Sweetened Beverage Tax Implementation and Change in Body Mass Index Among Children in Seattle.

Importance: Sweetened beverage taxes have been associated with reduced purchasing of taxed beverages. However, few studies have assessed the association between sweetened beverage taxes and health outcomes. Objective: To evaluate the association between the Seattle sweetened beverage tax and change in body mass index (BMI) among children. Design, Setting, and Participants: In this longitudinal cohort study, anthropometric data were obtained from electronic medical records of 2 health care systems (Kaiser Permanente Washington [KP] and Seattle Children's Hospital Odessa Brown Children's Clinic [OBCC]). Children were included in the study if they were aged 2 to 18 years (between January 1, 2014, and December 31, 2019); had at least 1 weight measurement every year between 2015 and 2019; lived in Seattle or in urban areas of 3 surrounding counties (King, Pierce, and Snohomish); had not moved between taxed (Seattle) and nontaxed areas; received primary health care from KP or OBCC; did not have a recent history of cancer, bariatric surgery, or pregnancy; and had biologically plausible height and BMI (calculated as weight in kilograms divided by height in meters squared). Data analysis was conducted between August 5, 2022, and March 4, 2024. Exposure: Seattle sweetened beverage tax (1.75 cents per ounce on sweetened beverages), implemented on January 1, 2018. Main Outcomes and Measures: The primary outcome was BMIp95 (BMI expressed as a percentage of the 95th percentile; a newly recommended metric for assessing BMI change) of the reference population for age and sex, using the Centers for Disease Control and Prevention growth charts. In the primary (synthetic difference-in-differences [SDID]) model used, a comparison sample was created by reweighting the comparison sample to optimize on matching to pretax trends in outcome among 6313 children in Seattle. Secondary models were within-person change models using 1 pretax measurement and 1 posttax measurement in 22 779 children and fine stratification weights to balance baseline individual and neighborhood-level confounders. Results: The primary SDID analysis included 6313 children (3041 female [48%] and 3272 male [52%]). More than a third of children (2383 [38%]) were aged 2 to 5 years); their mean (SE) age was 7.7 (0.6) years. With regard to race and ethnicity, 789 children (13%) were Asian, 631 (10%) were Black, 649 (10%) were Hispanic, and 3158 (50%) were White. The primary model results suggested that the Seattle tax was associated with a larger decrease in BMIp95 for children living in Seattle compared with those living in the comparison area (SDID: -0.90 percentage points [95% CI, -1.20 to -0.60]; P < .001). Results from secondary models were similar. Conclusions and Relevance: The findings of this cohort study suggest that the Seattle sweetened beverage tax was associated with a modest decrease in BMIp95 among children living in Seattle compared with children living in nearby nontaxed areas who were receiving care within the same health care systems. Taken together with existing studies in the US, these results suggest that sweetened beverage taxes may be an effective policy for improving children's BMI. Future research should test this association using longitudinal data in other US cities with sweetened beverage taxes.

The relationship between the price and demand of alcohol, tobacco, unhealthy food, sugar-sweetened beverages, and gambling: an umbrella review of systematic reviews.

BACKGROUND: The WHO highlight alcohol, tobacco, unhealthy food, and sugar-sweetened beverage (SSB) taxes as one of the most effective policies for preventing and reducing the burden of non-communicable diseases. This umbrella review aimed to identify and summarise evidence from systematic reviews that report the relationship between price and demand or price and disease/death for alcohol, tobacco, unhealthy food, and SSBs. Given the recent recognition as gambling as a public health problem, we also included gambling. METHODS: The protocol for this umbrella review was pre-registered (PROSPERO CRD42023447429). Seven electronic databases were searched between 2000-2023. Eligible systematic reviews were those published in any country, including adults or children, and which quantitatively examined the relationship between alcohol, tobacco, gambling, unhealthy food, or SSB price/tax and demand (sales/consumption) or disease/death. Two researchers undertook screening, eligibility, data extraction, and risk of bias assessment using the ROBIS tool. RESULTS: We identified 50 reviews from 5,185 records, of which 31 reported on unhealthy food or SSBs, nine reported on tobacco, nine on alcohol, and one on multiple outcomes (alcohol, tobacco, unhealthy food, and SSBs). We did not identify any reviews on gambling. Higher prices were consistently associated with lower demand, notwithstanding variation in the size of effect across commodities or populations. Reductions in demand were large enough to be considered meaningful for policy. CONCLUSIONS: Increases in the price of alcohol, tobacco, unhealthy food, and SSBs are consistently associated with decreases in demand. Moreover, increasing taxes can be expected to increase tax revenue. There may be potential in joining up approaches to taxation across the harm-causing commodities.

