Environmental Interventions to Reduce the Consumption of Sugar-Sweetened Beverages: Abridged Cochrane Systematic Review

Abstract

<b><i>Background:</i></b> Regular consumption of sugar-sweetened beverages (SSB) can increase the risk for obesity, type 2 diabetes, cardiovascular disease, and dental caries. Interventions that alter the physical or social environment in which individuals make beverage choices have been proposed to reduce the consumption of SSB. <b><i>Methods:</i></b> We included randomised controlled, non-randomised controlled, and interrupted time series studies on environmental interventions, with or without behavioural co-interventions, implemented in real-world settings, lasting at least 12 weeks, and including at least 40 individuals. Studies on the taxation of SSB were not included, as these are subject of a separate Cochrane review. We used standard Cochrane methods for data extraction, risk of bias assessment, and evidence grading and synthesis. Searches were updated to January 24, 2018. <b><i>Results:</i></b> We identified 14,488 unique records and assessed 1,030 full texts for eligibility. We included 58 studies comprising a total of 1,180,096 participants and a median length of follow-up of 10 months. We found moderate-certainty evidence for consistent associations with decreases in SSB consumption or sales for the following interventions: traffic light labelling, price increases on SSB, in-store promotion of healthier beverages in supermarkets, government food benefit programs with incentives for purchasing fruits and vegetables and restrictions on SSB purchases, multi-component community campaigns focused on SSB, and interventions improving the availability of low-calorie beverages in the home environment. For the remaining interventions we found low- to very-low-certainty evidence for associations showing varying degrees of consistency. <b><i>Conclusions:</i></b> With observed benefits outweighing observed harms, we suggest that environmental interventions to reduce the consumption of SSB be considered as part of a wider set of measures to improve population-level nutrition. Implementation should be accompanied by evaluations using appropriate methods. Future studies should examine population-level effects of interventions suitable for large-scale implementation, and interventions and settings not yet studied thoroughly.

Nutritional Status and Oral Frailty: A Community Based Study

“…The BDHQ asks about the consumption frequency of selected foods to estimate the dietary intake of fifty-eight food and beverage items during the preceding month. Details of the BDHQ's structure, method of calculating dietary intake are described by its developers [16][17][18][19][20]. Calculation of nutritional intakes was ordered from the DHQ support center (Gender Medical Research, Co. Ltd., Tokyo, Japan).…”

“…Dental researchers were involved as guideline editors for sugar intake published by World Health Organization [14]. However, studies on the relationship among oral health status, nutritional status, and nutrient intake other than sugar consumption are still insufficient [15,16]. Poor dietary intake increased the risk of periodontal disease.…”

How have media campaigns been used to promote and discourage healthy and unhealthy beverages in the United States? A systematic scoping review to inform future research to reduce sugary beverage health risks

“…First, future research should examine how media campaigns may synergize with other PSE approaches to influence diverse populations, age groups, and settings. 101 , 102 , 103 , 105 , 106 , 107 , 108 Second, research is needed to translate healthy beverage recommendations 9 , 10 , 11 , 71 , 109 into actionable and memorable messages for diverse populations.…”

Trajectories of Sugar Consumption and Dental Caries in Early Childhood

“…Furthermore, there is evidence that programs with government incentives to purchase fruits and vegetables, restrictions on soft drink purchases, and interventions that improve the availability of low-calorie beverages in the home environment are associated with reductions in sugar consumption (von Philipsborn et al 2020). Given the complex etiology of diet, interventions should incorporate behavior change at various levels relevant to the target population, for example, at home, school, and community (Chi and Scott 2019).…”