Journal Article•
Consumption of sugar drinks in the United States, 2005-2008.
TL;DR: One-half of the U.S. population consumes sugar drinks on any given day, and 25% consumes at least 200 kcal (more than one 12-oz can of cola), but sugar-drink consumption differs by sex, age, race and ethnicity, and income.
Abstract: One-half of the U.S. population consumes sugar drinks on any given day, and 25% consumes at least 200 kcal (more than one 12-oz can of cola). Sugar-drink consumption differs by sex, age, race and ethnicity, and income. For example, males consume more than females, and teenagers and young adults consume more than other age groups. Among adults, non-Hispanic black and Mexican-American persons consume more than non-Hispanic white persons, and low-income individuals consume more sugar drinks in relation to their total diet than higher-income individuals. More than one-half of sugar drinks are consumed in the home. Most sugar drinks consumed away from home are obtained from stores, but more than one-third are obtained in restaurants or fast-food establishments.
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TL;DR: The evidence that decreasing SSBs will decrease the risk of obesity and related diseases such as T2D is compelling and prevention of long‐term weight gain through dietary changes such as limiting consumption of SSBs is more important than short-term weight loss in reducing the prevalence of obesity in the population.
Abstract: Summary Sugar-sweetened beverages (SSBs) are the single largest source of added sugar and the top source of energy intake in the U.S. diet. In this review, we evaluate whether there is sufficient scientific evidence that decreasing SSB consumption will reduce the prevalence of obesity and its related diseases. Because prospective cohort studies address dietary determinants of long-term weight gain and chronic diseases, whereas randomized clinical trials (RCTs) typically evaluate short-term effects of specific interventions on weight change, both types of evidence are critical in evaluating causality. Findings from well-powered prospective cohorts have consistently shown a significant association, established temporality and demonstrated a direct dose‐response relationship between SSB consumption and long-term weight gain and risk of type 2 diabetes (T2D). A recently published meta-analysis of RCTs commissioned by the World Health Organization found that decreased intake of added sugars significantly reduced body weight (0.80 kg, 95% confidence interval [CI] 0.39‐1.21; P < 0.001), whereas increased sugar intake led to a comparable weight increase (0.75 kg, 0.30‐1.19; P = 0.001). A parallel meta-analysis of cohort studies also found that higher intake of SSBs among children was associated with 55% (95% CI 32‐82%) higher risk of being overweight or obese compared with those with lower intake. Another metaanalysis of eight prospective cohort studies found that one to two servings per day of SSB intake was associated with a 26% (95% CI 12‐41%) greater risk of developing T2D compared with occasional intake (less than one serving per month). Recently, two large RCTs with a high degree of compliance provided convincing data that reducing consumption of SSBs significantly decreases weight gain and adiposity in children and adolescents. Taken together, the evidence that decreasing SSBs will decrease the risk of obesity and related diseases such as T2D is compelling. Several additional issues warrant further discussion. First, prevention of long-term weight gain through dietary changes such as limiting consumption of SSBs is more important than short-term weight loss in reducing the prevalence of obesity in the population. This is due to the fact that once an individual becomes obese, it is difficult to lose weight and keep it off. Second, we should consider the totality of evidence rather than selective pieces of evidence (e.g. from short-term RCTs only). Finally, while recognizing that the evidence of harm on health against SSBs is strong, we should avoid the trap of waiting for absolute proof before allowing public health action to be taken.
778 citations
Additional excerpts
...Data from the National Health and Nutrition Examination Survey (2005–2008) show that half the US population consumes SSBs on a given day; one in four obtain at least 200 calories from such beverages, and 5% obtain at least 567 calories – equivalent to four cans of soda (11)....
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TL;DR: This review examines the current knowledge of water intake as it pertains to human health, including overall patterns of intake and some factors linked with intake, the complex mechanisms behind water homeostasis, and the effects of variation in water intake on health and energy intake, weight, and human performance and functioning.
Abstract: This review examines the current knowledge of water intake as it pertains to human health, including overall patterns of intake and some factors linked with intake, the complex mechanisms behind water homeostasis, and the effects of variation in water intake on health and energy intake, weight, and human performance and functioning. Water represents a critical nutrient, the absence of which will be lethal within days. Water's importance for the prevention of nutrition-related noncommunicable diseases has received more attention recently because of the shift toward consumption of large proportions of fluids as caloric beverages. Despite this focus, there are major gaps in knowledge related to the measurement of total fluid intake and hydration status at the population level; there are also few longer-term systematic interventions and no published randomized, controlled longer-term trials. This review provides suggestions for ways to examine water requirements and encourages more dialogue on this important topic.
