Child Sugar-sweetened Beverage Research Articles

Effectiveness of pictorial-warning intervention to reduce consumption of sugar-sweetened-beverages

Abstract Background & Aims Limited research have looked at pictorial-health-warnings (PHW) for sugar- sweetened beverages (SSB), despite the potential for behaviour change that pictorial warnings on tobacco products hold. This study aimed to examine how visual warnings impacted parents’ decisions to buy SSB for their children. Materials and methods All residents dwelling in the communities and local vendors available were subjected to a ten-week multi-strategy intervention by randomized stepped-wedge controlled trial to support the introduction of PHW labels. Stepped implementation of a two-week PHW intervention was delivered in a randomly selected order at one-week intervals. Follow-up data were collected for all three sectors two weeks following the completion of the PHW intervention in the third sector. The trial outcome was determined by comparing the overall perception change towards SSB among parents between the baseline and follow-up periods for three sectors combined. Secondary outcomes included reactions to the trial labels, attitudes toward SSB, and intentions to serve their child SSB. Results PHW led to a 30 % (-37.12%, -22.37%) reduction in purchases of SSB, along with lower intentions to serve SSB to children, higher thoughtfulness about the harms of SSB, more perceived control of healthy eating decisions, stronger negative emotional reactions, lower perceived healthfulness of SSB for their child, and greater injunctive norms to limit SSB for their child (all p < 0.05). No differences by sector or within sector were found between pre and post-intervention in the appeal of SSB or perceived tastiness of SSB (all p > 0.05). Nearly 53% of participants reported being more in control of making healthy eating decisions. Conclusions Warnings on SSB are a promising policy approach to reduce sugary drink purchasing. This evidence will support the health service adoption of implementation strategies to support PHW labels across the entire country. Key messages • Warnings on SSB are a promising policy approach to reduce sugary drink purchasing. • Support the health service adoption of implementation strategies to support PHW labels across the entire country.

Understanding Factors that Influence Parents' Provision of Beverages to Their Children: A Qualitative Evidence Synthesis.

Understand parental perceptions of beverages and factors influencing the beverage choices they make for their children. A literature search was conducted using PubMed, Scopus, and CINAHL. Included studies contained qualitative data examining parents' perceptions of beverages or factors that influence their child's beverage consumption, were conducted in the United States between 2000 and 2022, written in English, and enrolled parents of children aged 18years or younger. Authors, titles, study aims, methods, qualitative results, and representative quotations were extracted using Covidence. Qualitative findings were independently coded by two coders. Codes were compared and discrepancies resolved through discussion with a third team member. Themes and sub-themes were identified, and representative quotations selected. 13 studies met inclusion criteria. Five major themes emerged: 1) factors that influence parents' provision of beverages to their children, 2) parents' concerns about sugar-sweetened beverages (SSBs), 3) barriers to limiting children's SSB consumption, 4) strategies to lower children's SSB consumption, and 5) parents' perceptions of beverage healthfulness. Though most parents are aware of unfavorable health effects of frequent SSB intake, environmental and sociocultural factors pose barriers to limiting their child's SSB consumption. Changes to policy and the food environment are needed to initiate and sustain reductions in SSB intake, along with continued nutrition education efforts.

Trajectories of Sugar-Sweetened Beverage Intake in Early Life: Evidence from a Birth Cohort Study.

