Search Results (150)

Background/Objectives: Excessive sugar intake through sugar-sweetened beverages (SSBs) has raised global concerns due to its association with various health risks. This study evaluates the effectiveness of nudges—in the form of order placement, variety expansion, and a combination of both—in promoting non-SSB purchases at self-service kiosks, a key environment for SSB consumption. Methods: This study was conducted using a real-world kiosk at food and beverage outlets in South Korea from 28 May to 12 July, 2024. A total of 183 consumers aged 19 to 29 participated in this study. A single kiosk device was used with four screen layouts, each reflecting a different nudge strategy. Participants were unaware of these manipulations when making their purchases. After their purchases, participants completed a survey. All data were analyzed using IBM SPSS Statistics for Windows, Version 29.0. Results: Females reported significantly higher positive attitudes, preferences, and perceived necessity regarding nudges compared to males. In particular, both the single (variety) and combination (order and variety) nudges received positive responses from females (p < 0.001). The combination nudge significantly increased non-SSB purchases compared to the control (p < 0.05) and single (order) nudge groups (p < 0.01), which suggests that combination nudge is effective in promoting healthier beverage choices. Females were also more likely to purchase non-SSBs than males (p < 0.05). Conclusions: The findings suggest that the combination nudge strategy effectively promotes healthier beverage choices in real kiosk settings. Notably, females demonstrate significantly higher positive attitudes, preferences, and perceived necessity regarding nudges compared to males, and are also more likely to purchase non-SSBs. These findings offer valuable insights for real-world applications aimed at encouraging healthier consumption behaviors. Full article

Background/Objectives: Non-communicable diseases (NCDs) are strongly linked to beverage consumption. This study aimed to assess the average daily beverage intake of Saudi residents, energy intake from beverages, and the influence of socio-demographic factors, health behaviors, and health status on beverage intake. Methods: A nationally representative, cross-sectional study utilized stratified quota sampling to survey adults (≥18 years) across all 13 administrative regions of Saudi Arabia. Data were collected from April 2022 to December 2023 using the validated Arabic Beverage Frequency Questionnaire (ABFQ), assessing consumption patterns of 28 beverage types. Results: The study included 4385 participants (mean age: 36.1 ± 11.14 years, 65% male). Sweetened tea (28 mL/day), regular soft drinks (22.1 mL/day), and Saudi coffee (18 mL/day) were the most frequent beverages after water. Sweetened tea contributed to the highest average energy intake (33.2 ± 46.4 kcal/day). Consumption of sugar-sweetened beverages (SSBs) was higher among younger individuals (18–29 years: OR: 4.0, 95% CI [2.6–6.3]; 30–44 years: OR: 2.8, 95% CI [1.8–4.3]), males (OR:1.6, 95% CI [1.4–1.8]), and residents of specific regions [Al-Jawf (OR: 1.9, 95% CI [1.2–3.2]) and Jazan (OR: 3.2, 95% CI [2.2–4.7])]. Higher water intakes were associated with males (OR: 1.5, 95% CI [1.3–1.7]), higher education levels (OR: 1.4, 95% CI [1.2–1.8]), physically active (OR: 1.5, 95% CI [1.3–1.8]), and those overweight (OR: 1.6, 95% CI [1.2–2.3]) or obese (OR: 2, 95% CI [1.4–2.8]). Conclusions: This study provides a valuable insight into beverage consumption patterns among Saudi residents. The findings highlight the need for targeted public health interventions to promote healthier beverage choices, particularly among younger populations and those with lower socioeconomic status. Full article

Background/objective: We examined the prevalence of daily sugar-sweetened beverage (SSB) intake, identifying its sociodemographic determinants and exploring its potential association with undiagnosed non-communicable diseases (NCDs) among Malaysian adults. Methods: This cross-sectional study analyzed data from 6596 Malaysian adults participating in the 2019 National Health and Morbidity Survey (NHMS). Multiple logistic regression was used to examine the association between daily SSB intake and the risk of undiagnosed diabetes, hypertension, hypercholesterolemia, and obesity while adjusting for potential confounders. Results: The prevalence of daily SSB intake was 53.6%, with higher intake observed among females, older adults, Indians, and unemployed individuals. After adjusting for confounders, daily SSB intake was not significantly associated with undiagnosed diabetes (adjusted OR: 1.01, 95% CI: 0.80–1.29), undiagnosed hypertension (adjusted OR: 0.99, 95% CI: 0.81–1.22), undiagnosed hypercholesterolemia (adjusted OR: 0.99, 95% CI: 0.83–1.18), or obesity (adjusted OR: 1.08, 95% CI: 0.91–1.27). Conclusions: This study highlights the high prevalence of daily SSB intake among Malaysian adults, driven by sociodemographic factors. While a lack of direct associations with undiagnosed NCDs was observed, the high prevalence of SSB intake raises concerns about long-term health impacts. Targeted public health interventions are essential to address the cultural and economic determinants of SSB intake, as well as future research adopting longitudinal designs to explore how sustained reductions in SSB intake influence the risk of developing NCDs. Full article

