Beverage Choices Research Articles

Influence of environmental factors on food intake and choice of beverage during meals in teenagers: a laboratory study

Environmental conditions influence meal size in adults and children. Intake of sweet drinks could contribute significantly to energy intake and potentially affect body weight, particularly in young individuals. The objectives of the present study were to measure the lunch intake of food and drinks under controlled laboratory settings in teenagers and to compare the influence of different meal conditions. Normal-weight adolescents (fourteen males and fifteen females) participated in four standardised lunches, scheduled 1 week apart. The same popular items (meat dish, dessert, water, juice, soda) were served at all meals. Ad libitum intake was measured under four conditions: subjects ate alone; in groups; alone while viewing television; alone while listening to music. Visual analogue scales were used to assess pre- and post-meal hunger and thirst and meal palatability. Energy, solid food and fluid intake was different (significantly lower) only in the 'eating in group' condition, in spite of identical intensity of pre-meal hunger. More soda was consumed when participants were watching television, and more water was consumed while listening to music. Across all conditions, more soda than water was consumed. Post-meal ratings of hunger, thirst and palatability did not differ between conditions. We concluded that, in teenagers, a 'social inhibition' effect appears rather than the 'social facilitation' previously reported in adults. Although teenagers do not respond to the presence of television or another 'distractor' such as music by eating more, they do ingest more soda when the television is on. The social significance of meals, conditioned responses and habituation to 'distractors' may be different between adolescents and adults.

The Boston Middle School‐Corner Store Initiative: Development, implementation, and initial evaluation of a program designed to improve adolescents' beverage‐purchasing behaviors

AbstractThe Boston Middle School Corner Store Initiative (CSI) brought together schools, businesses, and community partners to develop, implement, and evaluate a multicomponent pilot program designed to promote healthier beverage purchasing at corner stores among 3,500 middle school students living in Boston, Massachusetts. Healthy drinks were defined for the purpose of this initiative as plain water, low‐fat and fat‐free milk, and 100% fruit juice. To accomplish the goals of the CSI, partnerships between middle schools and nearby corner stores in support of healthy beverage choices were formed; a social marketing plan aimed at middle school students was developed; local corner stores and schools engaged in the social marketing plan; school‐based educational and motivational components were implemented; and parents were provided with information about the campaign. The purpose of this article is to describe the: (1) design and implementation of the CSI with a focus on developing relationships across the varied partners (i.e., school, business, and community/researchers); (2) initial process and outcome evaluation data of this pilot study; and (3) lessons learned and directions for future replication and program development. © 2009 Wiley Periodicals, Inc.

Supermarket discounts: Are they promoting healthy non‐alcoholic beverages?

AbstractAim: The present study investigates the role of supermarket discounts in promoting healthy choices through evaluation of discounts applied to non‐alcoholic beverages in New Zealand supermarkets.Methods: Discount information was collected from four supermarkets in the Wellington region over a four‐week period. These included two supermarkets aimed at customers of a high socioeconomic status and two aimed at low‐socioeconomic‐status customers. The beverage brand and size were recorded along with the original and discounted prices. The beverages were classified into green (drink most), amber (drink in moderation) and red (drink less) categories based on the Waitemata District Health Board Beverage Guidelines.Results: A total of 1487 discounts were documented over the four‐week period with the majority (57.6%) of these from the high‐socioeconomic‐status supermarkets. A higher percentage of beverage discounts were classified as amber (40.9%) or red (44.1%) rather than green (14.9%) across all beverage groups except water (P < 0.001).Conclusions: This research suggests that less healthy beverages are discounted more frequently and to a larger extent than healthier beverages, but a nationwide study is required to confirm this. It appears likely that supermarkets could play a role in promoting healthy beverage choice if they refrain from discounting amber and red products.

