax scheme was implemented.

Efficacy of a school-based education intervention on the consumption of fruits, vegetables and carbonated soft drinks among adolescents.

To evaluate the efficacy of a school-based education intervention on the consumption of fruit, vegetables and carbonated soft drinks among adolescents. Cluster-randomised controlled trial. Eight secondary schools from Dhaka, Bangladesh, participated in this trial and were randomly allocated to intervention (n 160) and control groups (n 160). A total of 320 students from 8th to 9th grades participated and completed the self-reported questionnaires at baseline, and at 8 and 12 weeks. The intervention included weekly classroom-based nutrition education sessions for students and healthy eating materials for students and parents. Repeated measures ANCOVA was used to assess the effects of the intervention. Daily fresh fruit intake was more frequent in the intervention (26 %) compared to the control group (3 %) at 12 weeks (p = 0·006). Participants from the intervention group also reported a significantly (P < 0·001) higher (49 %) proportion of fresh vegetable intake compared to the control group (2 %) at 12 weeks. Frequency of daily carbonated soft drinks intake decreased (25 %) in the intervention group at 12 weeks compared to baseline, while it remained unchanged in the control group; the interaction effect was observed significant (P = 0·002). Our school-based education intervention increased the daily frequency of fresh vegetables and fruit intake and decreased carbonated soft drink consumption among adolescents in the intervention group. There is a need for scaling up the intervention to engage students and empower them to develop healthy dietary habits.

Consumption of carbonated soft drinks, fruits and vegetables and association with macroeconomic indicators: the analysis of students from seventy-four countries (2003-2015).

This study aimed to compare fruits and vegetables (FV), and carbonated soft drink (CSD) consumption among adolescents from seventy-four countries, according to macroeconomic indicators. This is an ecological study, developed with countries evaluated through the Global School-based Student Health Survey (2003-2014) and the National School Health Survey (PeNSE-Brazil, 2015). The percentages of students in each country who consumed CSD and FV daily and their association with the Human Development Index (HDI) and the Gross National Income per capita (GNIpc) were assessed. Scatter plots were constructed for each marker, and a multilevel model was tested to consider the effects of region in the associations. The overall prevalence of daily CSD consumption was 54·1 %. CSD consumption was positively associated with HDI and GNIpc through multilevel models, and Central and South America showed a considerable higher consumption compared with other regions. Overall, FV daily consumption was 67·9 % and 74·6 %, respectively, and no associations with macroeconomic indicators were found. The study shows concerning rates of CSD consumption among adolescents, and a trend of increased consumption with the improvement of the country's development and GNIpc. This points for the importance of public policies that regulate food and beverage industries to reduce CSD consumption and related co-morbidities among adolescents.

Adverse effect of consumption of carbonated soft drinks on orthodontic treatment - A systematic review.

The complications of soft drink consumption during orthodontic treatment includes degradation of enamel, reduction in the shear bond strength of orthodontic brackets, and also corrosion of orthodontic wires. The main objective of this review is to discuss the adverse effects of carbonated soft drink (CSD) consumption on patients undergoing fixed orthodontic treatment. A search of studies in MEDLINE (via PubMed), the Cochrane library, Web of science, IndMED, EMBASE, Google scholar and limited grey literature on the effects of consumption of CSDs was conducted. All pertinent abstracts were reviewed for inclusion. Full articles were retrieved for abstracts or titles that met the initial inclusion criteria or lacked sufficient detail for immediate exclusion. Out of the 4484 results obtained from search, 16 articles were selected based on title and 6 articles were eliminated after reading the abstracts. 10 articles were selected for systematic review which included 6 invitro studies, 1 animal study, 1 observational study and 2 invivo studies. Of these, six studies evaluated the effects of carbonated drinks on the shear bond strength of brackets on enamel of which two evaluated the microhardness of enamel, two studies evaluated the mechanical and chemical properties of wires, one evaluated tooth movement and one study focussed on white spot lesions. The results from the selected articles showed that with the consumption of carbonated drinks, there was reduced shear bond strength of orthodontic brackets, altered enamel characteristics, alteration of mechanical and physical properties of orthodontic wires and decrease in rate of orthodontic tooth movement. Based on the available evidence, CSD consumption during orthodontic treatment definitely has an effect on orthodontic appliances, enamel and possibly on tooth movement.