Infancy and early childhood are periods of dietary transition. Early exposure to specific foods and the establishment of dietary habits during this period can shape long-term food preferences and have lasting effects on health. This study aimed to examine the longitudinal trajectories of sugar-sweetened beverage (SSB) intake in Australian children from birth to age 3 years and identify early-life and socioeconomic factors influencing those trajectories. Mother-infant dyads (n = 934) from the Healthy Smiles Healthy Kids birth cohort study were interviewed on their weekly frequency of SSB intake at 4-month, 8-month, 1-year, 2-year, and 3-year age points. Group-based trajectory modelling analysis was performed to identify trajectories for SSB intake among Australian children. A multivariable logistic regression was performed to identify the maternal and child-related predictors of resulting trajectories. The intake of SSBs showed two distinct quadratic trajectories (high and low) with age. While the two trajectories remained distinctive throughout, the SSB consumption for both groups consistently increased between 4 months and 2 years of age and subsequently stabilised. Compared to low SSB consumers (75%), the high SSB consumers (25%) were significantly more likely to be living in households with three or more children (relative risk (RR): 1.59, 95%CI: 1.02-2.48), had low maternal education (left school < year 12-RR: 1.75, 95%CI: 1.09-2.81; completed year 12-RR: 1.57, 95%CI: 1.02-2.81), and resided in highly/the most socioeconomically disadvantaged areas (highly disadvantaged-RR: 1.89, 95%CI: 1.13-3.18; most disadvantaged-RR: 2.06, 95%CI: 1.25-3.38). Children's SSB intake patterns are established early in life as they transition from infancy to preschool age, and the trajectories of intake established during early childhood are strongly influenced by socioeconomic factors. Hence, interventions targeted to limit SSB intake and improve nutrition amongst children should occur in early life.

Potential Mediating Roles of Children's Health-Related Quality of Life and Weight-Related Behaviors in the Relationship Between Socio-Educational Advantage and Weight Status.

Background: Socioeconomic status is inversely associated with weight status in developed countries. Underlying mechanisms are still to be clarified. Our aim was to determine if weight-related behaviors and health-related quality of life (HRQoL) mediate the relationship between socio-educational advantage and weight status in Australian children 9 to 13 years of age. Methods: Secondary analysis of data collected by two cluster randomized trials (2019 wave). We measured children's (n = 3978) height, weight, diet, physical activity, sedentary behavior, and HRQoL. Socio-.educational advantage was assessed at school level using the Index of Community Socio-Educational Advantage (ICSEA). A counterfactual framework was used to explore potential mediators in the relationship between socio-educational disadvantage and (1) overweight/obesity and (2) BMI z-score (BMIz). Results: Low socio-educational advantage was associated with increased overweight/obesity and BMIz. The overweight/obesity association was mediated by sedentary behavior (natural indirect effect as a proportion of total, 7.5%) sugar-sweetened beverage (SSB) consumption (12.7%), physical functioning (11.9%), psychosocial health (10.9%), school (6.8%) and social functioning (15.6%), and total HRQoL score (13.8%). The ICSEA-BMIz relationship was mediated by sedentary behavior (5.7%), sleep duration (4.1%), SSB (10.6%), physical functioning (9.9%), psychosocial health (9.1%), school (5.5%) and social (13.7%) functioning, and total HRQoL score (11.7%). Conclusion: Victorian Children with low socio-educational advantage were more likely to be living with overweight or obesity. This relationship was mediated by children's sedentary behavior, SSB consumption, and HRQoL. Trial Registration: Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12616000980437 (registered July 26, 2016, retrospectively registered) and ACTRN12618001986268 (registered December 11, 2018, prospectively registered). https://www.anzctr.org.au/Trial/Registration.

Childhood Sugar-Sweetened Beverage Consumption: an Agent-Based Model of Context-Specific Reduction Efforts

Despite widespread recognition among public health experts that childhood sugar-sweetened beverage consumption should be reduced, doing so has proven to be a challenge. An agent-based model of early childhood sugar-sweetened beverage consumption was applied to data from three high-quality, longitudinal cohort studies to gain insight into potentially effective intervention strategies across contexts. From 2021 to 2023, a single agent-based model design was applied to data sets derived from three separate cohorts of children followed from infancy to childhood, with very different populations and environments (participants recruited in 1999-2002; 2003-2010; and 2009-2014). After assessing its ability to reproduce observed consumption patterns across cohorts, it was used to simulate potential impacts of multiple intervention strategies across contexts. Interventions reducing home availability of sugar-sweetened beverages consistently had the largest potential effects. Impact differed between cohort settings: a complete decrease in availability resulted in an estimated 87% decrease in overall early childhood consumption for one of the cohorts, compared with 61% and 54% in the others. Reducing availability in center-based child care resulted in substantially greater reduction in one cohort relative to the other two. There is untapped potential for strategies targeting children's sugar-sweetened beverage consumption in the home, but in some instances, other approaches might also yield meaningful effects. Tailoring approach to setting may be important, and agent-based models can be informative for doing so. This agent-based model has broad generalizability and potential to serve as a tool for designing effective, context-specific strategies to reduce childhood sugar-sweetened beverage consumption.