Association of sugary drinks, carbonated beverages, vegetable and fruit juices, sweetened and black coffee, and green tea with subsequent depression: A five-year cohort study.

BACKGROUND & AIMS: Evidence on the impact of beverage consumption on depression is limited in the Asian population. Specifically, there is little information available on vegetable and fruit juices, while whole vegetables and fruits are reportedly protective against depression. Furthermore, evidence is scarce in differentiating the impacts of sweetened and black coffee. We aimed to examine the association of the consumption of total sugary drinks, carbonated beverages, vegetable and fruit juices, sweetened and black coffee, and green tea with subsequent depression in a general population sample. METHODS: We studied individuals without a history of cancer, myocardial infarction, stroke, diabetes, or depression at baseline in 2011-2016, with a five-year follow-up. We used Poisson regression models and the g-formula, thereby calculating the risk difference (RD) for depression. Multiple sensitivity analyses were conducted. Missing data were handled using random forest imputation. We also examined effect heterogeneity based on sex, age, and body mass index by analyzing the relative excess risk due to interaction and the ratio of risk ratios. RESULTS: In total, 94,873 individuals were evaluated, and 80,497 completed the five-year follow-up survey for depression. Of these, 18,172 showed depression. When comparing the high consumption group with the no consumption group, the fully adjusted RD (95% CI) was 3.6% (2.8% to 4.3%) for total sugary drinks, 3.5% (2.1% to 4.7%) for carbonated beverages, 2.3% (1.3% to 3.4%) for vegetable juice, 2.4% (1.1% to 3.6%) for 100% fruit juice, and 2.6% (1.9% to 3.5%) for sweetened coffee. In contrast, the fully adjusted RD (95% CI) was -1.7% (-2.6% to -0.7%) for black coffee. The fully adjusted RD for green tea did not reach statistical significance. The results were robust in multiple sensitivity analyses. We did not find substantial effect heterogeneity based on sex, age, and body mass index. CONCLUSIONS: Total sugary drinks, carbonated beverages, vegetable and fruit juices, and sweetened coffee may increase the risk of depression, whereas black coffee may decrease it.

Sugar-sweetened beverage consumption and periodontitis among adults: A population-based cross-sectional study.

AIM: Investigating the association between sugar-sweetened beverages (SSBs) and periodontitis and whether the awareness of diabetes modifies this relationship. MATERIALS AND METHODS: Cross-sectional analysis was conducted using the National Health and Nutrition Examination Survey (NHANES III) data involving US adults aged 30-50. Periodontitis was classified according to the Centers for Disease Control and Prevention and American Academy of Periodontology (CDC-AAP), and SSB consumption as dichotomous (<5 or ≥5, <7 or ≥7 and <14 or ≥14 times/week), ordinal and continuous variables. Confounders included family income poverty ratio, education, race/ethnicity, sex, age, food energy intake, smoking and alcohol. Odds ratios (ORs) were obtained by logistic regressions using inverse probability weighting. Effect modification analysis was performed considering self-reported diabetes. RESULTS: Among 4473 cases analysed, 198 self-reported diabetes. SSBs were associated with periodontitis when individuals consumed ≥5 (OR 1.64; 95% confidence interval [CI] = 1.30-2.06), ≥7 (OR 1.92; 95% CI = 1.50-2.46) and ≥14 (OR 2.19; 95% CI = 1.50-3.18) times/week. The combined effect of consuming SSBs (≥5 and ≥14 times/week) and self-reported diabetes had less impact than the cumulative effect. CONCLUSIONS: SSB consumption was associated with higher odds of periodontitis, and the estimates were reduced among those with awareness of diabetes.

Analysis of the prevalence in sugar consumption in child care consultations / Análise da prevalência do consumo de açúcar em consultas de puericultura

