Warning Labels Reduce Sugar-Sweetened Beverage Intake among College Students.

Health-related warning labels may reduce the intake of sugar-sweetened beverages (SSBs), but the effectiveness of such labels in real-world settings is not well established. We investigated the influence of warning labels on SSB intake among college students at a large public Midwestern university. We conducted a quasi-experimental intervention study among 840 undergraduate students recruited from 3 dining halls on 1 university campus. One dining hall was selected as the intervention (I) site, whereas the other dining halls served as control (C) sites. In January 2019, warning labels were posted on SSB dispensers at the I site. All students reported their beverage intake using a modified beverage frequency questionnaire 2 mo before and 2 mo after the warning label implementation. Generalized linear models examined the influence of the warning labels on SSB consumption at the I site compared with the C sites, adjusting for students' sociodemographic characteristics. In the sample, 68% were aged 17-18 y old at baseline, and 51% identified as female. From baseline to follow-up, there was a 19% decrease in SSB intake at the I site, compared with a 5% decrease at the C sites (P = 0.049 comparing I with C). This difference was driven by significant decreases in the intakes of fruit-flavored drinks, sweetened teas, and flavored milk at the I site compared with the C sites. Although not an SSB, 100% fruit juce consumption decreased 21% at the I site, compared with a 1% increase at the C sites (P = 0.01 comparing I with C). No significant differences were observed in the intakes of soda, energy drinks, sweetened coffees, and nonsugary drinks at the I site compared with the C sites. Warning labels were effective in reducing SSB intake among college students, particularly for fruit-flavored drinks, sweetened teas, and flavored milk.This trial was registered at clinicaltrials.gov as NCT04435145.

Leung CW ，Wolfson JA ，Hsu R ，Soster K ，Mangan S ，Falbe J ... -  《-》

Food Insecurity and Dietary Intake among College Students with Unlimited Meal Plans at a Large, Midwestern University.

Food insecurity, a state of not being able to consistently access nutritious food due to financial constraints, has been associated with poor dietary intake among college students. The extent to which campus food resources contribute to this association is unknown. This study examined the association between food insecurity and dietary intake in a sample of undergraduate students with unlimited meal plans and dining hall access at a large, public Midwestern university. The study design is cross-sectional. The data used are baseline data from a broader sugar-sweetened beverage intervention study that were collected using a Qualtrics survey prior to the intervention. The sample consisted of 1033 undergraduate students recruited from 3 dining halls. The data were collected in November 2018. Food security was assessed using the 6-item Short Form Food Security Survey Module. Dietary intake was assessed using the National Cancer Institute 26-item Dietary Screener Questionnaire and the Beverage Intake Questionnaire-15. Generalized linear regression models were used to examine differences in dietary intake by students' food security status, adjusting for students' sociodemographic characteristics. In the sample, 14% of students were food-insecure. After adjusting for sociodemographic variables, food-insecure students reported 9% lower intake of fruits (P = 0.02), 9% lower intake of vegetables (P < 0.001), 10% higher intake of dairy (P = 0.002), 6% higher intake of total added sugars (P = 0.01), 10% higher intake of added sugars from sugar-sweetened beverages (P = 0.01), 4% higher intake of calcium (P = 0.01), and 4% lower intake of fiber (P = 0.01) compared with food-secure students. With respect to beverage intake, food-insecure students had 56% higher intake of total sugar-sweetened beverages (P = 0.002), which was driven by 185% higher intake of energy and sports drinks (P = 0.001), and 121% higher intake of sweetened teas (P = 0.001). Despite having identical food resources within campus dining halls, there were significant differences in the diets of college students by food security status.

Mei J ，Fulay AP ，Wolfson JA ，Leung CW ... -  《Journal of the Academy of Nutrition and Dietetics》

Warning labels and interpretive nutrition labels: Impact on substitution between sugar and artificially sweetened beverages, juice and water in a real-world selection task.