748 citations
Book•
01 Apr 2012
TL;DR: Because employers bear direct medical and indirect productivity costs of obesity, they can benefit from promoting and increasing physical activity, healthy eating, breastfeeding, and overall well-being in the workplace.
Abstract: One-third of adults are now obese, and children's obesity rates have climbed from 5 to 17 percent in the past 30 years. The causes of the nation's obesity epidemic are multi-factorial, having much more to do with the absence of sidewalks and the limited availability of healthy and affordable foods than a lack of personal responsibility. The broad societal changes that are needed to prevent obesity will inevitably affect activity and eating environments and settings for all ages. Many aspects of the obesity problem have been identified and discussed; however, there has not been complete agreement on what needs to be done to accelerate progress. Accelerating Progress in Obesity Prevention reviews previous studies and their recommendations and presents five key recommendations to accelerate meaningful change on a societal level during the next decade. The report suggests recommendations and strategies that, independently, can accelerate progress, but urges a systems approach of many strategies working in concert to maximize progress in accelerating obesity prevention.The recommendations in Accelerating Progress in Obesity Prevention include major reforms in access to and opportunities for physical activity; widespread reductions in the availability of unhealthy foods and beverages and increases in access to healthier options at affordable, competitive prices; an overhaul of the messages that surround Americans through marketing and education with respect to physical activity and food consumption; expansion of the obesity prevention support structure provided by health care providers, insurers, and employers; and schools as a major national focal point for obesity prevention. The report calls on all individuals, organizations, agencies, and sectors that do or can influence physical activity and nutrition environments to assess and begin to act on their potential roles as leaders in obesity prevention.
600 citations
TL;DR: Heterogeneity of heavy consumption by SSB types across racial/ethnic subpopulations and higher odds of heavy SSB consumption among low-SES populations should be considered in targeting policies to encourage healthful beverage consumption.
574 citations
Cites methods from "Consumption of sugar drinks in the ..."
...We applied the same measurement of heavy consumption for all age groups to obtain comparable results across age groups as in a previous study.(19) Individual factors controlled for in our multivariate regressionmodels included demographic factors (age, sex, and race/ ethnicity) and SES (education level and the level of per capita household income) based on self-reports....
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TL;DR: The epidemiological and clinical trial evidence evaluating added sugars, especially sugar-sweetened beverages, and the risk of obesity, diabetes, and cardiovascular disease are summarized and potential biological mechanisms are addressed with an emphasis on fructose physiology.
300 citations
References
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TL;DR: This document details the procedures and recommendations of the Goals and Metrics Committee of the Strategic Planning Task Force of the American Heart Association, which developed the 2020 Impact Goals, to improve the cardiovascular health of all Americans by 20% while reducing deaths from cardiovascular diseases and stroke by 20%.
Abstract: This document details the procedures and recommendations of the Goals and Metrics Committee of the Strategic Planning Task Force of the American Heart Association, which developed the 2020 Impact Goals for the organization. The committee was charged with defining a new concept, cardiovascular health, and determining the metrics needed to monitor it over time. Ideal cardiovascular health, a concept well supported in the literature, is defined by the presence of both ideal health behaviors (nonsmoking, body mass index 25 kg/m 2 , physical activity at goal levels, and pursuit of a diet consistent with current guideline recommendations) and ideal health factors (untreated total cholesterol 200 mg/dL, untreated blood pressure 120/80 mm Hg, and fasting blood glucose 100 mg/dL). Appropriate levels for children are also provided. With the use of levels that span the entire range of the same metrics, cardiovascular health status for the whole population is defined as poor, intermediate, or ideal. These metrics will be monitored to determine the changing prevalence of cardiovascular health status and define achievement of the Impact Goal. In addition, the committee recommends goals for further reductions in cardiovascular disease and stroke mortality. Thus, the committee recommends the following Impact Goals: "By 2020, to improve the cardiovascular health of all Americans by 20% while reducing deaths from cardiovascular diseases and stroke by 20%." These goals will require new strategic directions for the American Heart Association in its research, clinical, public health, and advocacy programs for cardiovascular health promotion and disease prevention in the next decade and beyond. (Circulation. 2010;121:586-613.)
