Sugar-Sweetened Beverages and Their Role in Obesity Prevention Programs and Policies

Abstract

It is well established that sugar-sweetened beverages (SSBs) are associated with obesity and chronic diseases. Although there is some emerging evidence that consumption of added sugars is declining in the United States, on average Americans’ consumption still exceeds recommended levels. Consequently, it is imperative that researchers continue to delve further into the question of exactly how SSBs influence obesity and associated chronic diseases, as well as consider creative and novel strategies for reducing their impact on consumers’ health. Several important gaps in the research are addressed by this dissertation. Chapter one considers the role of SSBs and overall diet quality with respect to the growing body of evidence that demonstrates an association between sleep duration and obesity. We used linear regression to examine the associations of sleep duration with dietary indicators in elementary school students taking part in a multi-sector, community-based obesity prevention intervention (the Massachusetts Childhood Obesity Research Demonstration Project). We found that students who reported sleeping <10 hours/day consumed soda more frequently and vegetables less frequently compared with students who reported optimal sleep.

Chapter two assesses whether fast food customers are worse at estimating the caloric content of their meal when their purchase includes a high-calorie beverage (HCB). We used linear regression to examine the association between purchasing HCB and calorie estimation among adult and adolescent fast food customers, and found that among adults, drinking HCB contributes to underestimating calories. HCB may be influencing calorie estimation in a unique way compared to high-calorie food items.

Chapter three considers the relevance of SSBs with respect to proposed changes to the Supplemental Nutrition Assistance Program (SNAP). Using sales data from a large supermarket chain in the Northeast, we used multivariate analysis of variance to determine whether there is an association between SNAP receipt and shopping patterns. We found that SNAP shoppers spent more than non-SNAP shoppers on sugar-sweetened beverages, red meat, and cold convenience foods, and spent less on fruits, vegetables and poultry.

Each chapter lends additional support for a focus on SSB consumption in obesity prevention efforts and will inform the development of prevention strategies in the future.