Abstract Objectives: to analyze the prevalence of sugar consumption and associated factors in childcare consultations. Methods: cross-sectional study with 599 children > six months to < 24 months of age, assisted by the Family Health Units. Outcomes: daily consumption of sweetened beverages, sweets/candies, recorded in the Food and Nutrition Surveillance System; independent variables: sociodemographic data. Multiple logistic regression test was applied. Results: 62.10% of the children consume sugary drinks and 42.23%, sweets/candies. Consuming sugary drinks was associated with the age of 12-17 months and 29 days (OR=2.525; CI95%=1.68-3.78) and 18-17 months and 29 days (OR=2.90; CI95%=1.90-4.43); children living with more than four people at home (OR=1.59; CI95%=1.11-2.26), aged 12-17 months and 29 days (OR=2.05; CI95%=1.34-3.13) and 18-23 months and 29 days (OR=2.51; CI95%=1.62-3.87) were more likely to consume sweets/candies than younger children. Maternal aspects, such as age (OR=0.66; CI95%=0.46-0.93), marital status (OR=1.67; CI95%=1.06-2.6), schooling (OR=2.14; CI95%=1.12-4.08), and presence of government assistance (OR=2.03; CI95%=1.41-2.93), were conditions associated with the consumption of sweets. Conclusions: the prevalence of sugar in children's diet was high and was associated with sociodemographic aspects. Health education actions should be carried out in childcare, in order to promote healthy food, minimizing the consumption of sugar.

Resumo Objetivos: analisar a prevalência do consumo de açúcar e fatores associados em consultas de puericultura. Métodos: estudo transversal com 599 crianças >seis a <24 meses de idade, assistidas por Unidades de Saúde da Família. Desfechos: consumo diário de bebidas adoçadas, doces/guloseimas, registrados no Sistema de Vigilância Alimentar e Nutricional; variáveis independentes: dados sociodemográficos. Aplicou-se teste de regressão logística múltipla. Resultados: 62,10% das crianças consomem bebidas açucaradas e 42,23% doces/guloseimas. Consumir bebidas açucaradas associou-se à idade de 12-17 meses e 29 dias (OR=2,525; IC95%=1,68-3,78) e 18-17 meses e 29 dias (OR=2,90; IC95%=1,90-4,43); crianças residirem com mais de quatro pessoas na casa (OR=1,59; IC95%:1,11-2,26), terem idade de 12-17 meses e 29 dias (OR=2,05; IC95%=1,34-3,13) e 18-23 meses e 29 dias (OR=2,51; IC95%=1,62-3,87) apresentaram maior chance de consumir doces/guloseimas que crianças mais novas. Aspectos maternos como idade (OR=0,66; IC95%=0,46-0,93), estado civil (OR=1,67; IC95%=1,06-2,6), escolaridade (OR=2,14; IC95%=1,12-4,08), e presença de auxílio do governo (OR=2,03;IC95%=1,41-2,93), foram condições associadas ao consumo de doces/guloseimas. Conclusão: foi alta a prevalência de açúcar na dieta das crianças e esteve associada a aspectos sociodemográficos. Ações de educação em saúde devem ser realizadas na puericultura, a fim de fomentar a alimentação saudável, minimizando o consumo de açúcar.

Sociodemographic, lifestyle, behavioral, and parental factors associated with sugar-sweetened beverage consumption in children in China.

OBJECTIVE: Evidence shows sugar-sweetened beverage (SSB) consumption is a risk factor for obesity and non-communicable diseases (NCDs) in children. Investigating the influential profiles, which have been examined insufficiently, will help to inform the reduction of SSB consumption. The present research examines the current trend in SSB consumption and associated factors among children in China, in order to inform policy development. METHODS: Secondary data was extracted from China's Health and Nutrition Survey (CHNS; 2004, 2006, 2009, and 2011), a repeated cross-sectional research, and a Chi-squared test was applied to compare SSB consumption in the last year, queried by social demographical, `environmental, behavioral, and parental factors. Multilevel mixed-effects logistic regression was employed to examine the trend and effects of the multiple factors. RESULTS: A total of 6015 Chinese children aged 6-17 years were investigated. From 2004 to 2011, the percentage of SSB consumption in children increased from 72.6% to 90.3%. The prevalence in urban areas was higher than the prevalence in rural areas, higher in high schools than primary and middle schools, higher in east coast affluent provinces than other provinces, and higher in high-income households than low-income households. Other associated factors include children's fast food and salty snacks preference, level of physical activity, sedentariness, and parental education. The strongest association with SSB consumption in children was the mother's SSB consumption (adjusted odds ratio: 5.54, 95% CI: 3.17-9.67). CONCLUSION: Children's SSB consumption has increased significantly in China, and is associated with socio-economic, demographic, level of physical activity, food preference, and parental factors. Future strategies aimed at reducing SSB consumption among children need to consider these factors.

Sugar-Sweetened Beverage Intake Linked to Early-Onset Colorectal Cancer Risk.

According to this study: Among women, a higher intake of sugar-sweetened beverages in adulthood and adolescence is associated with a substantially higher risk of early-onset colorectal cancer.Reducing the intake of sugar-sweetened beverages in this population may reduce the incidence of early-onset colorectal cancer.

