Correlates of sugar-sweetened beverage intake among low-income women during the first 1000 days.

OBJECTIVE: To describe prenatal and postpartum consumption of water, cows' milk, 100 % juice and sugar-sweetened beverages (SSB) among women enrolled in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) programme in New York City (NYC) and to identify correlates of SSB intake in this population. DESIGN: Cross-sectional data were collected from structured questionnaires that included validated beverage frequency questionnaires with the assistance of container samples. The association of maternal and household factors and non-SSB consumption with habitual daily energetic (kJ (kcal)) intake from SSB was assessed by using multivariable median regression. SETTING: WIC programme in NYC, NY. Data were collected in 2017. PARTICIPANTS: 388 pregnant or postpartum women (infant aged <2 years) from the NYC First 1000 Days Study. RESULTS: Median age was 28 years (interquartile range (IQR) 24-34); 94·1 % were Hispanic/Latina, and 31·4 % were pregnant. Overall, 87·7 % of pregnant and 89·1% of postpartum women consumed SSB ≥ once weekly, contributing to a median daily energetic intake of 410 kJ (98 kcal) (IQR (113-904 kJ) 27-216) and 464 kJ (111 kcal) (IQR (163-1013 kJ) 39-242), respectively. In adjusted analyses, only consumption of 100 % juice was associated with greater median energetic intake from SSB (adjusted ß for each additional ounce = 13; 95% CI 8, 31 (3·2; 95 % CI 2·0, 7·3). CONCLUSIONS: Among pregnant and postpartum women in WIC-enrolled families, interventions to reduce SSB consumption should include reduction of 100 % juice consumption as a co-target of the intervention.

Sugar-Sweetened Beverage Attitudes and Consumption During the First 1000 Days of Life.

OBJECTIVES: To examine the relationship of parental sugar-sweetened beverage (SSB) attitudes with SSB consumption during the first 1000 days of life-gestation to age 2 years. METHODS: We studied 394 Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)-enrolled families during the first 1000 days of life in northern Manhattan, New York, in 2017. In regression models, we assessed cross-sectional relationships of parental SSB attitude scores with habitual daily parent SSB calories and infant SSB consumption, adjusting for demographic and socioeconomic characteristics. RESULTS: Each point higher parental SSB attitude score was associated with lower parental SSB consumption (-14.5 median kcals; 95% confidence interval [CI] = -22.6, -6.4). For infants, higher parental SSB attitude score was linked with lower odds of infant SSB consumption (adjusted odds ratio [AOR] = 0.84; 95% CI = 0.71, 0.99), and adjustment for socioeconomic factors slightly attenuated results (AOR = 0.85; 95% CI = 0.71, 1.02). CONCLUSIONS: During the first 1000 days of life, greater negativity in parental attitudes toward SSB consumption was associated with fewer parental calories consumed from SSBs and lower likelihood of infant SSB consumption. Public Health Implications. Parental attitudes toward SSBs should be targeted in future childhood obesity interventions during pregnancy and infancy.

Text Messages to Curb Sugar-Sweetened Beverage Consumption among Pregnant Women and Mothers: A Mobile Health Randomized Controlled Trial.

Racial, ethnic, and socioeconomic disparities in childhood obesity in the United States (U.S.) originate in early life. Maternal sugar-sweetened beverage (SSB) consumption is an early life risk factor for later offspring obesity. The goal of this study was to test the effects of policy-relevant messages delivered by text messages mobile devices (mHealth) on maternal SSB consumption. In this three-arm 1-month randomized controlled trial (RCT), pregnant women or mothers of infants in predominantly Hispanic/Latino New York City neighborhoods were randomized to receive one of three text message sets: graphic beverage health warning labels, beverage sugar content information, or attention control. The main outcome was change in maternal self-reporting of average daily SSB consumption from baseline to one month. Among 262 participants, maternal SSB consumption declined over the 1-month period in all three arms. No intervention effect was detected in primary analyses. In sensitivity analyses accounting for outliers, graphic health warning labels reduced maternal SSB consumption by 28 kcal daily (95% CI: -56, -1). In this mHealth RCT among pregnant women and mothers of infants, graphic health warning labels and beverage sugar content information did not reduce maternal SSB consumption.

Food Insecurity and Sugar-Sweetened Beverage Consumption Among WIC-Enrolled Families in the First 1,000 Days.

OBJECTIVE: Determine the association between household food insecurity and habitual sugar-sweetened beverage (SSB) consumption among Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)-enrolled families during the first 1,000 days. METHODS: Cross-sectional analysis of pregnant women and mothers of infants aged under 2 years in the WIC was performed. Families recruited sequentially at consecutive visits completed food insecurity and beverage intake questionnaires; estimated logistic regression models controlled for sociodemographic characteristics. RESULTS: Of 394 Hispanic/Latino mothers and 281 infants, 63% had household food insecurity. Food insecurity significantly increased odds of habitual maternal (unadjusted odds ratio (OR), 2.39; 95% CI, 1.27-4.47; P = .01) and infant SSB consumption (OR, 2.05; 95% CI, 1.15-3.65; P = .02), and the relationship was not attenuated by maternal age, education, or foreign-born status. CONCLUSIONS AND IMPLICATIONS: Food insecurity increased odds of habitual SSB consumption in WIC families. Interventions to curb SSB consumption among WIC-enrolled families in the first 1,000 days in the context of household food insecurity are needed.

Parental and Provider Perceptions of Sugar-Sweetened Beverage Interventions in the First 1000 Days: A Qualitative Study.

BACKGROUND: Novel approaches to reduce sugar-sweetened beverage (SSB) consumption during the first 1000 days-pregnancy through age 2 years-are urgently needed. OBJECTIVE: To examine perceptions of SSB consumption and acceptability of potential intervention strategies to promote SSB avoidance in low-income families in the first 1000 days. METHODS: In this qualitative research, we performed semistructured, in-depth interviews of 25 women and 7 nutrition/health care providers. Eligible women were Women, Infants, and Children program-enrolled and pregnant or had an infant younger than age 2 years. Eligible providers cared for families during the first 1000 days. Using immersion-crystallization techniques, we examined perceptions, barriers, and facilitators related to avoidance of SSB consumption; acceptability of messages framed as positive gains or negative losses; and perceived influence on SSB consumption of various intervention modalities. RESULTS: Themes related to SSB consumption included parental confusion about healthy beverage recommendations and maternal feelings of lack of control over beverage choices due to pregnancy cravings and infant tastes. Themes surrounding message frames included negative health consequences of sugary drink consumption are strong motivators for behavior change; and savings and cost count, but are not top priority. Highly acceptable intervention strategies included use of images showing health consequences of SSB consumption, illustrations of sugar content at the point of purchase, and multimodal delivery of messages. CONCLUSIONS: Messages focused on infant health consequences and parental empowerment to evaluate and select healthier beverages based on sugar content should be tested in interventions to reduce SSB consumption in the first 1000 days.