Association between Soft Drink Consumption and Aggressive Behaviour among a Quarter Million Adolescents from 64 Countries Based on the Global School-Based Student Health Survey (GSHS)

Soft drink consumption has become a significant public health concern that is associated with various adverse health outcomes. We aim to examine the association between soft drink consumption and aggressive behavior among adolescents. We used open access data from 79 studies in 64 countries, including 263,890 adolescents aged 12–18 years who completed the global school-based student health survey (GSHS). Self-reported data on past 30-day carbonated soft drink consumption (number of times per day) and past 12-month physical fighting were utilized for analysis. Of the 263,890 participants (48% boys) aged 12–18 years, the weighted mean frequency of soft drink consumption varied from 0.5 in Kiribati to 2.5 times/day in Surname, while the weighted prevalence of frequent aggressive behavior varied from to 2.7% in Laos to 49.2% in Tuvalu. We found that each increment of soft drink consumption (time/day) was associated with an 11% (95%CI 10–13%) increase of the likelihood of frequent physical fighting. This result remained significant after adjusting for various covariates. In this large pooled sample of multinational data, there is a significant positive association between soft drink consumption and aggressive behavior among adolescents. Reducing soft drink consumption may help reduce aggressive behavior, a major risk factor for violence.

Is consumption of fast-food and carbonated soft drink associated with anxiety-induced sleep disturbance among adolescents? A population-based study

Unhealthy dietary behaviours have been associated with poor sleep among adolescents in many developed countries; however, evidence is lacking from resource-limited settings. This study aimed to examine the associations of fast-food or carbonated soft drink consumption with anxiety-induced sleep disturbance among adolescents in Bangladesh. We analysed data from the 2014 Bangladesh Global School-based Student Health Survey. Data on past 12-month anxiety-induced sleep disturbance, and past 30-day carbonated soft drink and past 7-day fast-food consumption were collected. We used Poisson regression to examine the associations. Data were available for 2742 adolescents aged 12-15 years (37% females). The prevalence of anxiety-induced sleep disturbance was 4.5%, while that of soft drink (≥3 times/day) and fast-food (≥3 days/past week) consumption were 17% and 26%, respectively. Multivariable analysis showed that adolescents who consumed carbonated soft drink ≥3 times/day had double the odds of reporting sleep disturbance than those who consumed<once/day (OR 2.05, 95% CI 1.01-4.18). Compared to those who did not have any fast-food in the past week, the odds of reporting sleep disturbance was 2.6 times higher among those who had fast-food ≥3 days during the past week (OR 2.64, 95% CI 1.33-5.24). Adolescents who had high intake of both fast-food and soft drink had 3.4 times higher odds of reporting sleep disturbance compared to those who had neither (OR 3.40, 95% CI 1.37-8.44). Our findings suggest positive associations between frequent consumption of soft drinks and/or fast-food with anxiety-induced sleep disturbance among adolescents. Prospective studies are needed to understand these associations better.

High carbonated soft drink consumption is associated with externalizing but not internalizing behaviours among university students in five ASEAN states.

BackgroundThe investigation aimed to estimate the association between carbonated soft drink consumption frequency and externalizing and internalizing behaviour among university students in five ASEAN counties.MethodsA cross-sectional survey included 3353 university students from Indonesia, Malaysia, Myanmar, Thailand and Vietnam, median age 20 years (interquartile range 3 years).ResultsIn all five ASEAN countries, the study found a prevalence no soft drink consumption in the past 30 days of 20.3%, less than one time a day 44.7%, once a day 25.4% and two or more times a day 9.6%. In the adjusted logistic regression analysis, higher frequency of soft drink consumption (one and/or two or more times a day) was associated with externalizing behaviour (in physical fight, injury, current tobacco use, problem drinking, drug use, pathological internet use and gambling behaviour), and higher frequency of soft drink consumption (two or more times a day) was associated with depression in females, but no association was found for the general student population in relation to internalizing behaviour (depression, posttraumatic stress disorder, suicidal ideation, suicide plan, suicide attempt and sleeping problem).ConclusionsFindings suggest that carbonated soft drink consumption is associated with a number of externalizing but not internalizing health risk behaviours.