Association between Emotional Eating and Frequency of Unhealthy Food Consumption among Taiwanese Adolescents.

Emotional eating is one factor that increases the consumption of unhealthy food. This study aimed to investigate the association between emotional eating and frequencies of consuming fast food, high-fat snacks, processed meat products, dessert foods, and sugar-sweetened beverages (SSBs) in adolescents. The baseline survey data (2015) from the Taiwan Adolescent to Adult Longitudinal Study (TAALS) were fitted into multivariate logistic regression models adjusted for sex, school type, Body Mass Index (BMI), eating while doing something, nutrition label reading, skipping breakfast, smoking, binge drinking, sedentary lifestyle, physical activity, peer and school support, and parental education level. Among the 18,461 participants (48.5% male and 51.5% female), those exhibiting emotional eating were more likely to consume fast food (Odds ratio (OR) = 2.40, 95% Confidence interval (CI): 2.18-2.64), high-fat snacks (OR = 2.30, 95% CI: 2.12-2.49), processed meat products (OR = 1.92, 95% CI: 1.78-2.08), dessert foods (OR = 2.49, 95% CI: 2.31-2.69), and sugar-sweetened beverages (OR = 1.83, 95% CI: 1.70-1.98). Factors that were positively associated with unhealthy food consumption included eating while doing other activities, binge drinking, smoking, and sedentary lifestyle. Among all the covariates, nutrition label reading was the only factor that was inversely associated with frequent unhealthy food consumption. Sex and school type may moderate the effect of emotional eating on the frequent consumption of specific unhealthy food groups. In conclusion, adolescents with high emotional eating were more likely to report frequent consumption of unhealthy foods in Taiwan. Our findings showed that male participants appeared to consume fast foods, high-fat snacks, processed meat, and SSBs more often and dessert foods less often than females. Future longitudinal studies are recommended for understanding the causal relationship between emotional eating and unhealthy food consumption.

Determinants of the Consumption of Regular Soda, Sport, and Energy Beverages in Spanish Adolescents.

Increasing sugar-sweetened beverages (SSB) consumption and associated health impacts warrant health-policy action. We assessed associations of socioeconomic and lifestyle variables with adolescents' consumption of regular soda (RSD), sport (SD), and energy (ED) drinks. Cross-sectional study of 3930 Spanish adolescents (2089 girls, 1841 boys) aged 13-18 years). We compared frequency of consuming each SSB type (European Food Safety Authority questionnaire) with sociodemographic and lifestyle variables (standardized questions). RSD, SD, and ED were consumed at least weekly by 72.7%, 32.3%, and 12.3% of participants, respectively, and more frequently (p < 0.001) by boys, compared to girls. Multivariate ordinal logistic regression showed inverse association between RSD, SD, and ED consumption and parental occupation-based socioeconomic status (p < 0.01). Daily smoking was associated (p < 0.001) with higher ED (OR 3.64, 95% CI 2.39-5.55) and RSD (OR 2.15, 95% CI 1.56-2.97) consumptions. SD intake was associated inversely with smoking (OR 0.60, 95% CI 0.40-0.89, p = 0.012) and directly with physical activity (OR 2.93, 95% CI 2.18-3.95, p < 0.001). School performance was lower among ED (OR 2.14, 95% CI, 1.37-3.35, p = 0.001) and RSD (OR 1.81, 95% CI 1.24-2.64, p = 0.002) consumers, compared to SD. Maleness and low socioeconomic status predicted SSB consumption. Smoking and low school performance were associated with higher ED and RSD intakes.

Food Insecurity and Dietary Intake among College Students with Unlimited Meal Plans at a Large, Midwestern University.

