Temporal trends of carbonated soft-drink consumption among adolescents aged 12-15 years from eighteen countries in Africa, Asia and the Americas.

Carbonated soft-drink consumption is detrimental to multiple facets of adolescent health. However, little is known about temporal trends in carbonated soft-drink consumption among adolescents, particularly in non-Western countries. Therefore, we aimed to examine this trend in representative samples of school-going adolescents from eighteen countries in Africa, Asia and the Americas. Cross-sectional data from the Global School-based Student Health Survey 2009-2017 were analysed. Carbonated soft-drink consumption referred to drinking carbonated soft-drinks at least once per day in the past 30 d. The prevalence of carbonated soft-drink consumption was calculated for each survey, and crude linear trends were assessed by linear regression models. Data on 74 055 students aged 12-15 years were analysed (mean age 13·9 (sd 1·0) years; 49·2 % boys). The overall mean prevalence of carbonated soft-drink consumption was 42·1 %. Of the eighteen countries included in the study, significant decreasing, increasing and stable trends of carbonated soft-drink consumption were observed in seven, two and nine countries, respectively. The most drastic decrease was observed in Kuwait between 2011 (74·4 %) and 2015 (51·7 %). Even in countries with significant decreasing trends, the decrease was rather modest, while some countries with stable trends had very high prevalence across time (e.g. Suriname 80·5 % in 2009 and 79·4 % in 2016). The prevalence of carbonated soft-drink consumption was high in all countries included in the present analysis, despite decreasing trends being observed in some. Public health initiatives to reduce the consumption of carbonated soft-drink consumption among adolescents are urgently required.

Efficacy of a school-based education intervention on the consumption of fruits, vegetables and carbonated soft drinks among adolescents.

OBJECTIVES: To evaluate the efficacy of a school-based education intervention on the consumption of fruit, vegetables and carbonated soft drinks among adolescents. DESIGN: Cluster-randomised controlled trial. SETTING: Eight secondary schools from Dhaka, Bangladesh, participated in this trial and were randomly allocated to intervention (n 160) and control groups (n 160). PARTICIPANTS: A total of 320 students from 8th to 9th grades participated and completed the self-reported questionnaires at baseline, and at 8 and 12 weeks. The intervention included weekly classroom-based nutrition education sessions for students and healthy eating materials for students and parents. Repeated measures ANCOVA was used to assess the effects of the intervention. RESULTS: Daily fresh fruit intake was more frequent in the intervention (26 %) compared to the control group (3 %) at 12 weeks (p = 0·006). Participants from the intervention group also reported a significantly (P < 0·001) higher (49 %) proportion of fresh vegetable intake compared to the control group (2 %) at 12 weeks. Frequency of daily carbonated soft drinks intake decreased (25 %) in the intervention group at 12 weeks compared to baseline, while it remained unchanged in the control group; the interaction effect was observed significant (P = 0·002). CONCLUSION: Our school-based education intervention increased the daily frequency of fresh vegetables and fruit intake and decreased carbonated soft drink consumption among adolescents in the intervention group. There is a need for scaling up the intervention to engage students and empower them to develop healthy dietary habits.

Beverage Consumption and Ulcerative Colitis: A Case-Control Study from Saudi Arabia.

BACKGROUND: The association between beverage intake and ulcerative colitis (UC) is not well-established, with no available data from Arab countries. Herein, we investigated the potential association of consuming coffee, tea, and carbonated soft drinks with UC among a population from Saudi Arabia. METHODS: This hospital-based case-control study used data of 171 newly diagnosed UC patients and 400 patients with other gastrointestinal conditions who served as controls. All UC cases were ascertained by endoscopy, while beverage intake was assessed by a questionnaire that was completed before diagnosis. We computed odds ratios (ORs) and 95% confidence intervals (95% CIs) of UC and UC extension for frequent versus infrequent intakes of coffee, tea, and carbonated soft drinks using logistic regression. RESULTS: Overall, 23.4% of UC patients had pancolitis, 21.1% extensive, 51.4% left-sided, and 4.1% proctitis. UC patients had a similar sex distribution to the controls but were older and had a lower BMI. After adjustment for age, sex, body mass index, and smoking history, frequent intakes of coffee and tea were associated with lower odds of UC: 0.62 (0.42, 0.91) and 0.53 (0.35, 0.79), respectively. On the other hand, frequent intakes of carbonated soft drinks were associated with increased odds of UC: 9.82 (6.12, 15.76). The frequency of beverage consumption was not associated with UC extension. CONCLUSION: UC was negatively associated with frequent coffee and tea consumption but positively associated with frequent carbonated soft drink intake in Saudi people. More population-based prospective cohort studies are needed to confirm our findings.