Consumption of carbonated soft drinks and suicide attempts among 105,061 adolescents aged 12–15 years from 6 high-income, 22 middle-income, and 4 low-income countries

Multinational studies on the relationship between consumption of sugar-sweetened beverages and suicidal behavior in youths are lacking. Thus, the goal of this study was to investigate the association between consumption of carbonated soft drinks and suicide attempts among adolescents from 6 high-income, 22 middle-income and 4 low-income countries. Cross-sectional data from the Global school-based student health survey (GSHS) were analyzed. Data on past 12-month suicide attempts and past 30-day carbonated soft drink consumption (number of times per day) were collected. Multivariable logistic regression and meta-analysis were conducted to assess associations. There were 105,061 adolescents (49.0% females) aged 12-15 years included in the analysis. The overall prevalence of suicide attempts and consumption of carbonated soft drinks ≥3 times/day were 10.2% and 10.7%, respectively. After adjustment for potential confounders (i.e., sex, age, food insecurity, alcohol consumption, smoking, physical activity, obesity, fruit and vegetable consumption, fast food consumption, country), compared to those who did not consume carbonated soft drinks, those who consumed 3 and≥4 times/day were 1.36 (95%CI=1.07-1.72) and 1.43 (95%CI=1.14-1.80) times more likely to have reported an attempted suicide in the past 12 months, respectively. Country-wise analyses showed that consumption of carbonated soft drinks ≥3 times/day (vs. <3 times/day) was associated with higher odds for suicide attempts (i.e., OR>1) in 22 of the 32 included countries with the pooled OR (95%CI) based on a meta-analysis being 1.20 (1.12-1.28; I2=28.6%). Our data indicate that there is a positive association between consumption of carbonated soft drinks and suicide attempts in the past 12 months. Further studies should confirm/refute our findings and investigate the potential underlying mechanisms.

Carbonated soft drinks induce oxidative stress and alter the expression of certain genes in the brains of Wistar rats.

In Saudi Arabia, the consumption of carbonated soft drinks is common and often occurs with each meal. Carbonated soft drink consumption has been shown to exhibit effects on the liver, kidney and bone. However, the effects of these soft drinks on brain activity have not been widely examined, particularly at the gene level. Therefore, the current study was conducted with the aim of evaluating the effects of chronic carbonated soft drink consumption on oxidative stress, brain gene biomarkers associated with aggression and brain histology. In total, 40 male Wistar rats were divided into four groups: Group 1 served as a control and was provided access to food and water ad libitum; and groups 2‑4 were given free access to food and carbonated soft drinks only (Cola for group 2, Pepsi for group 3 and 7‑UP for group 4). Animals were maintained on these diets for 3 consecutive months. Upon completion of the experimental period, animals were sacrificed and serological and histopathological analyses were performed on blood and tissues samples. Reverse transcription‑polymerase chain reaction was used to analyze alterations in gene expression levels. Results revealed that carbonated soft drinks increased the serum levels of malondialdehyde (MDA). Carbonated soft drinks were also observed to downregulate the expression of antioxidants glutathione reductase (GR), catalase and glutathione peroxidase (GPx) in the brain when compared with that in the control rats. Rats administered carbonated soft drinks also exhibited decreased monoamine oxidase A (MAO‑A) and acetylcholine esterase (AChE) serum and mRNA levels in the brain. In addition, soft drink consumption upregulated mRNA expression of dopamine D2 receptor (DD2R), while 5-hydroxytryptamine transporter (5‑HTT) expression was decreased. However, following histological examination, all rats had a normal brain structure. The results of this study demonstrated that that carbonated soft drinks induced oxidative stress and altered the expression of certain genes that are associated with the brain activity and thus should be consumed with caution.

Emerging protective and risk factors of mental health in Asian American students: findings from the 2013 Youth Risk Behavior Survey

