Strategies to Reduce the Consumption of Foods and Drinks with High Sugar Content in the UK: A Rapid Review Approach
Abstract
:1. Introduction
2. Methodology
2.1. Eligibility Criteria
2.2. Search Strategies
2.3. Screening Strategies and Selection Process
2.4. Assessment of the Quality of the Selected Articles and Critical Appraisal
2.5. Data Analysis
2.6. Ethical Consideration
3. Findings
3.1. Characteristics of the Included Studies
3.2. Discussions of Key Themes from the Included Studies
3.3. Theme Two: Product Reformulation
3.4. Theme Three: Traffic Light Front of Pack Labelling
3.5. Theme Four: Food Portion Size Intervention
3.6. Theme Five: Soft Drink Industry Levy (SDIL)
3.7. Limitations and Implications of the Study for Practice
4. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Ren, Y.; Castro Campos, B.; Peng, Y.; Glauben, T. Nutrition transition with accelerating urbanization? Empirical evidence from rural China. Nutrients 2021, 13, 921. [Google Scholar] [CrossRef]
- Westbrook, G.; Angus, A.; Top 10 Global Consumer Trends in 2022. Euromonitor International. January 2021, p. 82. Available online: http://www.portal.euromonitor.com/portal/analysis/tab (accessed on 23 March 2025).
- Deliza, R.; Lima, M.F.; Ares, G. Rethinking sugar reduction in processed foods. Curr. Opin. Food Sci. 2021, 40, 58–66. [Google Scholar] [CrossRef]
- Farhat, G.; Dewison, F.; Stevenson, L. Knowledge and perceptions of non-nutritive sweeteners within the UK adult population. Nutrients 2021, 13, 444. [Google Scholar] [CrossRef] [PubMed]
- Huang, K.; Wang, Y. Advances in bio-based smart food packaging for enhanced food safety. Trends Food Sci. Technol. 2025, 159, 104960. Available online: https://linkinghub.elsevier.com/retrieve/pii/S0924224425000962 (accessed on 25 March 2025). [CrossRef]
- Erickson, J.; Slavin, J. Total, added, and free sugars: Are restrictive guidelines science—Based or achievable? Nutrients 2015, 7, 2866–2878. [Google Scholar] [CrossRef]
- Mantzari, E.; Vasiljevic, M.; Turney, I.; Pilling, M.; Marteau, T. Impact of warning labels on sugar-sweetened beverages on parental selection: An online experimental study. Prev. Med. Rep. 2018, 12, 259–267. [Google Scholar] [CrossRef] [PubMed]
- Malik, V.S.; Popkin, B.M.; Bray, G.A.; Després, J.-P.; Hu, F.B. Sugar-sweetened beverages, obesity, type 2 diabetes mellitus, and cardiovascular disease risk. Circulation 2010, 121, 1356–1364. [Google Scholar] [CrossRef]
- British Nutrition Foundation [BNF]. Key Findings from NDNS Report for Years 9 to 11 (Combined) The National Diet and Nutrition Survey (NDNS) Report of Years 9 to. 2024. Available online: https://www.gov.uk/government/statistics/ndns-results-from-years-9-to-11-2016-to-2017-and-2018-to- (accessed on 2 April 2025).
- International Diabetes Federation (IDF) Atlas. Diabetes Around the World in 2025. 2025. Available online: https://diabetesatlas.org/resources/idf-diabetes-atlas-2025/ (accessed on 11 April 2025).