P17-039-23 Global, Regional, and National Consumption of Sugar-Sweetened Beverages in Children and Adolescents Between 1990 and 2018: New Findings From the Global Dietary Database

P17-039-23 Global, Regional, and National Consumption of Sugar-Sweetened Beverages in Children and Adolescents Between 1990 and 2018: New Findings From the Global Dietary Database

Staff Knowledge, Attitudes, and Beliefs About Child Sugar-Sweetened Beverage Intake and Acceptability of a Pediatric Clinic-Based Beverage Screener.

Beverages are the leading source of sugar in children's diets and a modifiable risk factor for adverse health conditions. Electronic health record-based screeners could facilitate health systems' efforts to reduce child consumption of sugary beverages. Before implementing a sugar-sweetened beverage screener in the electronic health record within academic healthcare system, 228 pediatric and family medicine clinic staff completed an online educational training to familiarize them with the screener and its rationale. Pretraining and posttraining surveys were used to examine the association between staff knowledge of sugar-sweetened beverages and the acceptability of the screening workflow. Respondents displayed high levels of pretraining knowledge about health consequences of added sugar intake, but lower levels of pediatric beverage guideline knowledge. Knowledge improved from pretraining to posttraining surveys, with high acceptability of the screening process. Staff compliance with sugar-sweetened beverage screening was examined using electronic health record data. During the 6 months after screener implementation, 47% of eligible pediatric patients were screened, with some variation in compliance by age group and practice type. This study demonstrated that engaging nursing and frontline staff to screen pediatric patients for behavioral determinants of health is feasible. Ongoing outreach and refreshers may improve sustainability.

Intergenerational transmission of parental risky health behaviors in Chinese children: Are there socioeconomic status differences?

Risky health behaviors in childhood, including smoking, alcohol consumption, and having a poor diet, are the major sources of non-communicable diseases in adulthood. This study aimed to examine how parents affect children's risky health behaviors and whether intergenerational transmission differs based on socioeconomic status (SES). Data were extracted from the 1991-2015 China Health and Nutrition Survey (CHNS). Smoking (n = 5,946), alcohol consumption (n = 7,821), and sugar-sweetened beverages (SSBs) consumption (n = 3,537) were used as proxies for risky health behaviors in children. A binary choice model for panel data with a random-effect specification was employed to examine whether risky health behaviors can be transmitted from parents to their children. Subsequently, we conducted a seemingly unrelated estimation test (SUEST) to explore the differences in parental transmission between the different SES groups. We found strong intergenerational persistence of smoking, alcohol drinking, and SSBs drinking behaviors, except for the mothers' smoking behavior. Mothers had a greater influence on children's alcohol drinking and SSBs drinking behaviors than fathers both in urban and rural areas and in different SES groups. The intergenerational transmission of SSBs drinking behavior exhibited a decreasing trend with increasing SES for both urban and rural families. In urban areas, mothers' alcohol drinking behavior has a decreasing trend with increasing education level, occupation, and income; however, in rural areas, the influence of mothers' alcohol drinking behavior occurred in the same direction with increasing education level and occupation type. In rural areas, the influence of fathers' drinking and smoking behaviors on children appears to mostly increase with increasing SES. Meanwhile, the influence of such behaviors among urban fathers would decrease with increasing SES. Parents' behaviors and SES can influence the initiation of risky health behaviors in their offspring. Thus, to promote healthy behaviors, policymakers can introduce health education programs for parents, particularly for those living in rural areas and with a low SES.