Background: Excessive consumption of sugar-sweetened beverages (SSBs) is linked to various health risks, including obesity, type 2 diabetes, and cardiovascular diseases. University students are particularly vulnerable due to lifestyle factors and high consumption patterns. Objective: This cross-sectional survey examined SSB consumption patterns, sugar intake, and awareness of health risks among Kuwait University students. Methods: Statistical analyses, including chi-square tests and logistic regression models, were conducted using SPSS. Results: Findings revealed a high prevalence of SSB consumption, with significant associations between intake levels and demographic characteristics. Regular soda was the most consumed SSB, with 42% of students drinking it 5–6 times per week and 32% consuming it daily. The median daily sugar intake from soda alone was 38 g, approaching or exceeding recommended limits. Overall, 34% of students were classified as high-sugar consumers. Males had a higher total sugar intake, while females consumed SSBs more frequently. Greater health awareness was associated with lower sugar consumption, such as obesity (OR = 0.142, 95% CI = 0.046–0.435, p < 0.001), whereas students who were aware of the sugar content in SSBs and who preferred unsweetened fruit juices had significantly lower sugar intake from SSBs (OR = 0.653, 95% CI = 0.435–0.980, p = 0.040; OR = 0.447, 95% CI = 0.295, 0.675; p < 0.001, respectively). Conclusions: The findings underscore the urgent need for targeted interventions—such as educational campaigns and policy measures—to reduce SSB consumption and promote healthier dietary habits among young adults in Kuwait. Full article

Background/Objectives: This paper aims to assess the unhealthy dietary habits and sedentary behaviours among adolescents and young adults simultaneously. Methods: The sample consists of 682 participants aged 10–24 years old (58.9% males and 68.2% aged 15–19 years old), recruited for the ALIMA (ALImentazione Multiculturale negli Adolescenti) study in both secondary schools and youth aggregation centres, located in Rome. The study utilizes structured questionnaires to gather data on anthropometric measurements, eating habits, alcohol consumption, physical activity, and sedentary behaviours. Data are analyzed by using the Pearson chi-squared test. Results: Excessive screen time (>3 h/day) and inadequate dietary habits (insufficient consumption of fruit, vegetables, and legumes, skipping breakfast, and a high consumption of sugar-sweetened beverages and alcohol) are observed in the total sample, but mainly in older adolescents aged 15–19 years old. The adherence to the MD, measured via the KIDMED index, is significantly different among the three age groups (p = 0.001); 47.8% of the sample has a medium adherence, while among those with a low adherence, the highest percentage is represented by older adolescents (39.8%); those with foreign-born parents have healthier diets, whereas lower parental education correlates with unhealthy behaviours. Conclusions: These results highlight the need for targeted interventions tailored to adolescents and young adults to encourage healthier lifestyle choices. Full article

Background: While unhealthy dietary trends, such as elevated confectionery consumption and decreased fruit intake, have been documented in adults, the longitudinal patterns of food consumption during childhood remain inadequately characterized. This study aimed to describe national trends in food group intakes among children and adolescents in Japan. Methods: Data on participants aged 1–19 years in the National Health and Nutrition Survey from 2001 to 2019 (n = 37,072) were used in this study. A 1-day, semi-weighed, household-based dietary record was used to assess dietary intake. Results: Decreasing trends in the intakes of animal-based foods, potatoes and starches, sugars and sweeteners, fruits (annual percentage change [APC] range: −5.04 to −0.62), algae, fish and shellfish (APC range: −3.22 to −2.02), eggs, milks, fats and oils, and confectionery were observed, while intakes of meats (APC range: 1.02 to 1.92) and beverages (APC range: 1.36 to 2.51) increased. Consumption of plant-based foods, cereals, legumes, nuts and seeds, vegetables, and mushrooms was mostly unchanged, whereas variable intakes of seasonings and spices were observed. Conclusions: This study showed that the intakes of many food groups (e.g., fruits, fish and shellfish, and milk) decreased among children and adolescents, but some increased (e.g., meats and beverages) or remained stable (e.g., cereals and vegetables). Further evidence is needed to enable policymakers to set target interventions to improve children’s diets. Full article