BACKGROUND: Food insecurity, a state of not being able to consistently access nutritious food due to financial constraints, has been associated with poor dietary intake among college students. The extent to which campus food resources contribute to this association is unknown. OBJECTIVES: This study examined the association between food insecurity and dietary intake in a sample of undergraduate students with unlimited meal plans and dining hall access at a large, public Midwestern university. DESIGN: The study design is cross-sectional. The data used are baseline data from a broader sugar-sweetened beverage intervention study that were collected using a Qualtrics survey prior to the intervention. PARTICIPANTS/SETTING: The sample consisted of 1033 undergraduate students recruited from 3 dining halls. The data were collected in November 2018. MAIN OUTCOME MEASURES: Food security was assessed using the 6-item Short Form Food Security Survey Module. Dietary intake was assessed using the National Cancer Institute 26-item Dietary Screener Questionnaire and the Beverage Intake Questionnaire-15. STATISTICAL ANALYSES PERFORMED: Generalized linear regression models were used to examine differences in dietary intake by students' food security status, adjusting for students' sociodemographic characteristics. RESULTS: In the sample, 14% of students were food-insecure. After adjusting for sociodemographic variables, food-insecure students reported 9% lower intake of fruits (P = 0.02), 9% lower intake of vegetables (P < 0.001), 10% higher intake of dairy (P = 0.002), 6% higher intake of total added sugars (P = 0.01), 10% higher intake of added sugars from sugar-sweetened beverages (P = 0.01), 4% higher intake of calcium (P = 0.01), and 4% lower intake of fiber (P = 0.01) compared with food-secure students. With respect to beverage intake, food-insecure students had 56% higher intake of total sugar-sweetened beverages (P = 0.002), which was driven by 185% higher intake of energy and sports drinks (P = 0.001), and 121% higher intake of sweetened teas (P = 0.001). CONCLUSIONS: Despite having identical food resources within campus dining halls, there were significant differences in the diets of college students by food security status.

Sugar-Sweetened Soda Consumption and Total and Breast Cancer Mortality: The Western New York Exposures and Breast Cancer (WEB) Study.

BACKGROUND: There is growing evidence of an association between sugar-sweetened beverages (SSB) and increased risk of mortality in various populations. However, SSB influence on mortality among patients with breast cancer is unknown. METHODS: We assessed the relationship between sugar-sweetened soda and both all-cause and breast cancer mortality among women with incident, invasive breast cancer from the Western New York Exposures and Breast Cancer Study. Breast cancer cases were followed for a median of 18.7 years, with ascertainment of vital status via the National Death Index. Frequency of sugar-sweetened soda consumption was determined via dietary recall using a food frequency questionnaire. Cox proportional hazards, adjusting for relevant variables, were used to estimate HRs and 95% confidence intervals (CI). RESULTS: Of the 927 breast cancer cases, 386 (54.7%) had died by the end of follow-up. Compared with never/rarely sugar-sweetened soda drinkers, consumption at ≥5 times per week was associated with increased risk of both total (HR = 1.62; 95% CI, 1.16-2.26; P trend < 0.01) and breast cancer mortality (HR = 1.85; 95% CI, 1.16-2.94; P trend < 0.01). Risk of mortality was similarly increased among ER-positive, but not ER-negative patients; among women with body mass index above the median, but not below the median; and among premenopausal, but not postmenopausal women for total mortality only. CONCLUSIONS: Reported higher frequency of sugar-sweetened soda intake was associated with increased risks of both total and breast cancer mortality among patients with breast cancer. IMPACT: These results support existing guidelines on reducing consumption of SSB, including for women with a diagnosis of breast cancer.

Consumption of Sweet Beverages and Cancer Risk. A Systematic Review and Meta-Analysis of Observational Studies.

The consumption of sweet beverages, including sugar-sweetened beverages (SSB), artificial-sweetened beverages (ASB) and fruit juices (FJ), is associated with the risk of different cardiometabolic diseases. It may also be linked to the development of certain types of tumors. We carried out a systematic review and meta-analysis of observational studies aimed at examining the association between sweet beverage intake and cancer risk. Suitable articles published up to June 2020 were sourced through PubMed, Web of Science and SCOPUS databases. Overall, 64 studies were identified, of which 27 were selected for the meta-analysis. This was performed by analyzing the multivariable-adjusted OR, RR or HR of the highest sweet beverage intake categories compared to the lowest one. Random effects showed significant positive association between SSB intake and breast (RR: 1.14, 95% CI: 1.01-1.30) and prostate cancer risk (RR: 1.18, 95% CI: 1.10-1.27) and also between FJs and prostate cancer risk (RR: 1.03, 95% CI: 1.01-1.05). Although the statistically significant threshold was not reached, there tended to be positive associations for the following: SSBs and colorectal and pancreatic cancer risk; FJs and breast, colorectal and pancreatic cancer risk; and ASBs and pancreatic cancer risk. This study recommends limiting sweet beverage consumption. Furthermore, we propose to establish a homogeneous classification of beverages and investigate them separately, to better understand their role in carcinogenesis.

Relations between sweetened beverage consumption and individual, interpersonal, and environmental factors: a 6-year longitudinal study in German children and adolescents.

