Health Warnings Meet Sugary Drinks

By Sara Bernate

Obesity is one of the leading causes of death in America and has been referred to as an epidemic due to its prevalence and association with other negative health outcomes. One recognized driver of obesity is the consumption of sugar-sweetened beverages (SSBs) well above the recommended levels. This is not surprising considering that beverage sizes range from small to extra large with the largest size containing up to 30 ounces of liquid. But how often do consumers think about the contents in sugar-sweetened beverages? And how does this affect their consuming behaviors and, in the long run, their health?

Past policy-mandated health warnings on harmful substances, such as cigarettes, have proved successful in reducing purchases and consumption. In hopes of a similar results, policies requiring health warnings on SSBs have been proposed. While past experimental studies designed to test the effects of health warnings on SSBs have supported a success in reducing the purchasing of SSBs, there is still much to understand about policy effects on population diets and health outcomes.

To understand how altered purchasing behavior of sugar-sweetened beverages affects health in the long run, a recent study conducted by faculty at the University of North Carolina Gillings School of Global Public Health developed a simulated model for the impact on dietary behaviors and body weight of a national SSB health warning policy requiring that health warnings be displayed on all containers, vending machines, and menus. First, the model simulated a sample of U.S. adults, ages 18-65, and assigned each individual the following: age, sex, race/ethnicity, income, and educational attainment. Then, height, weight, and SSB intake was assigned to each individual based off data from the 2005-2014 National Health and Nutrition Examination Survey Cycles. The sample experienced two separate scenarios: one in which a national SSB health warning policy was implemented and one in which no policy was implemented. Previous literature on the impact of SSB warnings’ on purchases, changes in total energy intake, and valid models of weight change informed the simulation. From this data, individuals in the sample underwent changes in their SSB intake, total energy intake, BMI, and obesity prevalence over a simulated 5-year period.

The study found that implementing a national SSB health warning policy would first directly reduce the intake of SSBs over the recommended consumption levels, which in turn would reduce the total energy intake. Over time, a gradual reduction in BMI was predicted to occur. After 5 years, the reduction in SSB intake, total energy intake, and BMI would ultimately lead to a reduction in the prevalence of obesity by 3.1%. Although it may seem like a small percentage, that 3.1% equates to more than 5 million adults. Furthermore, the study found that reduction in over-consumption behavior and negative health outcomes occurred in all demographic groups. Minority groups, however, experienced larger reductions, due to the fact that they consume disproportionately high amounts of SSBs.

In light of ongoing policy debates, the researchers concluded that the implementation of a national SSB health warning policy is a significant strategy for reducing the consumption and prevalence of obesity. Although simulation studies are not definitive, they can be crucial in bringing about change at the policy level to address today’s most pressing health matters.

Peer-edited by Jeffrey Letourneau

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