Background: Artificially sweetened beverages (ASBs) are commonly recommended as a substitute for sugar-sweetened beverages (SSBs) in dietary counseling. Childhood obesity, associated with comorbidities like type 2 diabetes (T2D), has risen alongside increased consumption of both SSBs and ASBs. Metformin, a common treatment for pediatric T2D, affects GDF-15, a hormone involved in weight regulation. This pilot study examines the impact of ASBs on the therapeutic effects of metformin in pediatric patients with obesity and prediabetes, focusing on growth differentiation factor 15 (GDF-15) as a potential mediator. Methods: Forty-six children aged 10–21 years were randomized into two groups: one consuming non-sweetened beverages (USB) and the other consuming ASBs during a 12-week metformin intervention. Results: While the USB group showed a greater decrease in the point estimate for mean BMI (−0.55 ± 1.49 USB vs. −0.23 ± 1.60 ASB) and an increase in the point estimate for mean GDF-15 (33.40 ± 58.34 in USB vs. 19.77 ± 85.87 in ASB), these differences were not statistically significant (p = 0.6). As a hypothesis-generating exercise, change in insulin resistance was explored. While again lacking statistical power, we observed that more participants in the USB group showed improvements in insulin resistance. Conclusions: Additional studies are needed to fully elucidate the impact of non-nutritive sweeteners on metabolic health and treatment outcomes in pediatric obesity. Full article

Background/Aims: Immigrant populations face unique dietary challenges influenced by food security and acculturation, particularly regarding sugar-sweetened beverages (SSBs). This study examines the interplay of nativity and food security on SSB consumption patterns. Methods: Data from the National Health and Nutrition Examination Survey (NHANES) 2007–2020 (N = 23,331) were analyzed in this cross-sectional study. SSB consumption was assessed through 24 h dietary recalls. Food security was categorized as high/marginal or low/very low, and nativity as U.S.-born or foreign-born. Stratified regression models by sex evaluated associations between nativity, food security, and SSB consumption. Results: U.S.-born adults with low food security had the highest sugar intake (men: β = 27.5, 95% CI [14.8, 40.3]; women: β = 30.4, 95% CI [11.0, 49.7]) and SSB consumption (men: β = 14.7, 95% CI [11.2, 18.3]; women: β = 23.6, 95% CI [15.2, 31.9]). Conclusions: The findings highlight associations that suggest the importance of culturally tailored interventions targeting vulnerable groups to address disparities in SSB consumption influenced by food security and nativity. Full article

(1) Background: Sugar-sweetened beverages (SSBs) are a major source of added sugars and have been linked to adverse health outcomes, including obesity and metabolic disorders. The global rise in adolescents who are overweight and obese presents critical public health challenges. Although there is a growing focus on SSB consumption globally, data on sugar and SSB intake in Iraq, particularly in the Kurdistan region, remain scarce. This study aims to assess SSB consumption and its association with body mass index (BMI) and waist circumference among adolescents in Erbil, Iraq, contributing to efforts to address obesity in this population. (2) Methods: This cross-sectional study included 379 intermediate school students aged 11 to 16 years from Erbil, Iraq. Data were collected using a validated questionnaire to gather information on sociodemographic characteristics, physical activity levels, sedentary behaviors, and sleep duration. Weight and height were measured, and age- and sex-adjusted BMI z-scores were calculated. Waist circumference was measured twice, with the average value recorded. Dietary data were obtained using two non-consecutive 24 h recalls (one on a school day and one on a weekend day), and the average daily SSB consumption was calculated. Multiple regression modeling was used to evaluate the associations between SSB consumption, BMI, and waist circumference, adjusting for potential confounders. Data analysis was conducted using SPSS version 26, with statistical significance set at 5%. (3) Results: The mean daily intake of SSBs was 686.71 ± 197.50 milliliters (mL), with males consuming significantly more (719.8 ± 185.9) than females (658.0 ± 185.3) (p = 0.001). The prevalence of overweight and obesity was 41.7%. Multiple regression analysis showed a significant positive association between BMI and SSB consumption, sedentary behavior, and total caloric intake (p < 0.001), while age was negatively associated with BMI. The consumption of SSBs was strongly associated with BMI, with each additional milliliter of SSB intake associated with a 0.002 unit increase in BMI (t-value = 12.498, p < 0.001). Waist circumference was significantly positively associated with SSB consumption, total caloric intake, and sedentary behavior (p < 0.001), while age (p < 0.001) and moderate-to-vigorous physical activity (MVPA) (p = 0.005) were negatively associated with waist circumference. For each additional milliliter of SSB consumed, waist circumference increased by 0.028 units (t-value = 12.498, p < 0.001). (4) Conclusions: High levels of SSB consumption were observed among adolescents in Erbil, particularly among males. Significant associations were found between SSB intake, overweight/obesity, and waist circumference. These findings highlight the urgent need for targeted public health interventions and further investigation into the factors driving SSB consumption in this population. Full article