- Saeedi, P.; Petersohn, I.; Salpea, P.; Malanda, B.; Karuranga, S.; Unwin, N.; Colagiuri, S.; Guariguata, L.; Motala, A.A.; Ogurtsova, K.; et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Pract. 2019, 157, 107843. [Google Scholar] [CrossRef]
- Baker, P.; Machado, P.; Santos, T.; Sievert, K.; Backholer, K.; Hadjikakou, M.; Russel, C.; Huse, O.; Bell, C.; Scrinis, G.; et al. Ultra-processed foods and the nutrition transition: Global, regional and national trends, food systems transformations and political economy drivers. Obes. Rev. 2020, 21, e13126. Available online: https://onlinelibrary.wiley.com/doi/full/10.1111/obr.13126 (accessed on 4 July 2022). [CrossRef]
- Scheelbeek, P.F.D.; Cornelsen, L.; Marteau, T.M.; Jebb, S.A.; Smith, R.D. Potential impact on prevalence of obesity in the UK of a 20% price increase in high sugar snacks: Modelling study. Br. Med. J. 2019, 366, l4786. [Google Scholar] [CrossRef]
- Capehorn, M.S.; Haslam, D.W.; Welbourn, R. Obesity Treatment in the UK Health System. Curr. Obes. Rep. 2016, 5, 320–326. [Google Scholar] [CrossRef] [PubMed]
- Scarborough, P.; Adhikari, V.; Harrington, R.A.; Elhussein, A.; Briggs, A.; Rayner, M.; Adams, J.; Cummins, S.; Penney, T.; White, M. Impact of the announcement and implementation of the UK soft drinks industry levy on sugar content, price, product size and number of available soft drinks in the UK, 2015–2019: A controlled interrupted time series analysis. PLoS Med. 2020, 17, e1003025. [Google Scholar] [CrossRef] [PubMed]
- Kirkpatrick, S.I.; Raffoul, A.; Maynard, M.; Lee, K.M.; Stapleton, J. Gaps in the evidence on population interventions to reduce consumption of sugars: A review of reviews. Nutrients 2018, 10, 1036. [Google Scholar] [CrossRef]
- Answers A Examining Qualitative and Quantitative Studies with CASP. 2018. Available online: https://nursinganswers.net/essays/examining-qualitative-and-quantitative-studies-with-casp-nursing-essay.php (accessed on 14 February 2021).
- Harrison, R.; Jones, B.; Gardener, P.; Lawton, R. Quality assessment with diverse studies (QuADS): An appraisal tool for methodological and reporting quality in systematic reviews of mixed- or multi-method studies. BMC Health Serv. Res. 2021, 21, 144. [Google Scholar]
- Shaheen, N.; Shaheen, A.; Ramadan, A.; Hefnawy, M.T.; Ramadan, A.; Ibrahim, I.A.; Hassanein, M.E.; Ashour, M.E.; Flouty, O. Appraising systematic reviews: A comprehensive guide to ensuring validity and reliability. Front. Res. Metr. Anal. 2023, 8, 1268045. [Google Scholar] [CrossRef] [PubMed]
- Braun, V.; Clarke, V. Using thematic analysis in psychology. Qual. Res. Psychol. 2006, 3, 77–101. [Google Scholar] [CrossRef]
- Suri, H. Ethical Considerations of Conducting Systematic Reviews in Educational Research. In Systematic Reviews in Educational Research; Springer: Wiesbaden, Germany, 2020; pp. 41–51. Available online: https://library.oapen.org/bitstream/handle/20.500.12657/23142/1007012.pdf?sequence=1#page=59 (accessed on 17 March 2021).
- Adams, J.; Pell, D.; Penney, T.L.; Hammond, D.; Vanderlee, L.; White, M. Public acceptability of the UK Soft Drinks Industry Levy: Repeat cross-sectional analysis of the International Food Policy Study (2017–2019). BMJ Open 2021, 11, e051677. [Google Scholar] [CrossRef]
- Osman, M.; Thornton, K. Traffic light labelling of meals to promote sustainable consumption and healthy eating. Appetite 2019, 138, 60–71. [Google Scholar] [CrossRef]
- Markey, O.; Le Jeune, J.; Lovegrove, J.A. Energy compensation following consumption of sugar-reduced products: A randomized controlled trial. Eur. J. Nutr. 2016, 55, 2137–2149. [Google Scholar] [CrossRef]
- Almiron-Roig, E.; Tsiountsioura, M.; Lewis, H.B.; Wu, J.; Solis-Trapala, I.; Jebb, S.A. Large portion sizes increase bite size and eating rate in overweight women. In Physiology and Behavior; Elsevier Inc.: Amsterdam, The Netherlands, 2015; Volume 139, pp. 297–302. [Google Scholar]
- Markey, O.; Lovegrove, J.A.; Methven, L. Sensory profiles and consumer acceptability of a range of sugar-reduced products on the UK market. Food Res. Int. 2015, 72, 133–139. [Google Scholar] [CrossRef]
- Porter, A.; Langford, R.; Summerbell, C.; Tinner, L.; Kipping, R. A qualitative exploration of food portion size practices and awareness of food portion size guidance in first-time parents of one- to two-year-olds living in the UK. BMC Public Health 2023, 23, 1779. [Google Scholar] [CrossRef]