OBJECTIVES: This study aims to characterize the consumption of sweetened beverages (SB) among young people in Germany in terms of individual and interpersonal-environmental correlates. METHODS: A representative sample of children and adolescents from Germany was assessed twice, 6 years apart (total longitudinal sample n = 11,691 children and adolescents aged between 0 and 17 years old; weighted). The relations between individual and interpersonal-environmental factors at baseline with SB intake 6 years later were analysed using bivariate and multivariate methods. RESULTS: The majority of children and adolescents in Germany consume sweetened beverages weekly, 23% daily. SB consumption is particularly high in boys and often accompanied by other unhealthy lifestyle behaviours including a high level of tobacco and media consumption with a concurrent deficiency in fruit and vegetable consumption. Interpersonal factors associated with higher sweetened beverage consumption include low socio-economic status, tobacco consumption of parents, and older maternal age. CONCLUSIONS: Research on factors that correlate with sweetened beverage consumption is crucial to design effective interventions. Our findings underline the importance of complex, multi-level interventions to target sweetened beverage intake and obesity.

Using a Socioecological Approach to Identify Factors Associated with Adolescent Sugar-Sweetened Beverage Intake.

BACKGROUND: Adolescents are among the highest consumers of sugar-sweetened beverages (SSBs) in the United States. More research is needed to understand the relationship of multiple levels of influence on adolescent SSB intake across the socioecological model in a nationally representative sample. OBJECTIVE: This secondary analysis of cross-sectional data aims to explain variance in adolescent SSB intake by exploring the associations of adolescent demographic (ie, age, race/ethnicity, and parent socioeconomic status), intrapersonal (ie, behavioral intention, self-efficacy, and media perception), interpersonal (ie, social norms and perceived parenting practices), and home availability variables. DESIGN: This study included 1,560 adolescents who participated in the 2014 National Cancer Institute-sponsored cross-sectional Family, Life, Activity, Sun, Health, and Eating study. Descriptive statistics, analyses of variance, and stepwise multiple linear regression models were used to explore factors associated with SSB intake. In the stepwise regression, a 4-step model was analyzed with each subsequent step adding variables from different socioecological model levels. RESULTS: The final step that included 14 variables individually associated with SSB intake significantly predicted 16.5% of the variance in SSB intake. Four variables were associated with higher SSB intake in the final step when controlling for all other variables: male sex (ß=.066), non-Hispanic black vs non-Hispanic white (ß=.123), adolescent's report of having parents allow them to have SSBs on a bad day (ß=.150), and home SSB availability (ß=.263). Race/ethnicity other than Hispanic and/or non-Hispanic black vs non-Hispanic white was associated with lower intake (ß= -.092). CONCLUSIONS: When considering potential targets for multilevel behavioral interventions aimed at reducing adolescent SSB intake, emphasis on reducing SSB availability at home may be especially important. Furthermore, although adolescence is a period of increasing independence, parent influence on adolescent's health behaviors may also be a key intervention target. Home and parental SSB factors may be more important than targeting intrapersonal factors and social norms among adolescents.

Oral health behaviour, attitude towards, and knowledge of dental caries among mothers of 0- to 3-year-old children living in Kaunas, Lithuania.

OBJECTIVES: This study aimed to investigate the oral health behaviours of mothers with young children and their attitudes towards dental caries. METHODS: The survey targeted all mothers with children under 3 years attending a primary healthcare centre (Department of Family Medicine at the Lithuanian University of Health Sciences [LSMU] Hospital) in Kaunas, Lithuania. The Bioethics Centre of the LSMU approved the study (No. BEC-OF-14). Of 176 mothers, 123 (69.9%) took part in the 2016-2017 study. The self-administered questionnaire enquired about mothers' attitudes towards oral health and behaviours related to the potential transmission of oral bacteria to their children, dietary habits, tooth brushing, smoking, and background factors. The chi-squared test and univariate/multivariate logistic regression analyses served for the statistical analysis. (p values ≤ .05 indicated statistically significant differences). RESULTS: Most (76; 68.5%) of the mothers brushed their teeth twice daily, and 97 (87.4%) reported themselves as nonsmokers. We found a statistically significant association between mothers who brushed their own teeth twice daily and those who cleaned their children's teeth likewise (OR = 5.42, 95% CI [1.28-6.63]; p = .005). We observed significant associations among mothers who gave their children sugar-sweetened beverages (SSBs) daily and the mothers' college or lower education (OR = 6.51, 95% CI [1.59-27.19]; p = .01) and maternal tooth brushing less than twice daily (OR = 3.88, 95% CI [0.99-15.18]; p = .05). CONCLUSIONS: A majority of mothers who took part in this survey did not brush their children's teeth as recommended. Mothers with a lower education and who brushed their teeth less than twice daily offered their children SSBs more frequently.