Implementation, home mediators and children’s sugary drink consumption - results from DAGIS study

Abstract Background and objectives The effectiveness of a health behavior intervention can depend on the extent to which the intervention is implemented; higher degree of implementation (DOI) might associate with larger intervention effects. This study examined whether the parental DOI of an health behavior intervention had an effect on children's consumption of sugar-sweetened beverages (SSB) and was the effect mediated by home factors. Methods the DAGIS preschool intervention was conducted in 2017-2018 in Finland among 3-6-year-olds with valid data from 476 children. At baseline and follow-up parents reported 1) children's SSB consumption in a semi-quantified food frequency questionnaire, 2) availability of SSB at home, parental role modelling of drinking SSB, and norm (parental view on the suitable amount of SSB for children), and 3) DOI: a dichotomized sum variable on several aspects of parental program implementation. In the analyses, high and low DOI were compared to control group. Mediation analysis of the effect of DOI on the change in children's SSB consumption via change in availability, role modelling and norm was conducted with R statistical software. Results High DOI was associated with reduced consumption of SSB (B -27.71, 95% CI -49.05, -4.80). No mediated effects were found. All studied mediators impacted the change in SSB consumption, but the DOI had no effect on the change in mediators. Conclusions Intervention effect on the consumption of SSB was only found in the high DOI group, which supports the importance of assessing intervention implementation. Since the found effect was not mediated by the studied mediators, other possible mediators should be examined, as understanding intervention mediators is crucial in developing successful interventions. Key messages

An agent-based model of child sugar-sweetened beverage consumption: implications for policies and practices

A strong body of evidence links young children's intake of sugar-sweetened beverages (SSBs) with myriad negative outcomes. Our research provides insight into whether and to what extent potential intervention strategies can reduce young children's consumption of SSBs. We built an agent-based model (ABM) of SSB consumption representing participants in the Project Viva longitudinal study between ages 2 and 7 y. In addition to extensive data from Project Viva, our model used nationally representative data as well as recent, high-quality literature. We tested the explanatory power of the model through comparison to consumption patterns observed in the Project Viva cohort. Then, we applied the model to simulate the potential impact of interventions that would reduce SSB availability in 1 or more settings or affect how families receive and respond to pediatrician advice. Our model produced age-stratified trends in beverage consumption that closely match those observed in Project Viva cohort data. Among the potential interventions we simulated, reducing availability in the home-where young children spend the greatest amount of time-resulted in the largest consumption decrease. Removing access to all SSBs in the home resulted in them consuming 1.23 (95% CI: 1.21, 1.24) fewer servings of SSBs per week on average between the ages of 2 and 7 y, a reduction of ∼60%. By comparison, removing all SSB availability outside of the home (i.e., in schools and childcare) had a smaller impact (0.77; CI: 0.75, 0.78), a reduction of ∼40%. These results suggest that interventions reducing SSB availability in the home would have the strongest effects on SSB consumption.

Association of sugar-sweetened beverages with executive function in autistic children

The association between sugar-sweetened beverages (SSBs) consumption and executive function (EF) among typically developing (TD) children has been investigated in previous studies but with inconsistent results. Furthermore, this relationship has been less investigated among autistic children who perform worse in EF compared with TD children. In this study, we aimed to investigate the association between SSB consumption and EF in autistic children, and whether the association between SSB and EF in autistic children is different from that in TD children. We recruited 106 autistic children and 207 TD children aged 6–12 years in Guangzhou, China. Children’s EF was assessed by using the Chinese version of parent-reported Behavior Rating Inventory of Executive Function, Stroop Color–Word Test, and working memory subscales of the Chinese version of Wechsler Intelligence Scale for children, Fourth edition. Meanwhile, we assessed children’s dietary intake and SSB consumption with a validated Food Frequency Questionnaire. In this study, 70 (66.0%) autistic children consumed SSB and 20 (18.9%) of them consumed more than two servings SSB a week. Among autistic children, over two servings per week SSB consumption was associated with poorer performance in emotional control [β = 7.20, 95% confidence interval (CI): 0.94–13.46] and plan/Organize (β = 6.45, 95% CI: 0.27–12.63). The association between over two servings/week SSB consumption and emotional control among autistic children was significantly different from that among TD children (βASD = 7.20; βTD = −3.09, Z = 2.72, p = 0.006). Results of this study show that SSB consumption was associated with an impairment in some subscales of EF in autistic children. Furthermore, the association between SSB and EF in autistic children might be different from that in TD children.