3,473 citations
"Consumption of sugar drinks in the ..." refers background in this paper
...Moreover, the American Heart Association has recommended a consumption goal of no more than 450 kilocalories (kcal) of sugar-sweetened beverages—or fewer than three 12-oz cans of carbonated cola—per week (7)....
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TL;DR: The weight of epidemiologic and experimental evidence indicates that a greater consumption of SSBs is associated with weight gain and obesity, and sufficient evidence exists for public health strategies to discourage consumption of sugary drinks as part of a healthy lifestyle.
2,559 citations
"Consumption of sugar drinks in the ..." refers background in this paper
...Sugar drinks have been linked to poor diet quality, weight gain, obesity, and, in adults, type 2 diabetes (4,5)....
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01 Jan 2005
TL;DR: The US Census Bureau report highlights the increasing poverty and racial inequality in America as mentioned in this paper, showing that the poverty rate increased from 12.5 percent in 2003 to 12.7 percent in 2004; 1.1 million more people -a total of 37 million -lived in poverty in 2004.
Abstract: This US Census Bureau report highlights the increasing poverty and racial inequality in America. In 2004, 45.8 million people did not have health insurance. The poverty rate increased from 12.5 percent in 2003 to 12.7 percent in 2004; 1.1 million more people - a total of 37 million - lived in poverty in 2004. This rise in poverty came despite economic growth and marks the first time on record that household incomes had failed to increase for five straight years. Black households had the lowest median income; 32.7 percent of the Hispanic population was without health insurance.
2,022 citations
TL;DR: Clear associations of soft drink intake with increased energy intake and body weight are found and recommended to reduce population soft drink consumption.
Abstract: In a meta-analysis of 88 studies, we examined the association between soft drink consumption and nutrition and health outcomes. We found clear associations of soft drink intake with increased energy intake and body weight. Soft drink intake also was associated with lower intakes of milk, calcium, and other nutrients and with an increased risk of several medical problems (e.g., diabetes).Study design significantly influenced results: larger effect sizes were observed in studies with stronger methods (longitudinal and experimental vs cross-sectional studies). Several other factors also moderated effect sizes (e.g., gender, age, beverage type). Finally, studies funded by the food industry reported significantly smaller effects than did non–industry-funded studies. Recommendations to reduce population soft drink consumption are strongly supported by the available science.
1,738 citations
"Consumption of sugar drinks in the ..." refers background in this paper
...Sugar drinks have been linked to poor diet quality, weight gain, obesity, and, in adults, type 2 diabetes (4,5)....
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DOI•
01 Jan 2008
TL;DR: This report presents data on income, poverty, and health insurance coverage in the United States based on information collected in the 2008 and earlier Annual Social and Economic Supplements (ASEC) to the Current Population Survey (CPS) conducted by the U.S Census Bureau.
Abstract: This report presents data on income, poverty, and health insurance coverage in the United States based on information collected in the 2008 and earlier Annual Social and Economic Supplements (ASEC) to the Current Population Survey (CPS) conducted by the U.S. Census Bureau. Data presented in this report indicate the following: • Real median household income increased between 2006 and 2007—the third annual increase.1 • The poverty rate was not statistically different between 2006 and 2007. • Both the number and the percentage of people without health insurance coverage decreased between 2006 and 2007. These results were not uniform across groups. For example, between 2006 and 2007, real median household income rose for non-Hispanic Whites and Blacks but remained statistically unchanged for Asians and Hispanics; the poverty rate increased for children under 18 years old but remained statistically unchanged for people 18 to 64 years old and people 65 and over; and the percentage of people without health insurance decreased for the native-born population, while the foreign-born population remained statistically unchanged.2, 3 These results are discussed in more detail in the three main sections of this report income, poverty, and health insurance coverage. Each section presents estimates by characteristics such as race, Hispanic origin, nativity, and region. Other topics include earnings of year-round, full-time workers; families in poverty; and health insurance coverage of children. This report concludes with a section discussing health insurance coverage by state using 2- and 3-year averages.
1,727 citations