Consumo de bebidas açucaradas em pacientes com doença aterosclerótica manifesta / Consumption of sugar-sweetened beverages in patients with established atherosclerosis disease

Resumo O presente estudo investigou a associação entre o consumo de bebidas açucaradas e variáveis antropométricas e bioquímicas em análise transversal, realizado com dados secundários referentes à primeira consulta do ensaio clínico randomizado Dieta Cardioprotetora Brasileira (2013-2014). Foram coletados peso, altura, circunferência da cintura, perfil lipídico e glicemia de jejum e dados de um recordatório alimentar de 24 horas. Diferenças entre o consumo e não consumo de bebidas açucaradas foram avaliadas pelo teste T de student. Para analisar a associação entre o consumo de bebidas açucaradas e fatores bioquímicos e antropométricos foi utilizado o teste qui quadrado. A amostra foi de 2.172 indivíduos, sendo a maioria homens (58,5%), idosos (63,6%), do nível econômico C (57,3%), com ensino fundamental (45,8%) e com excesso de peso (62,7%). Houve associação significativa entre o consumo de bebidas açucaradas e maior valores de índice de massa corporal (p=0,029), circunferência da cintura (p=0,004) e triglicerídeos (p=0,023). Esses resultados reforçam a necessidade de intervenção nutricional quanto ao consumo de bebidas açucaradas como parte do tratamento dietético desta população.

Abstract This study investigated the association between consumption of sugar-sweetened beverages and anthropometric and biochemical variables in a cross-sectional study conducted with secondary data from the first visit of the randomized clinical trial of the Brazilian Cardioprotective Nutritional Program (BALANCE Program) (2013-2014). Weight, height, waist circumference, lipid profile and fasting glycemia and a 24-hour diet recall were collected. Differences between consumption and non-consumption of sugar-sweetened beverages were evaluated by Student's t-test. The Chi-square test was employed to analyze the association between consumption and non-consumption of sugar-sweetened beverages and biochemical and anthropometric factors. The sample consisted of 2,172 individuals, mostly men (58.5%), elderly (63.6%), C-rated economic class (57.3%), and overweight (62.7%). A statistically significant difference was found between the consumption of sugar-sweetened beverages and higher BMI values (p=0.029), waist circumference (p=0.004) and triglycerides (p=0.023). These results emphasize the need for nutritional intervention regarding the consumption of sugar-sweetened beverages as part of the dietary treatment of this population.

Demographic, socioeconomic and lifestyle factors associated with sugar-sweetened beverage intake: a population-based study.

INTRODUCTION: The intake of sugar-sweetened beverages (SSB) varies according to the characteristics of the population. OBJECTIVE: To investigate the SSB intake and demographic, socioeconomic and lifestyle factors associated with its consumption in adolescents, adults, and older adults in São Paulo. METHODS: Data were drawn from the Health Survey of São Paulo, a cross-sectional population-based study including 1,662 individuals aged 12 years or more. SSB were classified into six groups: sugar-sweetened sodas, sweetened coffee and tea, sweetened milk and dairy products, sweetened fruit juice, sweetened fruit drink, and total SSB. The association of each group with demographic, socioeconomic and lifestyle variables was assessed using linear regression models. RESULTS: The mean SSB intake was 668.4 mL in adolescents, 502.6 mL in adults, and 358.2 mL in elderly adults. Sodas and sweetened coffee and tea represented had the greatest contribution to energy intake. SSB consumption was lower among female sex and higher among overweight adolescents, among sufficiently active adults, and among lower household per capita income older adults. Consumption of SSB was high, particularly among adolescents. Public policies are required in order to decrease the consumption of these beverages. CONCLUSION: Age group, sex, household per capita income, and body mass index status were associated with SSB intake.

Genotypes of HLA, TCF7L2, and FTO as potential modifiers of the association between sweetened beverage consumption and risk of LADA and type 2 diabetes.