Fruit Juice and Sugar-Sweetened Beverage Related Knowledge and Feeding Practices Among Parents of Infants and Young Toddlers

ObjectivesCurrent infant and young child feeding recommendations include a focus on sugar-containing beverages (SCBs). The American Academy of Pediatrics recommends delaying the introduction of fruit juice (FJ) until after age 12 months and limiting toddler consumption to 4 ounces/day, and the U.S. Dietary Guidelines advise avoiding sugar-sweetened beverages (SSBs) prior to age 2 years. Well-Child Visits (WCV) provide an opportunity to educate parents and promote recommended feeding practices. We aimed to describe the SCB-related knowledge and feeding practices of a sample of parents and the potential for using short videos during WCVs to provide early feeding related education.MethodsA convenience sample of parents attending 4–15 month WCVs at a busy metro area clinic in Georgia completed a self-administered survey to assess their infant/young toddler feeding practices and their knowledge of SCB-related feeding recommendations. A sub-sample also reported on their perceptions of a 3-minute educational video viewed during the visit.ResultsRespondents (n = 105) were primarily women (87%), non-Hispanic/Latino (93%), and Black/African-American (95%). Some parents: 12% and 77% respectively, believed it OK to give infants FJ before 6 months and 12 months of age; 6% reported introducing FJ before 4 months. Among those with children ≥ 12 months (12–18 months; n = 36), 81% reported having given them FJ before 12 months; 25% reported giving them > 4 ounces FJ/day; and 56% had already given their child SSBs. Age of FJ introduction was not modified by presence of older sibling or age of parent. Few (5%) parents were aware of any expert recommendation related to FJ consumption. Most parents who viewed an education video during the WCV (n = 47) reported being able to focus on (74%), enjoy (85%), and learn something (83%) from it; 96% liked the video length, 74% felt watching it was a good use of their time, 45% perceived a change in their thinking after viewing the video.ConclusionsOur findings demonstrate that consumption of FJ among infants and SSBs among young toddlers is common, that parents are unaware of expert recommendations related to FJ consumption, and short videos present an opportunity to support parent education efforts during WCVs.Funding SourcesThe Global Center for Diabetes Translation Research, pilot grant program.

Associations Between Parent Diet Quality and Child Sugar Sweetened Beverage Intake in Latinx Families Living in an Emerging Community

ObjectivesHispanic children have the highest rates of obesity among children in the US and sugar sweetened beverages (SSBs) intake is of concern. It has been established that parent diet is associated with child dietary outcomes. This association has been understudied in the context of Latinx families, particularly those living in emerging Latinx communities (areas with a small yet growing population) where culturally appropriate foods may not be readily available. This analysis aims to determine the relationship between parent diet quality and parent reported child consumption of SSBs. MethodsWe analyzed baseline data for parent/child (age 2–11 years) pairs (n = 53) from the “Raices” study, a 6-month intervention for improving social support, healthcare accessibility, physical activity, and nutrition behaviors among Latinx living in Allegheny county, Pennsylvania. Mothers were selected as primary caregivers. In cases where no maternal data was available, the father was used. A multinomial regression was used with parent diet quality (Starting the Conversation [SCT] 8-item questionnaire, range 0–16, higher scores representing poorer diet quality) as the independent variable and parent reported child SSB intake (modified 2010 NYPANS questionnaire) as the dependent variable with child age, child BMI category, parent age, and parent education as covariates. ResultsNearly 40% of parents (mean age = 37.9 ± 5.9 years; 98.1% female; 56.6% college educated; mean STC score = 5.9 ± 2.7; mean time living in US = 8.8 ± 6.8 years) reported their children (mean age = 6.1 ± 2.6 years; 64.2% female; 71.7% normal weight) consume ≥ 2 SSBs/day. The odds of a child consuming 0 SSB/day or 1 SSB/day compared with ≥ 2 SSBs/day was not significantly predicted by parent diet quality (0/d: OR = 0.74, 95% CI = 0.50, 1.09; 1/d: OR = 1.02, 95% CI = 0.78, 1.34), while controlling for child age, child BMI, parent age and parent education. ConclusionsParent diet quality was not associated with parent reported child SSB intake in this sample of Latinx families living in an emerging community. Future research should continue to explore determinants of food choice in Latinx children. Funding SourcesCenters for Medicare & Medicaid Services, HHS, 1HOCMS331535-01-00.