Beverage Consumption Patterns in the U.S. Population

Beverages play an important role in hydration and beverage choices have changed over the last few years. Therefore, it is important to understand beverage consumption patterns. Using data from the 2003‐2004 and 2005‐2006 National Health and Nutrition Examination Survey (NHANES), we examined beverage consumption for males and females aged 6‐11, 12‐19, 20‐39, 40‐59, and 60+ years and compared the results with those we published previously using NHANES 1999‐2002 data. Appropriate survey weights were used to calculate average consumption of fruit juices, coffee, tea, milk products, regular fruit drinks/ades, diet fruit drinks/ades, regular carbonated soft drinks (RCSD), and diet carbonated soft drinks (DCSD). Preliminary results show that beverage consumption patterns have changed. On average, RCSD, milk products, and fruit juice consumption have decreased, while consumption of diet fruit drinks/ades has increased across most age groups. Many of the consumption pattern differences between race/ethnicities found using the 1999‐2002 data persist.This study was supported by the American Beverage Association.

The “alcopops” tax: heading in the right direction

:here is strong evidence that increasing the cost of alcohol reduces the amount that is consumed.l In a range of :countries, price increases have been consistently shown to reduce alcohol consumption and related harms in both the general population and at−risk populations such as young people and heavy drinkers. Conversely, price decreases have resulted in an increase in consumption and harm.1−3 In this context, the Austra− lian Government's April 2008 increase in excise (Bill introduced on 11 February 2009) on ready−to−drink (RTD) spirit−based prod− ucts (RTDs; alcopops) is an evidence−based strategy to reduce excessive RTD consumption among young people. The alcoholic content of RTDs is now taxed at a similar rate to that of other (tax increased from $39.36 to $66.67 per litre of pure alcohol). Critics have argued that the RTD increase has not reduced alcohol consumption by young people, and will not do so. One claim is that young people will merely switch to other beverages. These arguments have been made by some from the alcohol industry and some researchers. Doran and Shakeshaft, for exam− ple, argued that young people seem to be price inelastic about their alcohol demand.* Citing a national school survey, they claimed that spirits are by far the beverage of choice for the 45% of 16−17−year−old Australians who drink, despite being the most highly taxed beverage in Australia, and the most expensive per litre of alcohol. This is not evidence for price inelasticity They also argued that overall rates of usual or binge consumption in Australia are unlikely to substantially fall, because hold a smaller market share than beer, and young people will more than likely switch their preference.4 The weight of scientific evidence suggests otherwise − that consumption is likely to decline because young people's demand for alcohol is elastic. 1−3 The survey series on which Doran and Shakeshaft rely shows that beverage preferences vary between boys and girls and over time•In 1999, before reductions in and in the retail price of RTDs in 2000, RTDs were the preferred beverage of about 23% of 12−17−year−old female drinkers. By 2005, after the decrease, 48% of young females drank RTDs, while the preference for higher−taxed fell from 42% to 30%. For 12−17−year−old males, RTD consumption increased from 6% to 14%, a small share compared with (39%) and beer (33%).5 Although new products and marketing strategies may have contributed to this substantial change, these data suggest that young Australians, like their counterparts in other countries,2 do alter their beverage choices in response to price changes. Definitive statements about the impact of the alcopops tax are premature in the absence of independent alcohol sales data. It is regrettable that there are no readily available, official monthly sales data for all alcoholic beverages, like those obtained by the detailed monitoring that we know is conducted by private industry 6

Mystery Meat, Beverage, and Your Choice of a Just Desserts

Mystery Meat, Beverage, and Your Choice of a Just Desserts

Effects of 'Ubiquitous Healthcare' on the Ability of Self-Management in Elderly Diabetic Patients