PURPOSE: Sweetened beverage consumption is associated with type 2 diabetes (T2D) and LADA. We investigated to what extent this association is mediated by BMI and whether it is modified by genotypes of HLA, TCF7L2 rs7903146, or FTO rs9939609. METHODS: Swedish case-control data including incident cases of LADA (n = 386) and T2D (n = 1253) with matched population-based controls (n = 1545) was used. We estimated adjusted ORs of diabetes (95% CI) in relation to sweetened beverage intake (per daily 200 mL serving) and genotypes. The impact of BMI was estimated using causal mediation methodology. Associations with HOMA-IR and HOMA-B were explored through linear regression. RESULTS: Sweetened beverage intake was associated with increased risk of LADA (OR 1.15, 95% CI 1.03-1.29) and T2D (OR 1.21, 1.11-1.32). BMI was estimated to mediate 17% (LADA) and 56% (T2D) of the total risk. LADA was associated with risk variants of HLA (3.44, 2.63-4.50) and TCF7L2 (1.27, 1.00-1.61) but not FTO. Only among non-carriers of high-risk HLA genotypes was sweetened beverage intake associated with risk of LADA (OR 1.32, 1.06-1.56) and HOMA-IR (beta = 0.162, p = 0.0047). T2D was associated with TCF7L2 and FTO but not HLA, and the risk conferred by sweetened beverages appeared modified by FTO (OR 1.45, 95% CI 1.21-1.73 in non-carriers). CONCLUSIONS: Our findings suggest that sweetened beverages are associated with LADA and T2D partly through mediation by excess weight, but possibly also through other mechanisms including adverse effects on insulin sensitivity. These effects seem more pronounced in individuals without genetic susceptibility.

Sugar-sweetened beverage consumption among Indigenous Australian children aged 0-3 years and association with sociodemographic, life circumstances and health factors.

OBJECTIVE: To explore beverage intake and associations between sugar-sweetened beverage (SSB) intake and sociodemographic, life circumstances, health and well-being factors in a national cohort of Indigenous children. DESIGN: We calculated prevalence ratios for any SSB consumption across exposures, using multilevel Poisson regression (robust variance), adjusted for age group and remoteness. A key informant focus group contextualised these exploratory findings. SETTING: Diverse settings across Australia. PARTICIPANTS: Families of Indigenous children aged 0-3 years, in the Longitudinal Study of Indigenous Children. RESULTS: Half (50·7 %, n 473/933) of children had ever consumed SSB at survey, increasing from 29·3 % of 0-12-month-olds to 65·7 % of 18-36-month-olds. SSB consumption prevalence was significantly lower in urban and regional v. remote areas, and in families experiencing socio-economic advantage (area-level advantage, caregiver employed, financial security), better life circumstances (caregiver social support, limited exposure to stressors) and caregiver well-being (non-smoking, social and emotional well-being, physical health). SSB consumption prevalence was significantly lower among those engaged with health services (adequate health-service access, regular prenatal check-ups), except SSB consumption prevalence was higher among those who received home visits from an Aboriginal Health Worker compared with no home visits. Key informants highlighted the role of water quality/safety on SSB consumption. CONCLUSIONS: A substantial proportion of Indigenous children in this sample consumed SSB from an early age. Health provider information needs to be relevant to the context of families' lives. Health system strategies must be paired with upstream strategies, such as holistic support programmes for families, reducing racism and improving water quality.

Effects of a sugar-sweetened beverage tax on prices and affordability of soft drinks in Chile: A time series analysis.

Chile is one of several countries that recently implemented a fiscal policy to reduce soft drink (SD) intake and obesity. In 2014 the government increased the existing ad-valorem tax on high-sugar SD by 5% and decreased by 3% the tax on low-sugar SD, based on a 6.25gr/100 ml sugar threshold. This study aims to evaluate the tax modification passed-on to consumers through prices, and to calculate changes in affordability of SDs. We analysed nationally representative consumer price index data of 41 soft drinks within 6 beverage categories between 2009 and 2016. Price change post-tax implementation was estimated for different categories (carbonates, juices, concentrates, waters and energy-sport drinks), using time-series analyses. In addition, changes in affordability were evaluated by estimating the changes in prices relative to wages. The price of carbonates increased by 5.60% (CI 95% 3.18-8.03%) immediately after the tax was implemented. A sustained increase in the prices of concentrates was observed after the implementation. Unexpectedly, a smaller increase was also seen for the price of bottled water - a category that saw no tax change. There were no effects for juices and energy-sports drinks. There was a reduction in affordability for carbonates, concentrates and waters. Overall, the fiscal policy was effective in increasing prices and there are some signs of reduced affordability. Results varied substantially among categories directly affected by the tax policy. While for carbonates the price increase exceeded the tax change ('over-shifting'), in other categories subject to a tax cut, a price reduction was expected but the opposite occurred. As the effect of the tax on prices differed between categories, the effects of the tax policy on consumption patterns are likely to be mixed. Our findings underline the need to better understand and anticipate price setting behaviour of firms in response to a tax.