A large number of studies observed inconsistent findings about mental health among Asian American adolescents. Using data from the 2013 Youth Risk Behavior Survey, this study examined a set of emerging risk and protective factors (dietary patterns, bullying, cyberbullying, TV consumption, and physical activity) for psychosocial distress (depression and suicidal ideation) in 12- to 18-year-old 671 Asian compared to 6,415 Caucasian and 3,477 African adolescents. Using descriptive statistics and bivariate logistic regression analysis, this study found that Asian students (27.1%) reported more depression than their African (25.9%) but less depression than their Caucasian (29.4%) counterparts. Asian students (18.8%) reported more suicidal ideation than their African (15.9%) and Caucasian (16.8%) counterparts. Results also depicted that lower carrot intake increased depression risk (odd ratio (OR): 1.53, 95% confidence interval (CI): 1.05, 2.21), while higher milk and less carbonated soft drink consumption decreased suicidal ideation risk (OR: .49, 95% CI: .26, .91, OR: .53, 95% CI: .32, .88, respectively), only applicable to Asian students. However, unexpectedly, low levels of bullying on school property resulted in higher depression (Asians, OR: 1.53, 95% CI: 1.05, 2.24; Africans, OR: 3.32, 95% CI: 2.96, 3.72; and Caucasians, OR: 2.40, 95% CI: 2.04, 2.83). Similarly, lower cyber bullying (Asians, OR: 3.54, 95% CI: 2.12, 5.93; Africans, OR: 2.88, 95% CI: 2.47, 3.34; and Caucasians, OR: 2.59, 95% CI: 2.19, 3.04) predicted higher odds of depression and suicidal ideation in all racial groups. Another interesting risk factor of higher suicidal ideation in overall racial groups was high levels of breakfast consumption (Asians, OR: 3.19, 95% CI: 1.91, 5.31; Africans, OR: 1.52, 95% CI: 1.21, 1.90; and Caucasians, OR: 1.35, 95% CI: 1.17, 1.54). School staff and mental health professionals should embrace culturally responsive healthy dietary patterns to promote positive youth development in Asian Americans.

Association between soft drink consumption, oral health and some lifestyle factors in Swedish adolescents

Objective. The aim was to investigate the relationship between soft drink consumption, oral health and some lifestyle factors in Swedish adolescents. Materials and methods. A clinical dental examination and a questionnaire concerning lifestyle factors, including drinking habits, oral hygiene, dietary consumption, physical activity and screen-viewing habits were completed. Three hundred and ninety-two individuals completed the study (13–14 years, n = 195; 18–19 years, n = 197). The material was divided into high and low carbonated soft drink consumption groups, corresponding to approximately the highest and the lowest one-third of subjects in each age group. Differences between the groups were tested by the Mann-Whitney U-test and logistic regression. Results. Intake of certain dietary items, tooth brushing, sports activities, meal patterns, screen-viewing behaviors, BMI and parents born outside Sweden differed significantly between high and low consumers in one or both of the two age groups. Dental erosion (both age groups) and DMFT/DMFS (18–19 years group) were significantly higher in the high consumption groups. Logistic regression showed predictive variables for high consumption of carbonated soft drinks to be mainly gender (male), unhealthy dietary habits, lesser physical activity, higher BMI and longer time spent in front of TV/computer. Conclusion. High soft drink consumption was related to poorer oral health and an unhealthier lifestyle.

Substitution Patterns Can Limit the Effects of Sugar-Sweetened Beverage Taxes on Obesity

Substitution Patterns Can Limit the Effects of Sugar-Sweetened Beverage Taxes on Obesity

Soft drink advertising and consumption in the United States 1984–2007

In recent years, the carbonated soft drink (CSD) industry has come in for a lot of criticism from consumer advocacy and special interest groups for producing and marketing a product that is considered one of the causes of obesity. Critics point to advertising as one of the major contributing factors for increased CSD consumption, particularly among children and teens. Surprisingly, there has been no empirical research done in this area to answer this controversial question. The current study is a first of its kind to use an ordinary least squares regression procedure to investigate the link between annual advertising expenditures and consumption for carbonated soft drinks sold in the United States from 1984 to 2007.

Carbonated Soft Drinks and Dental Caries in the Primary Dentition

We analyzed fluid intake data among children aged 2-10 years from a 24-hour dietary recall interview in the NHANES III (1988-94) to investigate the effect of high consumption of carbonated soft drinks on caries in the primary dentition. We used cluster analysis to determine fluid consumption patterns. Four distinct fluid consumption patterns were identified: high carbonated soft drinks, high juice, high milk, and high water. About 13% of children had a high carbonated soft drink consumption pattern; they also had a significantly higher dental caries experience in the primary dentition than did children with other fluid consumption patterns. A fluid intake pattern comprised mainly of milk, water, or juice was less likely to be associated with dental caries. Findings of this study suggest that high consumption of carbonated soft drinks by young children is a risk indicator for dental caries in the primary dentition and should be discouraged.