Associations of parent dietary role modeling with children's diet quality in a rural setting: Baseline data from the NU-HOME study

These analyses examined associations of parent dietary role modeling with diet quality among school-age children in a rural community. Past research has found protective associations between parent role modeling and children's dietary intake; however, there is a gap in understanding these associations for families in rural communities. Baseline data (2017 -2018) were drawn from the New Ulm at Home (NU-HOME) randomized controlled trial, conducted in the United States. The trial recruited 114 children (7–10 years old) and parents. Parents self-reported dietary intake [fruit and vegetable (FV), sugar-sweetened beverage (SSB), fast food (FF)] and frequency of sitting and eating with their child. Children reported parent role modeling of healthful eating (FV and salad at the evening meal; FV as snacks). Two 24-h dietary recalls assessed child diet quality indicators [Healthy Eating Index-2015 (HEI-2015) total scores, FV intake, SSB intake]. General linear models (GLM) and logistic regression analyzed associations of child diet quality (HEI score, FV intake, SSB intake) with parent dietary intake, parent sitting and eating the evening meal with their child, and child perceptions of parent role modeling healthful eating, adjusted for highest level of education in the home. Higher child HEI-2015 scores were positively associated with more frequent parent role modeling of fruit intake at meals, and inversely associated with more frequent parent role modeling of fruit as a snack; no significant associations of child FV intake with parent role modeling were observed. Higher child SSB intake was positively associated with parent FF intake. In this rural community, parents play significant roles in shaping children's dietary quality and intake, though more work needs to be done to address optimal intervention strategies to promote parent role modeling of healthful eating.

Longer Participation in the Special Supplemental Nutrition Program for Women, Infants, and Children Is Not Associated with Reduced Sugar-Sweetened Beverage Intake among Black Participants.

This study assessed relationships of duration of family Special Supplemental Nutrition Program for Women, Infants and Children (WIC) participation with racial/ethnic disparities in child sugar-sweetened beverage (SSB) and water intake. Child beverage intake and family duration on WIC were collected during three cross-sectional surveys of WIC-participating families in Los Angeles County, California (2014, 2017 and 2020; n = 11,482). The associations of family duration of WIC participation, a proxy for the amount of WIC services received, with daily intake of total SSBs, fruit-flavored SSBs and water were assessed in race/ethnicity strata with multivariable negative binomial and Poisson regression models. Among English-speaking Hispanic children, those of families reporting 10 years of WIC participation consumed 33% and 27% fewer servings of total and fruit-flavored SSBs compared to those of families reporting 1 year on WIC. Among Black children, those from families reporting 5 and 10 years of participation in WIC consumed 33% and 45% more daily servings of fruit-flavored SSBs than those from families reporting 1 year on WIC. Disparities in daily total and fruit-flavored SSB intake between Black and White children increased with longer family duration on WIC. Duration of family WIC participation is associated with healthier beverage choices for infants and children, but does not appear to be equally beneficial across racial/ethnic groups in Los Angeles County.

A Comparative Analysis of Rural versus Urban Preschool Children's Sugar-Sweetened Beverage Consumption, Body Mass Index and Parent's Weight Status.