Background: The need for a new healthcare system is growing due to the paradigm shift from health supervision to health maintenance. Previously, we performed a pilot study that examined the effectiveness of a ubiquitous healthcare (U-healthcare) diabetes management program which consists of self-monitoring of blood glucose (SMBG) and mobile phone services for elderly patients with type 2 diabetes mellitus. In this study, we investigated the effect of a diabetes management program using U-healthcare based on the self-care skills of elderly patients with diabetes mellitus. Methods: From July to October 2005, 17 patients were recruited and provided with a blood glucometer with the ZigBee module and a mobile phone. In addition, the patients' understanding of diabetes self-care skills was examined at the beginning and end of the study. At the end of the study, we determined the level of patient satisfaction regarding U-healthcare services. Results: The patients' test scores on their understanding of diabetes mellitus improved from 57.2 ± 20.7 to 72.7 ± 13.4%. Specifically, patient knowledge of the basic principles for a proper diabetic diet (52.9% vs. 82.4%, P = 0.046), foods that influence blood sugar level (41.2% vs. 76.5%, P = 0.007) and the influence of beverage choice (41.2% vs. 64.7%, P = 0.007), all increased. In addition, a significant increase in knowledge of living standards regarding diabetes mellitus was observed (64.7% vs. 88.2%, P = 0.0032). Conclusion: We conclude that the U-healthcare incorporating SMBG could be promising, as it improves self-management skills of diabetes mellitus patients, as well as their understanding of the disease. (Korean Diabetes J 33:58-64, 2009)

Alcohol Types and Sociodemographic Characteristics as Risk Factors for Barrett's Esophagus

Little is known about the effects of alcohol use and sociodemographics on the risk of Barrett's esophagus, a precursor to esophageal adenocarcinoma. We evaluated the association between alcohol use, alcohol type, sociodemographic profiles, other lifestyle factors, and the risk of Barrett's esophagus. With the use of a case-control study within the Kaiser Permanente Northern California membership, patients with a new diagnosis of Barrett's esophagus (n = 320) diagnosed between 2002 and 2005 were matched to persons with gastroesophageal reflux disease (GERD; n = 316) and to population controls (n = 317). We collected information using validated questionnaires during direct in-person interviews. Analyses used multivariate unconditional logistic regression. Total alcohol use was not significantly associated with the risk of Barrett's esophagus, although stratification by beverage type showed an inverse association for wine drinkers compared with nondrinkers (>/=7 drinks of wine per week vs none: odds ratio, 0.44; 95% confidence interval, 0.20-0.99; multivariate analysis). Among population controls, those who preferred wine were more likely to have college degrees and regularly take vitamin supplements than those who preferred beer or liquor, although adjustment for these factors or GERD symptoms did not eliminate the inverse association between wine consumption and Barrett's esophagus. Education status was significantly inversely associated with the risk of Barrett's esophagus. There are associations between alcohol types, socioeconomic status, and the risk of Barrett's esophagus. Although choice of alcoholic beverages was associated with several factors, multiple adjustments (including for GERD) did not eliminate the association between alcohol and Barrett's esophagus. Further research to evaluate the associations among socioeconomic status, GERD, and Barrett's esophagus is warranted.

Like Parent, Like Child

To examine food and beverage choices of preschool-aged children. Semistructured observational study. While pretending to be adults during a role-play scenario, children selected food and beverage items from a miniature grocery store stocked with 73 different products, of which 47 foods and beverages were examined in this analysis. Parents self-reported how frequently they purchased specific grocery items. A behavioral laboratory. One hundred twenty children, aged 2 to 6 years, and 1 parent for each child. Main Outcome Measure Children's total purchases were classified according to the number of healthier and less healthy products they selected as least healthy, somewhat healthy, and most healthy choices. The same categories were used to classify parents' self-reported purchases. Most of the children (70.8%) purchased foods that were categorized as least healthy choices. Only 13 children (10.8%) had shopping baskets consisting of the healthiest choices. On average, children in the group with the least healthy choices purchased the same number of healthier and less healthy products, whereas children in the group with most healthy choices purchased 5 healthier products for each less healthy product selected. The healthfulness of children's total purchases were significantly (P = .02) predicted by their parents' purchasing categorization. When presented with a wide array of food products, young children chose combinations of healthier and less healthy foods and beverages. The data suggest that children begin to assimilate and mimic their parents' food choices at a very young age, even before they are able to fully appreciate the implications of these choices.

Product variety in Australian snacks and drinks: how can the consumer make a healthy choice?