CARBONATED BEVERAGES AFFECT LEVELS OF ANDROGEN RECEPTOR AND TESTOSTERONE SECRETION IN MICE.

Objectives: This work aimed to study the influences of carbonated beverages (CBs) on the testis growth and the expression levels of androgen receptor (AR) of mice. Methods: Two experimental groups of 30 mice each PEP-1 and PEP-2 drank 50% and 100% Pepsi-Cola, respectively for 15 days. Other 2 experimental groups of 30 mice each COC-1 and COC-2 drank 50% and 100% Coca-Cola, respectively for 15 days. The control group (CG) of 30 mice drank water. Bilateral testes were harvested aseptically on days 0, 5, 7, 10, 13 and 15. Real-time PCR and Western blot were implemented to detect levels of androgen receptor (AR) mRNA and protein in testis tissues. Results: Testes masses of PEP-2, COC-1 and COC-2 were greater than those of PEP-1 and CG (P < 0.05). On day 15, testis longitudinal diameter (TLD) of CBs-treated mice was increased as compared to CG. TLD, testes transverse diameters (TTD) and AR proteins levels of PEP-2 and COC-2 were increased in comparison with CG (P<0.05). Serum testosterone concentrations of PEP-2 were higher than that of COC-1 and CG (P < 0.05). Levels of AR mRNAs of four CBs-treated mice were increased by 60.18%, 67.26%, 65.93% and 78.76%. Conclusions: A high concentration of Coca-Cola and Pepsi-Cola could raise TLD and TDD, enhance testosterone secretion, and increase serum EGF concentrations.

Medicaid expansion and non-alcoholic beverage choices by low-income households.

This article investigates the impact of the 2010 Patient Protection and Affordable Care Act (ACA) on the healthfulness of non-alcoholic beverage (NAB) choices of low-income households. A theoretical analysis proposes an income effect that increases unhealthy beverage purchases after Medicaid expansion and a nutrition education effect that decreases them. To empirically test these effects, we utilize household-level data for NAB purchases in 52 U.S. metropolitan areas. Our identification strategy is based on eligible households following the 2012 Supreme Court ruling that allowed states to opt out of Medicaid expansion. We examine changes in purchases across NAB categories and in purchases at the product-brand level. Empirical results indicate that Medicaid expansion resulted in eligible households buying more diet carbonated soft drinks (CSDs) and bottled water, with no effect on regular CSDs, fruit juice, fruit drinks, milk, or tea. Moreover, the expansion led to decreases in sugar purchases and increases in purchases of NAB products with lower sugar content, highlighting the benefits of supplementing the medical benefits of Medicaid with diet quality programs, such as nutrition education.

Consumption of carbonated soft drinks and suicide attempts among 105,061 adolescents aged 12-15 years from 6 high-income, 22 middle-income, and 4 low-income countries.

BACKGROUND & AIMS: Multinational studies on the relationship between consumption of sugar-sweetened beverages and suicidal behavior in youths are lacking. Thus, the goal of this study was to investigate the association between consumption of carbonated soft drinks and suicide attempts among adolescents from 6 high-income, 22 middle-income and 4 low-income countries. METHODS: Cross-sectional data from the Global school-based student health survey (GSHS) were analyzed. Data on past 12-month suicide attempts and past 30-day carbonated soft drink consumption (number of times per day) were collected. Multivariable logistic regression and meta-analysis were conducted to assess associations. RESULTS: There were 105,061 adolescents (49.0% females) aged 12-15 years included in the analysis. The overall prevalence of suicide attempts and consumption of carbonated soft drinks ≥3 times/day were 10.2% and 10.7%, respectively. After adjustment for potential confounders (i.e., sex, age, food insecurity, alcohol consumption, smoking, physical activity, obesity, fruit and vegetable consumption, fast food consumption, country), compared to those who did not consume carbonated soft drinks, those who consumed 3 and ≥ 4 times/day were 1.36 (95%CI = 1.07-1.72) and 1.43 (95%CI = 1.14-1.80) times more likely to have reported an attempted suicide in the past 12 months, respectively. Country-wise analyses showed that consumption of carbonated soft drinks ≥3 times/day (vs. <3 times/day) was associated with higher odds for suicide attempts (i.e., OR>1) in 22 of the 32 included countries with the pooled OR (95%CI) based on a meta-analysis being 1.20 (1.12-1.28; I2 = 28.6%). CONCLUSIONS: Our data indicate that there is a positive association between consumption of carbonated soft drinks and suicide attempts in the past 12 months. Further studies should confirm/refute our findings and investigate the potential underlying mechanisms.