Effective strategies to reduce free sugar intake are needed. This study examined exposure to a warning label, independently and in conjunction with a Health Star Rating (HSR) label, on the selection of commercially available cold beverages with real decision-making stakes. Participants (N = 511, 47.9% female, mean = 21.7 (SD = 6.1) years) accessed an online convenience store app via an on-campus laptop to select one of 10 beverages (5 sugar-sweetened beverages [SSBs], 1100% fruit juice, 2 artificially sweetened beverages [ASBs] and 2 waters). The task was repeated with the addition of a warning label on high-sugar drinks in Round 2, and the addition of an HSR label on all drinks in Round 3. Participants were informed that they would receive a complementary drink (valued at <$5AUD) based on their selections following the completion of a brief questionnaire. Baseline results indicated that SSBs and waters were the most and least popular choices, respectively. For both males and females, there was a significant decrease in SSB selection (p < 0.001) and significant increase in ASB and water selection (p < 0.001) following the addition of warning labels to high-sugar drinks. The decreased selection of SSBs and increased selection of waters was maintained in Round 3 when HSR labels were added to all drinks. 100% fruit juice selection decreased with the addition of a warning label for females only (p < 0.01), but increased following the addition of a 4-star HSR label, for both males (p < 0.05) and females (p < 0.001). Warning labels reduced young adults' selection of SSBs and promoted substitution to water. The HSR reinforced this effect for the least healthy drinks. Increased water selection may be further enhanced by ensuring that warning label thresholds and HSR algorithms align to present consistent messaging.

Miller C ，Ettridge K ，Pettigrew S ，Wittert G ，Wakefield M ，Coveney J ，Roder D ，Martin J ，Brownbill A ，Dono J ... -  《-》

Changing beverage consumption patterns have resulted in fewer liquid calories in the diets of US children: National Health and Nutrition Examination Survey 2001-2010.

Beverage consumption patterns have been linked to obesity and chronic disease risk. Although the consumption of sugar-sweetened beverages (SSBs) has decreased recently, little is known about the parallel trends in intake of other beverages. To describe recent trends in consumption of all commonly consumed beverages among US children aged 2 to 19 years. Twenty-four-hour dietary recalls from 18,541 participants in the National Health and Nutrition Examination Survey from 2001-2010 were used to assess beverage intake, including SSBs (ie, sodas, fruit-flavored drinks, sport and energy drinks, fruit juices, coffees/teas, and other [nondairy] sugar-sweetened drinks); milks (ie, plain whole, reduced fat, and low-/nonfat, sweetened, other milks/milk-based drinks, and milk alternatives); 100% juices (ie, fruit, and vegetable/mixed without added sugar); low-/no-calorie beverages (ie, unsweetened or artificially sweetened: sodas, coffees/teas, flavored waters, diet sport/energy drinks, and other low/no-calorie drinks); alcohol-containing; and plain water (during 2005-2010 only). Weighted mean intakes (percent total energy and total ounces) and consumption prevalence were estimated. Regression models and analytical procedures that account for the complex sampling methods were used to test trends. Between 2001-2002 and 2009-2010, total daily beverage consumption (excluding water) decreased from 24.4% to 21.1% energy (32.0 to 27.9 oz). Significant decreases (P<0.05) occurred in sugar-sweetened sodas (13.5% to 10.2% energy), whole milk (2.7% to 1.6% energy), fruit juices with sugar added (2.3% to 2.1% energy), and fruit-flavored drinks (1.6% to 0.8% energy). Significant increases occurred for sweetened coffees/teas, energy drinks, sport drinks, and unsweetened juices though the contribution of each to total energy intake remained <1%. Low-/no-calorie drink consumption also increased, rising from 0.2 to 1.3 oz/day. Changing beverage consumption patterns reflect positive trends in the form of reduced intake of SSBs, whole milk, and total calories from beverages. Although the consumption of sport drinks, energy drinks, and low-calorie beverages have increased, their contribution to total beverage intake remains small.

Mesirow MS ，Welsh JA 《Journal of the Academy of Nutrition and Dietetics》

Examining changes in school vending machine beverage availability and sugar-sweetened beverage intake among Canadian adolescents participating in the COMPASS study: a longitudinal assessment of provincial school nutrition policy compliance and effectivene

Godin KM ，Hammond D ，Chaurasia A ，Leatherdale ST ... -  《International Journal of Behavioral Nutrition and Physical Activity》