To combat this association, study investigators concluded a reduction in daily soft drink consumption should be a priority among school-going adolescents.
In a study recently published in Jama Network Open, the prevalence of obesity in children was associated with the daily consumption of soft drinks for school-going adolescents, and that taking action to reduce consumption is important to lower overweight and obesity prevalence among this group.
Study authors note that the association of soft drink consumption and weight gain in school-going adolescents is present, however not much is known about the association of soft drink consumption and obesity prevalence in children. To determine this association, investigators conducted a cross-sectional study that used data from 3 other cross-sectional studies across 107 countries and regions. Each country or region participated in the Global School-Based Student Health Survey (GSHS) (2009-2017), the European Health Behavior in School-Aged Children study (HBSC) (2017-2018), and the US Youth Risk Behavior Survey (YRBS) (2019).
A representative sample of a national population was featured in each survey, which collected soft drink and obesity and overweight data. Since data from the 3 previous studies were open-access and previously obtained informed consent from their respective investigators, the current study was exempt from ethics approval.
Soft drinks in the 3 initial studies referred to “carbonated beverages that typical contain sugar, including but not limited to brands such as Coca-Cola and Pepsi, as well as nonbrand carbonated beverages with sugar.” In the current study, consumption was measured as daily consumption (1 or more times in a day) and nondaily consumption (less than 1 time per day or never). The initial students’ body weight and height data were collected by trained survey staff in the GSHS, while the HBSC and YRBS counted on self-reported data. If body mass indexes (BMI) were more than 1 mean (SD) higher than age- and sex-specific median, students were classified as overweight. They were classified as obese if they were more than 2 SD above the median. Ages, sex, daily vegetable consumption, daily fruit consumption, soft drink taxes, physical activity, country income groups, and year of data were covariates.
The mean age of the 405,528 students from 107 countries and regions in the study was 14.2 (1.7) years and 48.4% were male. Of the 107 countries and regions, 65 were low- and middle-income while the remaining 42 were high-income. In total, 32 countries had taxes on sugar-sweetened soft drinks, and high-income countries were more likely to implement these taxes (18 of 42 [42.9%]) compared to low- and middle-income countries (14 of 65 [21.5%]) (P = .02).
The analysis demonstrated that out of all school-going adolescents, approximately 17.2% were overweight or obese (95% CI, 17.0%-17.5%). For adolescent students in countries and regions with soft drink taxes, the population-weighted prevalence of overweight and obesity was “marginally higher” (17.4% [95% CI, 17.1%-17.7%]) compared to students of countries and regions without soft drink taxes (16.3% [95% CI, 15.9-16.8%]) (P = .05). For students who consumed 1 or more soft drinks per day, the population-weighted prevalence was 32.9% (95% CI, 32.3%-33.4%). Compared to countries without soft drink taxes (33.5% [95% CI, 32.8%-34.1%]), the weighted prevalence of daily soft drink consumption was lower in countries with soft drink taxes (30.2% [95% CI, 29.6%-30.8%]) (P < .001).
Overall, the prevalence of students consuming soft drinks 1 or more times per day varied from 3.3% in Iceland to 79.6% in Niue (95% CI, 2.9-3.7; 95% CI, 74.0-85.3). A positive correlation was observed between daily soft drink consumption prevalence and overweight and obesity prevalence (R, 0.44; P < .001). Using individual-level data, a pooled analysis demonstrated a statistically significant association between daily soft drink consumption and overweight and obesity (daily consumption vs nondaily consumption), “with an odds ratio of 1.14 (95% CI, 1.08-1.21) among school-going adolescents,” according to results.
Based on the study analysis and other evidence, the investigators concluded that reduction of soft drink consumption should be a priority to curb adolescent overweight and obesity, as daily consumption was associated with overweight and obesity prevalence.
Hu H, Song J, MacGregor GA, He FJ. Consumption of soft drinks and overweight and obesity among adolescents in 107 countries and regions. JAMA Netw Open. 2023;6(7):e2325158. doi:10.1001/jamanetworkopen.2023.25158