Carbonated Soft Drink Consumption and Risk of Esophageal Adenocarcinoma

Carbonated soft drinks (CSDs) have been associated with gastroesophageal reflux, an established risk factor for esophageal adenocarcinoma. As both CSD consumption and esophageal adenocarcinoma incidence have sharply increased in recent decades, we examined CSD as a risk factor for esophageal and gastric cancers in a U.S. multicenter, population-based case-control study. Associations between CSD intake and risk were estimated by adjusted odds ratios (ORs), comparing the highest versus lowest quartiles of intake. All statistical tests were two-sided. Contrary to the proposed hypothesis, CSD consumption was inversely associated with esophageal adenocarcinoma risk (highest versus lowest quartiles, OR = 0.47, 95% confidence interval = 0.29 to 0.76; Ptrend = .005), due primarily to intake of diet CSD. High CSD consumption did not increase risk of any esophageal or gastric cancer subtype in men or women or when analyses were restricted to nonproxy interviews. These findings indicate that CSD consumption (especially diet CSD) is inversely associated with risk of esophageal adenocarcinoma, and thus it is not likely to have contributed to the rising incidence rates.

Associations of Adequate Intake of Calcium with Diet, Beverage Consumption, and Demographic Characteristics among Children and Adolescents

Objective: The objective of this study is to examine various factors associated with total calcium intake and percent adequate intake (% AI) of calcium by children and adolescents, with respect to age, gender, race/ethnicity, and diet and beverage choices.Design: Data from the U.S. Department of Agriculture’s Continuing Survey of Food Intake by Individuals 1994–96, 98 were used in the analyses. Age groupings (2–3, 4–8, 9–13, and 14–18 year olds) were based on the National Academy of Sciences recommendations for AI of calcium—500, 800, 1,300, and 1,300 mg calcium per day, respectively.Results: Consumption of milk products was strongly and positively associated with calcium intake. Consumption of carbonated soft drinks and other non-dairy beverages was also positively associated with calcium intake, but this association was very weak. Beverage choices of African-American children and adolescents are significantly different than white and Hispanic children and adolescents. For example, African-American adolescent girls consume fewer milk products and more fruit drinks/ades. Average daily carbonated soft drink consumption is approximately 1.6 and 1.0 twelve ounce cans among 14–18 year old boys and girls, respectively.Conclusion: Carbonated soft drink consumption among adolescent girls is modest and does not appear to be linked to decreased calcium intake. The analyses in this paper show that creative effective, efficient, and targeted policies should be considered to help adolescent girls increase calcium intake. Making low-fat milk products, flavored milks, calcium-fortified beverages and foods more attractive and available will help encourage girls to consume more of this important mineral. When adequate calcium intake is not achieved through foods, health professionals should consider recommending calcium supplements.

Carbonated soft drink consumption and bone mineral density in adolescence: the Northern Ireland Young Hearts project.

In an observational study of 1335 boys and girls aged 12 and 15 years, higher intakes of carbonated soft drinks (CSDs) were significantly associated with lower bone mineral density at the heel, but only in girls. Owing to the upward trend in CSD intake in adolescence, this finding may be of concern. High consumption of carbonated soft drinks (CSD) during adolescence may reduce bone mineral accrual and increase fracture risk. The aim of this study was to examine the relationship between CSD consumption and bone mineral density (BMD) in a representative sample of adolescents. This was a cross-sectional observational study in 36 postprimary schools in Northern Ireland. Participants included 591 boys and 744 girls either 12 or 15 years old. BMD was measured by DXA, and usual beverage consumption was assessed by the diet history method. Adjusted regression modeling was used to investigate the influence of CSD on BMD. A significant inverse relationship between total CSD intake and BMD was observed in girls at the dominant heel (beta, -0.099; 95% CI, -0.173 to -0.025). Non-cola consumption was inversely associated with dominant heel BMD in girls (beta, -0.121; 95% CI, -0.194 to -0.048), and diet drinks were also inversely associated with heel BMD in girls (beta, -0.087; 95% CI, -0.158 to -0.016). However, no consistent relationships were observed between CSD intake and BMD in boys. Cola consumption and nondiet drinks were not significantly related to BMD in either sex. CSD consumption seems to be inversely related to BMD at the dominant heel in girls. It is possible that the apparent association results from the displacement of more nutritious beverages from the diet. Although the inverse association observed between CSD consumption and BMD is modest and confined to girls, this finding may have important public health implications given the widespread use and current upward trend in CSD consumption in Western populations.