- Mauri, C.; Grazzini, L.; Ulqinaku, A.; Poletti, E. The effect of front-of-package nutrition labels on the choice of low sugar products. Psychol. Mark. 2021, 38, 1323–1339. [Google Scholar] [CrossRef]
- Bradley, J.; Gardner, G.; Rowland, M.K.; Fay, M.; Mann, K.; Holmes, R.; Foster, E.; Exley, C.; Bosco, A.D.; Hugueniot, O.; et al. Impact of a health marketing campaign on sugars intake by children aged 5–11 years and parental views on reducing children’s consumption. BMC Public Health 2020, 20, 331. [Google Scholar] [CrossRef] [PubMed]
- Forde, H.; Solomon-Moore, E. A qualitative study to understand the potential efficacy of an information-based sugar reduction intervention among low socioeconomic individuals in the UK. Int. J. Environ. Res. Public Health 2019, 16, 413. [Google Scholar] [CrossRef] [PubMed]
- Ellen Lee Gardner, G. Exploring Stakeholders’ Views on the Change4Life “Sugar Smart” Campaign and School Food to Improve Children’s Diets: Two Qualitative Studies. Ph.D. Thesis, Newcastle University, Newcastle upon Tyne, UK, 2020. [Google Scholar]
- Swift, J.A.; Strathearn, L.; Morris, A.; Chi, Y.; Townsend, T.; Pearce, J. Public health strategies to reduce sugar intake in the UK: An exploration of public perceptions using digital spaces. Nutr. Bull. 2018, 43, 238–247. [Google Scholar] [CrossRef]
- Public Health England. New Change4Life Campaign Encourages Parents to ‘Be Food Smart’. 2017. Available online: https://www.nhs.uk/Change4Life (accessed on 2 April 2025).
- Kunz, S.; Haasova, S.; Rieß, J.; Florack, A. Beyond healthiness: The impact of traffic light labels on taste expectations and purchase intentions. Foods 2020, 9, 134. [Google Scholar] [CrossRef]
- Frohlich, X. The informational turn in food politics: The US FDA’s nutrition label as information infrastructure. Soc. Stud. Sci. 2017, 47, 145–171. Available online: https://journals.sagepub.com/doi/abs/10.1177/0306312716671223 (accessed on 17 April 2022). [CrossRef]
- Ogundijo, D.A.; Tas, A.A.; Onarinde, B. Factors influencing the perception and decision-making process of consumers on the choice of healthier foods in the United Kingdom: A systematic review using narrative synthesis. Int. J. Food Sci. Technol. 2021, 57, 881–897. [Google Scholar] [CrossRef]
- Klotz, M.; Krpan, D.; Lohmann, P.M.; Galizzi, M.M.; Reisch, L.A. Stop, think, buy: An online randomised controlled experiment comparing the effects of traffic light nutritional labelling and price promotion on steering consumer food choice. Appetite. 2025, 211, 108005. Available online: https://linkinghub.elsevier.com/retrieve/pii/S0195666325001588 (accessed on 25 March 2025). [CrossRef]
- Wakui, N.; Matsuoka, R.; Ichikawa, K.; Togawa, C.; Okami, A.; Kawakubo, S.; Kagi, H.; Watanabe, M.; Tsubota, Y.; Yamamura, M.; et al. Investigation of the 1-week effect of traffic light nutrition labeling on diet selection among Japanese university students: A randomized controlled trial. BMC Public Health 2024, 24, 381. [Google Scholar] [CrossRef]
- Hollands, G.J.; Shemilt, I.; Marteau, T.M.; Jebb, S.A.; Lewis, H.B.; Wei, Y.; Higgins, J.P.T.; Ogilvie, D. Portion, package or tableware size for changing selection and consumption of food, alcohol and tobacco. In Cochrane Database of Systematic Reviews; John Wiley and Sons Ltd.: Hoboken, NJ. USA, 2015; Volume 2017. [Google Scholar]
- Egnell, M.; Kesse-Guyot, E.; Galan, P.; Touvier, M.; Rayner, M.; Jewell, J.; Breda, J.; Hercberg, S.; Julia, C. Impact of Front-of-Pack Nutrition Labels on Portion Size Selection: An Experimental Study in a French Cohort. Nutrients 2018, 10, 1268. [Google Scholar] [CrossRef] [PubMed]
- Steenhuis, I.; Poelman, M. Portion Size: Latest Developments and Interventions. Curr. Obes. Rep. 2017, 6, 10. [Google Scholar] [CrossRef] [PubMed]
- Almiron-Roig, E.; Navas-Carretero, S.; Emery, P.; Martínez, J.A. Research into food portion size: Methodological aspects and applications. Food Function. R. Soc. Chem. 2018, 9, 715–739. Available online: https://pubs.rsc.org/en/content/articlehtml/2018/fo/c7fo01430a (accessed on 23 June 2021). [CrossRef] [PubMed]
- HM Revenue & Customs. Check If Your Drink is Liable for the Soft Drinks Industry Levy. 2025. Available online: https://www.gov.uk/guidance/work-out-the-sugar- (accessed on 22 February 2025).
