Daily Soft Drink Consumption Increases Obesity, Overweight Rates in Adolescents

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The prevalence of daily soft drink consumption had a statistically significant positive association with the prevalence of overweight and obesity in adolescent-aged students, according to new research.¹

Using data from more than 400,000 school-aged adolescents across 107 countries and regions, the consumption of soft drinks was found to account for nearly 12% of the variation in the overweight and obesity rate, supporting the need to reduce soft drink consumption among young people.

“In conjunction with the evidence from prospective cohort studies and randomized trials, our findings support that reducing soft drink consumption should be a prioritized approach for curbing the pandemic of overweight and obesity among adolescents,” wrote the study investigators, led by Huan Hu, PhD, from the research center for prevention from radiation hazards of workers at the National Institute of Occupational Safety and Health.

Soft drink consumption has increased in both high-income and low- and middle-income countries within the past few decades. Hu and colleagues indicate the importance of a comprehensive understanding of soft drink consumption to curb the increasing trend of obesity, particularly in countries where soft drink companies have introduced new marketing and promotional strategies.²

However, there is limited data on the association between soft drink consumption and country-level prevalence of overweight and obesity. The primary objective of the current analysis was to investigate the association between the prevalence of soft drink consumption in adolescent students and the prevalence of overweight and obesity using aggregate data obtained from national school-based surveys.

Three school-based surveys were included in analysis: the Global School-Based Health Survey (2009 - 2017), the European Health Behavior in School-Aged Children (2017-2018) in Europe, and the US National Youth Risk Behavior Survey (2019). The analysis labeled soft drink consumption is a dichotomous variable: daily consumption (≥1 time per day) and non-daily consumption (never or ≤1 time per day).

For the county-level data analysis, the investigative team estimated the prevalence of adolescent students consuming ≥1 soft drink per day; the prevalence of overweight and obesity; mean age; percentage of female students; the prevalence of students eating fruit and/or vegetables ≥1 time per day; and the prevalence of physical activity. In the pooled analysis, a logistic regression model was used to investigate the association between daily soft drink consumption and overweight and obesity.

Among the 107 countries and regions included in the analysis, 65 were low- and middle-income and 42 were high-income countries and regions. A total of 405,528 school-going adolescents with a mean age of 14.2 years comprised the patient population.

Upon analysis, the prevalence of overweight and obesity among school-going adolescents ranged from 3.3% (95% CI, 2.6 - 4.1) in Cambodia to 64.0% (95% CI, 57.0 - 71.6) in Niue. The analysis revealed the prevalence of adolescents consuming soft drinks ≥1 time per day varied from 3.3% (95% CI, 2.9 - 3.7) in Iceland to 79.6% (95% CI, 74.0 - 85.3) in Niue.

Investigators identified a positive correlation between the prevalence of daily soft drink consumption and the prevalence of overweight and obesity, with a partial correlation coefficient of 0.44 (95% CI, 0.26 - 0.58; P <.001). For every 10% increase in the prevalence of daily soft drink consumption, there was a 3.7% (95% CI, 2.2 - 5.2) increase in the prevalence of overweight and obesity after adjusting for covariates.

Moreover, the prevalence of daily soft drink consumption accounted for 12.4% (95% CI, 3.0 - 25.8) of the variation in the prevalence of overweight and obesity among countries. In the pooled analysis, individual-level data showed a statistically significant association between daily soft drink consumption and overweight and obesity among adolescents, with an odds ratio of 1.14 (95% CI, 1.08 - 1.21).

In their conclusion, the investigative team pointed to the role of government in taxing soft drinks to lower consumption or reducing the amount of sugar consumption in soft drinks as steps to help curb the rise in obesity.

“Additional strategies beyond soft drink taxation, such as reducing saturated fat and calorie intake and increasing physical activity, are also necessary to effectively reduce the burden of obesity in the population,” investigators wrote.

References

1. 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
2. Popkin BM, Hawkes C. Sweetening of the global diet, particularly beverages: patterns, trends, and policy responses. Lancet Diabetes Endocrinol. 2016;4(2):174-186. doi:10.1016/S2213-8587(15)00419-2PubMed