To estimate the proportion of snack food and beverage choices available to an Australian consumer. A survey of product Nutrition Information Panels (NIP) and product labels on snack foods and beverages offered for sale. Data on nutrient content were compared with criteria from different nutrient profile systems to estimate the proportion of items conforming to a choice. A large supermarket in metropolitan Melbourne, Australia. A consumer could choose from 1,070 different snack foods and 863 different drinks. Flavour variety was more common in snacks (maximum thirteen per product) while variation in container size was more common for drinks (up to ten per product). Recommended serving size for snacks varied greatly (1822 % of snack foods presented for sale could be deemed by multiple criteria. Similarly, only 14 healthy healthier' snack foods and beverages, e.g. by reformulation of many products by the food industry and their presentation in smaller, standardised portion-size packaging.

The Allure of the Few

The Allure of the Few

Modeling Expert Opinions on Food Healthiness: A Nutrition Metric

BackgroundResearch over the last several decades indicates the failure of existing nutritional labels to substantially improve the healthiness of consumers' food and beverage choices. The obstacle for policy-makers is to encapsulate a wide body of scientific knowledge into a labeling scheme that is also comprehensible to the average shopper. Here, we describe our method of developing a nutrition metric to fill this void.MethodsWe asked leading nutrition experts to rate the healthiness of 205 sample foods and beverages, and after verifying the similarity of their responses, generated a model that calculates the expected average healthiness rating that experts would give to any other product based on its nutrient content. ResultsThe form of the model is a linear regression that places weights on 12 nutritional components (total fat, saturated fat, cholesterol, sodium, total carbohydrate, dietary fiber, sugars, protein, vitamin A, vitamin C, calcium, and iron) to predict the average healthiness rating that experts would give to any food or beverage. We provide sample predictions for other items in our database.ConclusionsMajor benefits of the model include its basis in expert judgment, its straightforward application, the flexibility of transforming its output ratings to any linear scale, and its ease of interpretation. This metric serves the purpose of distilling expert knowledge into a form usable by consumers so that they are empowered to make healthier decisions.

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.

Milk: the new sports drink? A Review

There has been growing interest in the potential use of bovine milk as an exercise beverage, especially during recovery from resistance training and endurance sports. Based on the limited research, milk appears to be an effective post-resistance exercise beverage that results in favourable acute alterations in protein metabolism. Milk consumption acutely increases muscle protein synthesis, leading to an improved net muscle protein balance. Furthermore, when post-exercise milk consumption is combined with resistance training (12 weeks minimum), greater increases in muscle hypertrophy and lean mass have been observed. Although research with milk is limited, there is some evidence to suggest that milk may be an effective post-exercise beverage for endurance activities. Low-fat milk has been shown to be as effective, if not more effective, than commercially available sports drinks as a rehydration beverage. Milk represents a more nutrient dense beverage choice for individuals who partake in strength and endurance activities, compared to traditional sports drinks. Bovine low-fat fluid milk is a safe and effective post exercise beverage for most individuals, except for those who are lactose intolerant. Further research is warranted to better delineate the possible applications and efficacy of bovine milk in the field of sports nutrition.

The "Skinny" on Coffee Drinkers: Gender Differences in Healthy Beverage Choices

The "Skinny" on Coffee Drinkers: Gender Differences in Healthy Beverage Choices

Beer and Wine Consumers' Perceptions of the Nutritional Value of Alcoholic and Nonalcoholic Beverages

In general beer has not been portrayed as part of a balanced diet. However, red wine has been promoted as a beneficial part of a nutritious diet. The evidence is that beer is at least the equal of wine from a nutritional perspective and in countering ailments such as coronary heart disease. This study used surveys to compare beer and wine consumers' perceptions of alcoholic and nonalcoholic beverages. The consumers ranked 7 beverages based upon perceived healthfulness both before and after they were exposed to nutritional information about the beverages. The ranked data were analyzed using analysis of variance. The variance due to the 3-way interaction of place of recruitment, beverage, and ranking was found to be significant at P < 0.05. There was no significant difference between genders. Overall, consumers of alcoholic beverages perceived red wine to be more healthful than the other 6 beverages, including beer and white wine. The perceived healthfulness of a beverage does not appear to be the main factor driving the choice of beverage. Nutritional information does impact consumers' perceptions of the healthfulness of beverages. Consumers who are predominately beer drinkers were more heavily influenced by nutritional information than consumers who were predominately wine drinkers.