BackgroundChildhood overweight and obesity continues to be a major public health concern, especially in minority, low-income, and rural populations. In order to develop health promotion interventions aimed at reducing obesity rates, there is a need to identify which populations have the highest rates of obesity and the risk factors associated with these high rates.MethodsData collected from low-income, preschool children and their parents in an urban community and a rural community in Alabama were analyzed and compared. Body Mass Index (BMI) was collected during school based health screenings, and information regarding parent's BMI and child's consumption of sugar-sweetened beverages (SSBs) were collected by parent report.ResultsOf the 363 children screened, 12.8% (15.2% rural and 11.9% urban) were considered overweight, and 15.8% (20.2% rural and 14.2% urban) of the sample was classified as obese. Rates of overweight and obesity for mothers were 27.6% (25.3% rural and 28.4% urban) and 48% (56.3% rural and 44.8% urban) respectively and 39.6% (53.3% rural and 34.4% urban) and 34.6% (28.3% rural and 36.9% urban) for fathers. Parents reported their child consumed 3.82 SSBs per day. Overall, mother's BMI, father's BMI and sugar-sweetened beverage consumption was positively associated with child's BMI. However, there were no significant interactions between the rural and urban groups.ConclusionRates of overweight and obesity remain high in low-income, predominantly minority preschool children and their parents in two communities in Alabama. Consumption of SSBs, mother's BMI, and father's BMI are three factors impacting the weight status of low-income preschool children. These factors are significant in both rural and urban children.

Sugar-Sweetened Beverage Consumption in Children: The Interplay of Household SNAP and WIC Participation

Although sugar-sweetened beverage (SSB) consumption is associated with Supplemental Nutrition Assistance Program (SNAP) and Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participation, no national studies have examined the interplay between these programs. This study compares children's sugar-sweetened beverage consumption across households enrolled in one, both, or neither program. A total of 4 waves (2009-2010 to 2015-2016) of the National Health and Nutrition Examination Survey were combined to obtain a sample of 4,772 children aged 0-19 years living in households eligible for both SNAP and WIC (households with income ≤130% of the Federal Poverty Level). Children were grouped as living in 4 household types: SNAP only; WIC only; SNAP + WIC; and neither program. Beverages with any added sugars were classified as SSBs. Two-part regression models examined the adjusted association between SSB consumption and program participation. Analyses were conducted in 2020. Compared with the SNAP‒only group, children in all other household types had lower odds of SSB consumption (AOR=0.44, p=0.002 for WIC only; AOR=0.69, p=0.020 for SNAP+WIC; AOR=0.61, p=0.025 for neither program). The lower probability of SSB consumption for children from WIC‒participating households was mostly driven by children aged 0-5 years, with the differences weakening for children aged 6-12 years and completely disappearing for those aged 12-19 years. No significant differences were observed for the amount of added sugar consumed by SSB consumers. Household WIC participation-whether jointly with SNAP or alone-may confer protection against SSB consumption. Unlike SNAP, WIC, by design, provides participating households with more information and opportunities to access and consume healthier diets. Understanding how SNAP and WIC interact can help policymakers improve the design and nutritional benefit of the U.S. food safety net.

Five-Year Trends in Sugar-Sweetened Beverage Consumption Among Mothers, Teenagers, Children From SNAP-Ed Eligible Households Indicate Increased Intake Among Children