Global Patterns of Adolescent Fruit, Vegetable, Carbonated Soft Drink, and Fast-Food Consumption: A Meta-Analysis of Global School-Based Student Health Surveys.

BACKGROUND: Adolescence presents an opportunity to influence diet, which impacts present and future health outcomes, yet adolescent diets globally are poorly understood. OBJECTIVE: We generate evidence on adolescent diets globally and explore patterns and trends by subpopulation. METHODS: We estimated mean frequency of consumption and prevalence of less-than-daily fruit and vegetable consumption, at-least-daily carbonated beverage consumption, and at-least-weekly fast-food consumption among school-going adolescents aged primarily 12 to 17 years from the Global School-based Student Health Surveys in Africa, Asia, Oceania, and Latin America between 2008 and 2015. Random-effects meta-analysis was used to pool estimates globally and by subgroup. RESULTS: On average, adolescents consumed fruit 1.43 (95% confidence interval [CI] 1.26-1.60) times per day, vegetables 1.75 (1.58-1.92) times per day, carbonated soft drinks 0.99 (0.77-1.22) times per day, and fast food 1.05 (0.78-1.32) times per week. Overall, 34.5% (95% CI 29.4-39.7) consumed fruit less than once per day, 20.6% (15.8-25.9) consumed vegetables less than once per day, 42.8% (35.2-50.7) drank carbonated soft drinks at least once per day, and 46.1% (38.6-53.7) consumed fast food at least once per week. Mean daily frequency of fruit consumption was particularly low in South and East Asia (1.30 [1.02-1.58]); carbonated soft drink consumption high in Latin America (1.54 [1.31-1.78]), high-income countries (1.66 [1.29-2.03]), and modern food system typologies (1.44 [0.75-2.12]); and mean weekly fast food consumption high in mixed food system typologies (1.29 [0.88-1.71]). CONCLUSIONS: School-going adolescents infrequently consume fruits and vegetables and frequently consume carbonated soft drinks, but there is wide variability by subpopulation.

Temporal patterns of caffeine intake in the United States.

To investigate whether caffeine intake among adolescents and adults in the U.S. varies across the week or throughout the day, data from a 7-day online beverage consumption survey (2010-2011) were analyzed. Mean (206.8-213.0 mg/day) and 90th percentile (437.4-452.6 mg/day) daily caffeine intakes among consumers 13 years and older were relatively constant across the week with no marked difference among weekdays versus weekend days. Percent consumers of caffeinated beverages likewise remained stable across the week. Mean daily caffeine intake for coffee and energy drink consumers 13 years and older was higher than contributions for tea and carbonated soft drink consumers. Caffeinated beverage consumers (13 + yrs) consumed most of their caffeine in the morning (61% versus 21% and 18% in the afternoon and evening) which was driven by coffee. Caffeinated beverage consumption patterns among adolescents (13-17 yrs) - who typically consume less daily caffeine - were more evenly distributed throughout the day. These findings provide insight into U.S. temporal caffeine consumption patterns among specific caffeinated beverage consumers and different age brackets. These data suggest that while caffeine intakes do not vary from day-to-day, mornings generally drive the daily caffeine intake of adults and is predominantly attributed to coffee.

Knowledge, Attitude, Frequency and Level of Consumption Regarding Non-alcoholic Carbonated Soft Drinks among Students from Two High Schools in Hanoi, Vietnam in 2015.