Does Beverage Type Matter?

The purpose of this article is to review the associations of different beverage types with different types of harm and discuss their likely causes. The key issue is whether alcohol policy can influence the occurrence of harms by affecting consumers' beverage choices. This is dependent on the following questions addressed in this article: 1) Does beverage choice affect alcohol-related harm if quantity of alcohol is equal? 2) Does beverage choice impact the quantity of alcohol consumed? 3) Can beverage choice influence the nature of the drinking situation and thereby quantities and harm? The literature review did not reveal great differences between different beverages with regard to harm if equal amounts are drunk, although it seems that spirits are somewhat more closely associated with alcohol poisonings and aggressive behaviour. Our results showed that spirits have a prominent role in Finnish binge drinking: the proportion of spirits consumed increases in direct proportion to the amounts of alcohol consumed on individual drinking occasions. we conclude that it would be unwise to encourage consumers to favour spirits. Currently, the difference in taxes on spirits and mild alcoholic beverages in Finland is larger than the corresponding difference in harm per litre of ethyl alcohol. However, an equal rate of taxes would make spirits much cheaper per litre of ethyl alcohol than other beverages. Based on our review, this situation would in all probability lead to an increase in alcohol-related harm.

Editors' Introduction International Perspectives on Alcohol Policy Effect Studies, Policy Opinion, and Policy Formation

In recent decades there have been dramatic international changes in alcohol policy initiatives, access to alcohol, level of consumption, drinking patterns, and damage associated with alcohol consumption. A number of studies have shown strong associations among drinking levels, drinking patterns and the physical harms and social problems derived from the effects of alcohol (e.g., Babor, Caetano, Casswell, Edwards, Giesbrecht, Graham, et al. 2003; Edwards, Anderson, Babor, Casswell, Ferrence, Giesbrecht et al. 1994; Rehm, Chisholm, Room & Lopez 2006). Concurrently, evaluations and reviews of alcohol policies and other interventions demonstrate that some prevention strategies are more effective than others in reducing alcohol-related harms (Babor et al. 2003). However, recent changes in many jurisdictions have effectively increased access to alcohol, suggesting that drinking rates and levels of damage may increase in the future (e.g., WHO 2007).While research has documented the substantial damage from alcohol (Rehm et al. 2006; WHO 2002) and pointed to effective interventions, some of the most effective policy levers have been eroded in recent years (Room, Babor & Rehm 2005). Thus it is expected that alcohol-related social and health harms will increase, particularly in jurisdictions where controls on alcohol are eroded or underdeveloped, where a large portion of drinking occasions involve high-volume consumption and/or where overall alcohol consumption rates are on the rise.The articles in this issue and its companion issue (Volume 34, No. 3) are based on some of the research papers presented at a thematic symposium of the Kettil Bruun Society for Social and Epidemiological Research on Alcohol (KBS), which was held in Toronto, Canada, in October 2006. The title of the symposium was Population Level Studies of Alcohol Consumption and Harm. It offered an opportunity to provide an update on recent and ongoing international studies of alcohol consumption and damage and to examine their implications and impact, if any, on the policy process or outcomes. Of particular interest were international and national studies that examined population-level studies of changes in alcohol management and access to alcohol, alcohol control systems, drinking patterns and levels, and damage associated with alcohol use.As illustrated in this issue and its companion issue, articles were presented from several Latin American countries, two European jurisdictions, Canada, and the United States. The ten articles in this edition are organized into two groups: the first four are policy-effect studies and the next six focus on themes of policy opinion and policy formation and implementation. In the companion issue the focus is on population surveys and epidemiological studies.Salme Ahlstrom and Petri Huhtanen (2007) use a combination of archival data (minimum legal purchasing age or MLDA) and cross-sectional self-reported data from 30 countries that participated in the 2003 European School Survey Project on Alcohol and Other Drugs (ESPAD). The authors examine the perceived availability of alcoholic beverages, reported purchasing habits, and prevalence of drinking and intoxication. Perceived good availability of wine and spirits was associated with the probability of purchasing and drinking wine and spirits; however, perceived availability was not associated with prevalence of self-reported intoxication.Martin Stafstrom (2007) uses two cross-sectional student surveys conducted in southern Sweden in 2003 and 2005 to examine the drinking patterns of adolescents. Between the two surveys he found an increase of 31% in the proportion reporting that they often or always consumed imported alcohol, but a significant decrease in binge drinking. In recent years an increase in access to alcohol, particularly in southern Sweden-brought about by a dramatic elevation in import upper limits from the late 1990s and increased transportation access to cheaper alcohol in Denmark and Germany-appears to have contributed to changes in beverage choices among adolescents in southern Sweden, but not necessarily to an increase in binge drinking. …