Abstract Objectives Previously we reported improved dietary intake from 2015 to 2017 for fruits and vegetables, water, and Healthy Eating Index-2015 scores for mothers, teenagers, and children from households eligible for Supplemental Nutrition Education Program-Education (SNAP-Ed). Sugar-sweetened beverage (SSBs) consumption was unchanged during this three-year period across age groups. Our objective was to now examine trends in SSB intake with data from 2018 and 2019. Methods Cross-sectional surveys of mothers and their teenager or child were conducted from 2015 to 2019. Respondents were randomly sampled from households with reported incomes ≤185% of the federal poverty level. A study introduction letter in English or Spanish was sent to sampled households. Next, bilingual staff confirmed by phone household eligibility, the youngest mother (or caregiver), and one teenager (12 to 17 years) or child (5 to 11 years). During the subsequent interviews, staff administered the Automated Self-administered 24-Hour Dietary Assessment Tool (ASA24) in English or Spanish. The quantity and size of each reported food or beverage item was determined by asking mothers to reference pictures in a portion-size booklet or measuring cups or spoons previously mailed to each household. The procedures were replicated to obtain 24-hour dietary information from the teenager or child. Daily SSB intake was converted to ounces and regressed on year of survey with the covariates age, education for mothers, and gender for children. Significance of difference between means was adjusted by Bonferroni. Results Participants over the five-year period were 22,827 mothers, 5855 teenagers, and 10,778 children. Most (64.2%, 69.2%, and 67.9%) survey participants were Latinx. The trend for SSB intake for children was significant, with ounces per day increasing from 5.7 in 2017 to 7.3 in 2018 and 7.9 in 2019 (P = 0.0055). Conclusions A previous study found that, despite improvements across dietary behaviors, SSB intake was unchanged among mothers and children from SNAP-Ed eligible households. This follow-up study adds two years of data and findings indicate that children's SSB intake has increased. Findings suggest a need for interventions and policy work addressing children's SSB intake. Funding Sources California Department of Social Services.

A Systematic Review of the Recent Consumption Levels of Sugar-Sweetened Beverages in Children and Adolescents From the World Health Organization Regions With High Dietary-Related Burden of Disease.

This review aimed to investigate national estimates of sugar-sweetened beverage (SSB) consumption in children and adolescents aged two to 18 years, from countries in regions particularly burdened by dietary-related chronic illnesses. The most recent studies or reports from included countries (n = 73) with national-level consumption data of SSBs in children and adolescents, collected between January 2010 and October 2019, were considered for inclusion. A random effects meta-analysis was used to calculate pooled estimates of the mean consumption of SSB in millimeters per day. Heterogeneity between national estimates was assessed using the I2 statistic and explored via subgroup analyses by the World Health Organization region, age groups, and country-level income. Forty-eight studies were included in the review reporting national estimates of consumption for 51 countries. The highest estimate of daily consumption was in China at 710.0 mL (95% confidence interval (CI) [698.8, 721.2], while the lowest was in Australia at 115.1 mL (95% CI [111.2, 119.1]). Pooled synthesis of daily SSB consumption of the 51 countries was 326.0 mL (95% CI [288.3, 363.8]), although heterogeneity was high, and was not explained by subgroup analyses. While there is considerable variability between countries, intake of SSB remains high among children and adolescents internationally underscoring the need for public health efforts to reduce SSBs consumption.

The effect of educational program based on social cognitive theory in adopting behaviors to prevent excessive consumption of Sugar-Sweetened Beverages in children; application of social network software(Shad)

Abstract Background: Excessive consumption of Sugar-Sweetened Beverages (SSBs) is a health problem in most societies today; Which has adverse consequences in the areas of: health, social and economic. The aim of this study was to investigate the effect of the application of social cognitive theory (SCT) in the design and evaluation of educational intervention in order to adopt behaviors to prevent excessive consumption of Sugar-Sweetened Beverages (SSBs) in students.Materials and Methods: The current study was a quasi-experimental study. Using multistage sampling, 100 Junior High-school students in Urmia, Iran in 2021 were selected and assigned to two groups, namely intervention (n=100) and control (n=100). To collect the study data, researchers utilized a researcher-made questionnaire including items about demographic information and SCT constructs such as awareness, outcome expectations, self-regulation, self-efficacy, social support , barriers and Preventive behaviors, which was completed in two stages before and three months after the last training session; the data were analyzed using SPSS software version 25.0.Results: The mean age of the intervention and control groups was 13.71 ± 0.71 and 13.84 ± 0.81, respectively. Before the intervention, the mean scores of social cognitive theory structures and desired behavior were not significantly different between the two groups. But three months after the intervention, the mean scores of knowledge constructs, outcome expectations, self-regulation, self-efficacy, social support, perceived barriers, and desirable student behavior showed a significant difference between the two groups(P<0.001).Conclusion: The results of the study showed that social cognitive theory can be used as a theoretical basis for designing and evaluating interventions to encourage people to follow a proper diet and reduce the consumption of SSBs.