- Hashem, K.M.; Burt, H.E.; Brown, M.K.; Macgregor, G.A. Outcomes of sugar reduction policies, United Kingdom of Great Britain and Northern Ireland. Bull World Health Organ. 2024, 102, 432–439. [Google Scholar] [CrossRef]
- King, V.J.; Stevens, A.; Nussbaumer-Streit, B.; Kamel, C.; Garritty, C. Paper 2: Performing rapid reviews. Syst. Rev. 2022, 11, 151. [Google Scholar] [CrossRef]
Inclusion Criteria | Exclusion Criteria |
---|---|
Studies that analysed the strategies for reducing sugar consumption in the UK retail market | Studies analysed the strategies for reducing sugar consumption outside the UK retail market |
Peer-reviewed studies | Non-peer-reviewed data, such as news, books, reports |
Articles that are written in the English language | Articles that are not written in the English Language |
Publications from 2014 to 2024 | Articles published before 2014 |
Primary studies comprising qualitative, quantitative, or both (mixed method) | Secondary studies, such as reviews, reports, etc. |
Study Type | Author and Year | Was the Aim of the Research Clearly Stated? Yes/No | Did the Study Design Sufficiently Meet the Aims of the Study? Yes/No | Was the Recruitment Strategy Aligned with the Research Aims? Yes/No | Were Ethical Issues Considered? Yes/No | Was the Analysis of the Data Conducted Vigorously? Yes/No | Are the Findings in the Study Clearly Stated? Yes/No | Does the Conclusion Section Summarise the Findings of the Research? Yes/No | Are the Limitations of the Study Clearly Stated? Yes/No |
---|---|---|---|---|---|---|---|---|---|
Quantitative | Adams et al. [20] | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
Osman and Thornton [21] | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | |
Markey, Le Jeune and Lovegrove [22] | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | |
Almiron-Roig et al. [23] | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | |
Markey, Lovegrove and Methven [24] | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | |
Qualitative | Porter et al. [25] | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
Mauri et al. [26] | Yes | Yes | Yes | No | Yes | Yes | Yes | Yes | |
Bradley et al. [27] | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | |
Forde and Solomon-Moore [28] | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | |
Mixed method | Gardner [29] | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
Swift et al. [30] | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
Author/Year | Intervention Type | Study Design/Type | Population | Settings | Participant Characteristics | Purpose of the Study | Findings |
---|---|---|---|---|---|---|---|
Swift et al. [30] | Change4Life Sugar Smart campaign | Mixed method | Healthy adult | Online survey, Online questionnaire | Study 1: 184 online questionnaires. Study 2: 412 participants, Facebook parent forum. | The study aims to create awareness among parents to reduce sugar in their children’s meals, the use of the strategies, and how people feel about the Change2Life Sugar Smart app | Findings showed that public officials need to ensure that the implemented strategies are being followed appropriately. In this study, consumers accepted the importance of sugar intake. |
Forde and Solomon-Moore [28] | Information-based intervention (IBI) “Sugar Smart” | Qualitative | Healthy Adult (volunteer and food bank individuals) | Four food bank stores are located in Bristol. A face-to-face semi-structured interview. | 14 individuals (8 food bank staff and 6 volunteers). | The purpose of the study is to evaluate people with low socio-capacity and to know about the factors and knowledge regarding their sugar consumption and their acceptance in the IBI. | The study concluded that the intervention effectively reduces sugar consumption, and the research also anticipates appropriate ways for people with low socio-economic status to embrace the IBI and its impact on other individuals. |
Bradley et al. [27] | Change4Life sugar smart campaign (CSS) | Qualitative | Adolescents/children | One-on-one semi-structured qualitative intervention. Between 1 month, 10 month, and 12 month 837 participants, 539 follow-ups | Children 5–11 years | This study aims to motivate parents to help reduce their children’s food and drink. | The study shows that Change4Life’s marketing campaigns helped reduce sugar. Consumers should be aware of the different sugars present in food and appropriate labelling should be done. |
Gardner [29] | Information-based intervention “Change4Life” sugar smart campaign | Mixed method | Children, adults (parents) and school staff | School-based in Newcastle upon Tyne. Duration: 30- to 40-min one-to-one interview. Follow-up: 12 months | 35 candidates, which include four staff from the canteen, 11 parents, 15 children, two council members, two head teachers, and one deputy head. | To help educate parents on the method to control sugar for their young ones by using the Change4Life smartphone application | The study’s findings explained that there may be fewer changes in sugar intake due to the food the children eat at school, which needs to be monitored, and the implementation of some measures to reduce excessive sugar intake at school. A corporation needs different stakeholders to help fight against the intake of excessive sugar. |
