Key points What is the association between soft drink consumption and the prevalence of overweight and obesity in adolescents? Findings In this cross-sectional study using data from 405,528 school-aged adolescents (children enrolled in school) from 107 countries and regions, the prevalence of daily soft drink consumption was associated with the prevalence of overweight and obesity. Meaning These findings suggest that reducing soft drink consumption is important to reduce overweight and obesity in adolescents, and steps should be taken to reduce soft drink consumption. |
Consumption of soft drinks, particularly sugary drinks, is associated with weight gain. In recent decades, soft drink consumption has increased in both high-income and low- and middle-income countries. For its part, the prevalence of overweight and obesity in children, adolescents and adults has also increased. A comprehensive understanding of the association between soft drink consumption and overweight and obesity is important to curb the growing trend of obesity, especially in low- and middle-income countries because many soft drink companies are stepping up their marketing and promotion of soft drinks. soft drink sales. in this countries.
Systematic reviews of cohort studies and experimental studies have provided considerable evidence that soft drink consumption is associated with weight gain in children and adolescents. However, there is only limited data on the association between soft drink consumption and the prevalence of overweight and obesity at the country level. A study in adults using data from 75 countries showed that every 1% increase in soft drink consumption was associated with a 4.8% increase in overweight and obesity. However, no such studies have been conducted in adolescents who are increasingly targeted by the soft drink industry. Information on the role of soft drink consumption in the prevalence of overweight and obesity among adolescents is essential to prompt policymakers to prioritize actions to reduce soft drink consumption.
The primary objective of this study is to investigate the association between the prevalence of adolescent students consuming soft drinks once a day or more and the prevalence of overweight and obesity in 107 countries and regions, using aggregate data obtained from national school surveys. Additionally, we analyzed individual-level data to investigate the association between daily soft drink consumption and overweight and obesity among school-going adolescents (hereafter, school-going adolescents).
Importance
Soft drink consumption is associated with weight gain in children and adolescents, but little is known about the association between soft drink consumption and the prevalence of overweight and obesity in adolescents.
Aim
To investigate the association of soft drink consumption with overweight and obesity in school-enrolled adolescents (hereinafter, school-attending adolescents) using country- and individual-level data.
Design, environment and participants
This cross-sectional study used data from 3 cross-sectional studies including 107 countries and regions participating in the Global School Student Health Survey (2009-2017), the European Health Behavior Study in School-Age Children (2017- 2018) and the US Youth Risk Behavior Survey (2019).
Exposure
Daily soft drink consumption (consume soft drinks 1 or more times a day or not).
Main Result and Measurement
Overweight and obesity defined by the World Health Organization Growth Reference Data.
Results
Among the 107 countries and regions, 65 were low- and middle-income countries and regions, and 42 were high-income countries and regions, with a total of 405,528 school-age adolescents (mean age [SD], 14.2 [1 .7] years; 196 147 [48.4%] men).
The prevalence of overweight and obesity among adolescent students ranged from 3.3% (95% CI, 2.6 to 4.1) in Cambodia to 64.0% (95% CI, 57.0 to 71.6) in Niue , and the prevalence of adolescent students consuming soft drinks 1 or more times per day ranged from 3.3% (95% CI, 2.9 to 3.7) in Iceland to 79.6% (95% CI, 74 .0 to 85.3) in Niue.
There was a positive correlation between the prevalence of daily soft drink consumption and the prevalence of overweight and obesity (R, 0.44; P < .001).
Pooled analysis with individual-level data also showed a statistically significant association between daily soft drink consumption and overweight and obesity (daily soft drink consumption vs. non-daily soft drink consumption), with an odds ratio of 1.14 ( 95% CI, 1.08 to 1.21) among school-going adolescents.
Figure : Data comes from the School-Based Global Student Health Survey (2009-2017), the European Health Behavior Study in School-Age Children (2017-2018), and the US Youth Risk Behavior Survey USA (2019). Consumption is the prevalence of daily soft drink consumption (1 or more times per day) among school-attending adolescents. The partial correlation coefficient (each country has the same weight) is 0.44 ( p < 0.001) for all students, 0.36 ( p < 0.001) for men and 0.50 ( p < 0.001) for women. women, controlling for average age, percentage of female students (for the general analysis), prevalence of daily fruit consumption, prevalence of daily vegetable consumption, percentage of physical activity, implementation of taxes on soft drinks, country groups by income and year of data collection.
Our study found that there was a significant association between the prevalence of daily soft drink consumption and the prevalence of overweight and obesity among school-aged adolescents in all countries and that soft drink consumption accounted for approximately 12% of the variation in overweight. and the obesity rate. Together with evidence from prospective cohort studies and randomized trials, our findings support that reducing soft drink consumption should be a priority approach to curb the pandemic of overweight and obesity among adolescents. |
Discussion
To our knowledge, our study is the first to examine the association between soft drink consumption and overweight and obesity among school-going adolescents, both at the national and individual levels. Using nationally representative data from adolescent students from 107 countries and regions, our study found a statistically significant positive association. For every 10% increase in the prevalence of daily soft drink consumption, there was a 3.7% increase in the prevalence of overweight and obesity after adjusting for potential confounders. Additionally, using individual-level data, our study also found a statistically significant association between daily soft drink consumption and overweight and obesity among school-attending adolescents.
Some potential mechanisms underlying the association between soft drink consumption and the development of overweight and obesity have been proposed. One possible mechanism is that consumption of soft drinks, which typically contain high levels of added sugar , may lead to excessive energy consumption and therefore promote weight gain. Additionally, soft drinks may decrease satiety and result in incomplete compensation of energy intake in subsequent meals for the ingestion of liquid calories, which consequently may lead to weight gain.
Final message
In this study of 107 countries and regions, the prevalence of daily soft drink consumption was associated with the prevalence of overweight and obesity among adolescent students. Our results, along with other evidence, suggest that reducing soft drink consumption should be a priority to combat overweight and obesity in adolescents.