OBJECTIVE: This article aims to describe the knowledge, attitude, frequency and level of consumption regarding non-alcoholic carbonated soft drinks (NCSD) among students from two high schools in Hanoi. MATERIALS AND METHODS: A cross-sectional survey including a semi-quantitative food frequency were conducted with 620 students from two high schools, one in the urban area and the other in the rural area of Hanoi city. RESULTS: Data on knowledge of health risk associated with the consumption of NCSD showed neagtive results (only 11.9% of the students were able to identify all the contents of NCSD correctly, and 2.7% knew all eight health risks due to consumption of NCSD). Besides, 31.4% of all students did not have the intention to quit NCSD despite being aware of health risks associated with the consumption of NCSD. Students who reported consuming NCSD within one month prior to the study constituted 83.1%, and those who consumed NCSD 1-2 times/week accounted for the highest proportion, being 21.3%. On average, each student consumed 2,094 ml NCSD within one month prior to the study. Suburban students and male students consumed more than urban and female ones, respectively (p < 0.01). RECOMMENDATIONS: Students should be equipped with information about NCSD related health risks and encouraged to consume less NCSD.

Fatores associados ao consumo de bebidas açucaradas entre pré-escolares brasileiros: inquérito nacional de 2006 / Factors associated with the consumption of soft drinks among Brazilian preschool children: national survey of 2006

Resumo O crescente consumo de bebidas açucaradas como os refrigerantes ou sucos artificiais está associado à prevalência de obesidade no Brasil e no mundo. Este estudo se propõe a conhecer a frequência de consumo destas bebidas entre crianças brasileiras de 24 a 59 meses e investigar associações com variáveis demográficas, socioeconômicas e nutricionais. Utilizando dados da Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher − 2006, o padrão alimentar foi obtido com o questionário de frequência de alimentos e bebidas nos sete dias anteriores à data da entrevista e a antropometria usou medidas de peso e de estatura das crianças. Entre os pré-escolares, 37,3% consumiram refrigerantes e sucos artificiais 4 dias ou mais por semana. Os fatores que apresentaram associação estatisticamente significante com consumo frequente de BA foram residir em regiões de maior desenvolvimento econômico do país, em áreas urbanas, pertencer ao estrato de maior poder aquisitivo, mães que assistiam TV regularmente e excesso de peso da criança, estavam associados ao consumo de refrigerantes e sucos artificiais em 4 ou mais dias por semana. Novos estudos são necessários para a compreensão da real contribuição das bebidas açucaradas na epidemia de obesidade infantil.

Abstract The rising consumption of sweetened beverages such as soft drinks or artificial juices is associated with the prevalence of obesity in Brazil and around the world. This study seeks to verify the frequency of consumption of these beverages among Brazilian children aged 24-59 months and to investigate the association of soft drinks with demographic, socioeconomic and nutritional variables. Using data from the National Survey on Demography and Health of Women and Children − 2006, the eating habits were obtained using the food and drink frequency questionnaire for the seven days preceding the interview, and anthropometry recorded the weight and height of children. Among preschoolers, 37.3% consumed soft drinks and artificial juices 4 or more days per week. The factors significantly associated with frequent consumption of soft drinks were living in regions of higher economic development of the country, in urban areas, belonging to the higher income bracket, with mothers watching TV regularly and excess weight of the child, were associated with consumption of soft drinks and artificial juices 4 or more days per week. Further studies are needed to understand the effective contribution of soft drinks on the epidemic of childhood obesity.

Determination of metals in soft drinks packed in different materials by ETAAS.

The present work proposes a method for the direct determination of Al, Cu, Cr, Fe and Ni in Brazilian carbonated soft drinks by electrothermal atomic absorption spectrometry (ETAAS). Samples of different flavors packed in containers made of different materials (polyterephthalate ethylene and glass bottles, and aluminum and steel cans) were analyzed. The method was optimized by building up pyrolysis and atomization curves in sample medium and by evaluating the calibration approach. Under optimized conditions, recoveries in the range of 92-104% were obtained in the evaluation of method accuracy. The limits of quantification for Al, Cu, Cr, Fe and Ni were 2.3, 0.93, 0.17, 0.90 and 1.2 µg L(-1), respectively. Also, the impact of the material used in the packaging and flavor on the concentrations of each metal in the samples was evaluated. It was proved that neither flavor nor packaging material affected the concentrations of Al and Fe in the samples. On the other hand, the packaging material influenced the concentration of Cu, Cr and Ni, and only the flavor affected the concentration of Cu in the samples. These conclusions were based on the data obtained from the application of a two-way ANOVA evaluation at 95% confidence level.