Markey, Lovegrove and Methven [24] | Product reformulation | Quantitative | Healthy consumers | Community centre-based settings | 116 participants 20 to 49 years | The study aims to determine if consumers will accept the reformulated products. | Findings showed that product reformulation is one measure of reducing sugar consumption. They also found that the overall liking of regular and low-sugar products differs. |
Markey, Le Jeune and Lovegrove [22] | Product reformulation | Quantitative/RCT/double-blinded/crossover dietary intervention | Healthy adult | Community-based/UK household 8 weeks control Follow up: 4 weeks | 50 participants (16 men and 34 women) Age 20 to 49 years | It examines the effect of an 8-week sugar reformulation on the body’s weight and energy balance. | The study’s findings explained that product reformulation strategies help to reduce sugar consumption but have no other effect on the density of lipids and weight of the body. |
Osman and Thornton [21] | Traffic light labelling intervention | Quantitative | Healthy adult | Opportunistic sampling method Duration: 5 min for 5 days | Study 1: 120 participants 36 males/84 females. Age: 19–64 years. Study 2: 297 participants, 197 males/99 females/1 bigender. Age:18 to 75 | The study aims to investigate how traffic light labelling affects food choice and to determine what consumers prefer by providing additional information on the label. | Findings showed that traffic light labelling assists in behavioural change in consumers’ choice of healthier meals. Traffic light labels is a means of providing and creating awareness for consumers. |
Mauri et al. [26] | Front of package label (Traffic light) | Qualitative | Healthy adult | Community-based settings by invitation. Online study | Study 1:199 participants Study 2: 272 participants Over 18 years of age | It contributes to the effectiveness of using labels to watch out for sugar levels. | The outcome of the study stated that using a teaspoon label on the front-of-package (FOP) label will likely reduce the amount of sugar intake rather than using a traffic-light FOP label |
Almiron-Roig et al. [23] | Food portion size | Quantitative/cross-sectional | Overweight women | Community-based. Eating questionnaire Use of the Sussex ingestion pattern monitor (SIPM) | 37 overweight women 18 to 60 years | To determine the outcome of the size of the portion on the time of meal intake, the amount of bite-sized portions, and the rate of eating | The study shows that eating large portions of food aids overconsumption. Appropriate changes will decrease the tendency to eat too much. |
Porter et al. [25] | Food portion size | Qualitative | Healthy adult (parent) | One-to-one, partially organised interview | Mixed adult Woman (first-time parent): 25. White:18. Higher level education: 24. Fathers = 2 | The purpose is to create awareness among first-time mums about feeding their kids using portion size and food portion recommendations. | Findings showed that most parents are unaware of the six-portion guidance, and it also depends on the child’s perception. |
Adams et al. [20] | Soft Drink Levy (SDIL) | Quantitative/Repeat cross-sectional online survey | UK Household Healthy Adult | Online survey-based intervention. Duration: 2017 (4 months) before SDIL, 2018 (8 months), and 2019 (20 months after SDIL | 18–64 years Male and female School-level and beyond education | To assess the degree of public willingness to the change between 4 months before and 20 months after the implementation of SDIL | The study describes the changes in sugar reduction after implementing the levy from 70% to 67%. |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Ogundijo, D.A.; Tas, A.A. Strategies to Reduce the Consumption of Foods and Drinks with High Sugar Content in the UK: A Rapid Review Approach. Obesities 2025, 5, 36. https://doi.org/10.3390/obesities5020036
Ogundijo DA, Tas AA. Strategies to Reduce the Consumption of Foods and Drinks with High Sugar Content in the UK: A Rapid Review Approach. Obesities. 2025; 5(2):36. https://doi.org/10.3390/obesities5020036
Chicago/Turabian StyleOgundijo, Daniel Agboola, and Ayten Aylin Tas. 2025. "Strategies to Reduce the Consumption of Foods and Drinks with High Sugar Content in the UK: A Rapid Review Approach" Obesities 5, no. 2: 36. https://doi.org/10.3390/obesities5020036
APA StyleOgundijo, D. A., & Tas, A. A. (2025). Strategies to Reduce the Consumption of Foods and Drinks with High Sugar Content in the UK: A Rapid Review Approach. Obesities, 5(2), 36. https://doi.org/10.3390/obesities5020036