The undergraduate college years are a critical transition period for young adults in establishing life-long health behaviors. Background/Objective: Within the FRESH Study, we aimed to understand the relationship between perceived physical health, perceived mental health, and specific health metrics (e.g., physical activity, food insecurity, sleep quality) among college students following the COVID-19 pandemic. Methods: First-year undergraduate students (n = 271) from an urban university were recruited in three study waves (2021–2022, 2022–2023, and 2023–2024). Participants answered online surveys on demographics, health perceptions, physical activity, dietary patterns, beverage consumption, food insecurity, stress, and sleep quality. Results: Overall, participants rated their physical health better than their mental health (‘good’, ‘very good’, or ‘excellent’; 89.6% vs. 62.2%), even though 30.7% were not of ‘healthy weight’ status, 34.5% did not meet physical activity recommendations, and 42.2% of students consumed some sugar-sweetened beverages (SSBs). Students reporting suboptimal (‘fair’ or ‘poor’) physical and mental health were more likely to report food insecurity (p < 0.001, p = 0.010), poor sleep quality (p = 0.012, p < 0.001), and elevated stress (p = 0.001, p < 0.001). In addition, fast-food consumption (p < 0.001), breakfast consumption (p = 0.031), and food insecurity (p = 0.004) showed changes over three years. Conclusions: These findings call for targeted wellness initiatives addressing nutrition, food insecurity, stress management, sleep improvement, and physical activity among students and in university health programs. The FRESH Study emphasizes the need for continued longitudinal research to track health behaviors and inform future interventions. Full article

Background: Studies on the effectiveness of community-based health interventions (CBHIs) in improving lifestyle practices among older adults are limited. Objectives: This study evaluated the impact of a CBHI on health knowledge, lifestyle goal attainment, and practices among older adults in Singapore. Methods: Older adults (aged ≥60 years) were recruited from 29 senior recreation centres to participate in the “Wise and Well” programme, a 3-month CBHI designed to empower individuals to make healthier lifestyle choices. Pre- and post-programme assessments of health knowledge, goal attainment, and lifestyle behaviours (dietary practices and physical activity levels) were conducted using a health knowledge questionnaire, Goal Attainment Scaling (GAS), the Modified Dietary Practice Questionnaire (DPQ), and the Global Physical Activity Questionnaire (GPAQ), respectively. Statistical analysis was performed using the Wilcoxon signed-rank and McNemar’s tests (α = 0.05). Results: The study comprised 464 participants (mean age 73.1 years [SD 7.6]; 75.9% women). Three months post-program, participants showed significantly increased health knowledge (p < 0.001) and improved lifestyle goal attainment (p < 0.001). Additionally, there was a significant increase in the proportion of participants meeting or exceeding fruit (p < 0.001) and vegetable (p = 0.002) intake recommendations and reductions in sugar-sweetened beverage consumption (p = 0.002). However, no significant changes were observed in fried food consumption or physical activity levels. High health knowledge scores were associated with 2.17 (95% confidence interval 1.02,4.64) times greater odds of increased vegetable intake. Conclusions: The CBHI shows potential as an effective approach to improving health knowledge and enhancing lifestyle goals and practices among older adults Full article

Background: Latino children in the United States (US) have a higher prevalence of overweight/obesity compared to white children. Previous studies suggest that acculturation to the US is associated with health behaviors such as diet, body mass index (BMI), and physical activity. However, the role of parental acculturation remains understudied, particularly with the use of validated measures. Objective: The objective of this study was to evaluate parental acculturation and its association with parental interpersonal factors and health behaviors in the preschool-aged child. Methods: Data were analyzed from 187 Latino parents in Nevada. Parents completed a self-reported, cross-sectional survey. Acculturation was assessed using Norris’ 4-item validated acculturation measure. The average age of the preschool-aged children was 45.5 months, and their mean BMI percentile was 96.4% (SD ± 18.7). The mean parental acculturation score was 2.1 (SD ± 1.2). Children were physically active an average of 4.9 (SD ± 2.0) days per week. After controlling for covariates, the results indicated that parental acculturation was positively associated with physical activity and sugar-sweetened beverage consumption. However, parental acculturation was not associated with child BMI percentile, or the consumption of fruits, vegetables, and sweet snacks. Conclusions: These findings can inform future research on culturally tailored intervention strategies to boost physical activity and reduce sugar-sweetened beverage intake among Latino preschool-aged children. Full article