Feeding the 1 to 7-year-old child. A support paper for the South African paediatric food-based dietary guidelines.

Young children embark on a transitional nutritional journey, progressing from total reliance on caregivers to independence, autonomy and self-determination. Appropriate nutritional intake in young children is a diverse concept, incorporating suitable nutritional choices and feeding behaviours. Lessons learnt in childhood will have long-term effects on the individual and society overall. Since South African children are raised in a country where under- and over-nutrition exist simultaneously, a careful balance should be achieved in any national public health message. The South African paediatric food-based dietary guidelines for children younger than 7 years strive to facilitate the education of carers of young children in the adoption of healthy eating practices. The guidelines address issues regarding variety in the diet that has been shown to improve both micro- and macronutrient intakes. Specific reference is made to starchy foods, vegetables, fruit and water along with protein sources, which should be consumed regularly. Milk, has been emphasised in these guidelines because of the poor calcium intake in South African children. The only guideline that limits intake is the sweet treats or drinks message, because of public health concerns such as obesity and dental caries. Other messages pertaining to eating habits take cognisance of the child's physiological limitations in gastric capacity and suggest small regular meals. Clean, safe drinking water is the beverage of choice. Non-food-based guidelines are also included, which recognize the importance of active play, for developmental and health purposes, as well as regular clinic attendance.

Tea or Coffee: A Study of the Beverage Choice Pattern and its Affecting Factors at Teatime in Kaohsiung, Taiwan

This paper aims to understand the decision making process of people in the Kaohsiung area with regard to their preference of tea or coffee. The contributing factors behind consumers' decision-making are further investigated. This paper also looks into the frequency of tea and coffee consumer teatime habits and consumer demographic structure. The relationship between tea and coffee consumers in relation to their reasons of consuming decision-making is studied. The issues as to whether demographic variables influence the decision-making and consuming reasons are also examined. A questionnaire survey was adopted in our research, which utilizes statistical analyses. The sample was comprised of 316 people living in Kaohsiung. The main findings are: 1) Tea was preferred by most individuals. 2) Approximately 72% of the sampled subjects in Kaohsiung area have a teatime habit every week (21.5% more than 3 times a week, along with another 50.9% fewer than 3 times per week). 3) Males were older and had higher incomes than females; also, males were involved in teatime activity more frequently than their female counterparts. 4) The main factor when selecting tea or coffee was ”flavor and taste” followed by ”atmosphere and environment”. 5) Respondents who preferred tea held a significantly higher level of agreement in the areas of ”fair price”, ”health benefits”, ”friends' influences”, ”beauty benefits”, and ”religion” as influencing factors of the beverage selection compared to those who opted for coffee. Meanwhile, coffee consumers put more emphasis on ”effect of alertness and refreshment” and ”atmosphere and environment.” 6) Significant discrepancies existed among different demographic subgroups, based on gender, age, income and occupation variables in relation to certain consumption patterns. The findings of the study lend themselves to reference for teatime and cafe industry professionals.