Background: The Chinese beverage industry is experiencing rapid growth, particularly in the popularity of non-sugar sweetened beverages (NSSs) and ready-to-drink beverages (RSBs). This study aimed to assess current consumption patterns and determinants of various beverage types among retail visitors. Methods: A total of 44 observation points, including 22 supermarkets and 22 convenience stores, were randomly selected across Shanghai. At each location, at least 100 individuals were recruited to participate. Data were collected using an electronic self-administered questionnaire. Results: The consumption rates of total beverages, sugar-sweetened beverages, NSSs, and RSBs were 57.70%, 56.94%, 19.60%, and 29.50%, respectively; the median consumption amounts among the drinking population were 162.57 mL/day, 137.98 mL/day, 32.85 mL/day, and 32.85 mL/day, respectively. The consumption proportions of NSSs and RSBs ranked 2nd and 3rd. The multifactorial analyses showed that people aged 6–18 years consumed more beverages (p < 0.05). Males were more likely to consume sugar-sweetened beverages and NSSs, but females were more likely to consume RSBs (p < 0.05). Higher educated people and bachelors were more likely to consume beverages (p < 0.05). Conclusions: The emerging beverage categories, NSSs and RSBs, warrant attention due to their significant consumption rates. Tailored intervention strategies should be considered for demographic groups varying by age, gender, and educational attainment. Full article

Background: Previous studies reported screen time in association with unhealthy dietary behaviors, such as excessive intake of sugar-sweetened beverages leading to dental caries. Thus, we aimed to explore the association between screen time on mobile devices and dental caries experience in adolescents, as well as whether sugar-sweetened beverages would mediate the association. Methods: We analyzed 24,374 junior and senior high school students of age 12 to 17 years from the 2021 “Surveillance for common diseases and health risk factors among students” Project in Jiangsu Province of China. Dental caries experience was determined by the designated dentists. Screen time and consumption of sugar-sweetened beverages were self-reported and treated as a priori risk. We employed an instrumental variable (IV) approach for the current cross-sectional setting. We used the lasso technique to shortlist covariates from a range of confounding factors. Binary logistic regression or ordered logistic regression was performed where appropriate to explore the associations of screen time on mobile devices with dental caries and sugar-sweetened beverages. Results: The prevalence rate of dental caries was 38.4% in the study population. In comparison with <2 h/d screen time on mobile devices, extended screen time (≥2 h/d) was associated with higher dental caries risk (coefficient: 1.27, 95%; confidence interval: 0.80–1.75). Mediation analysis suggested that sugar-sweetened beverage intake might be an independent risk factor for dental caries, instead of the mediator between screen time on mobile devices and dental caries. None of the interaction terms under investigation was statistically significant. Conclusions: Exposure to mobile device screens and sugar-sweetened beverages was associated with dental caries in adolescents. These findings highlighted the importance of increasing awareness of potential risks owing to mobile device usage and sugar-sweetened beverages and the necessity to develop appropriate intervention strategies for school-aged adolescents. Full article

Background: Universal community engagement interventions can address childhood obesity. Objectives: This review aimed to evaluate the effectiveness of these interventions in improving body mass index (BMI) (primary outcome) as well as dietary choices and activity levels (secondary outcomes) among children and adolescents. Methods: Eight electronic databases were searched from inception dates to January 2024. A meta-analysis was conducted using the random-effect model, when appropriate; otherwise, the findings were narratively synthesized. Heterogeneity was determined by the I² statistics and Cochran’s Q chi-squared test. The Cochrane ROB tool and the GRADE approach were used to assess the quality appraisal at the study and outcome levels, respectively. Results: Twenty-two studies were included in this review. The results showed that these interventions had a limited effect in improving children’s standardized BMI (BMI-z) scores post-intervention. A meta-analysis on BMI-z scores showed that the intervention group had a statistically non-significantly lower BMI-z score than the control group (MD = −0.02, 95%CI = [−0.07, 0.03], Z = 0.83, p = 0.40) at immediate post-intervention. It was also reported that universal community engagement interventions had a limited effect in improving children’s dietary choices and activity levels. Only the meta-analysis on children’s daily sugar-sweetened beverage intake measured using continuous data reported a statistically significant small effect favoring the intervention group (SMD = −0.25, 95%CI = [−0.38, −0.13], Z = 3.98, p < 0.0001) at immediate post-intervention. Conclusions: Universal community engagement interventions have the potential to address childhood obesity. Children and adolescents could benefit more from interventions that focus on implementing both environmental and behavioral changes, and interventions that include parental involvement. Full article