Sugar-Sweetened Beverages During Adolescence Linked To Dental Cavities

MedicalResearch.com Interview with:
“Caries” by COM SALUD Agencia de comunicación is licensed under CC BY 2.0Teresa A. Marshall, PhD
Professor in the Department of Preventive and Community Dentistry
University of Iowa College of Dentistry
Iowa City

MedicalResearch.com: What is the background for this study?

Response: Dental caries is a process during which oral bacteria ferment carbohydrates to produce acid. The acid demineralizes enamel and/or dentin at the tooth surface leading to white spots and eventually cavitation in the tooth. Added sugars – those not naturally present in foods or beverages, but rather added during processing – are the primary type of carbohydrate associated with caries. Sugar-sweetened beverages (SSBs; beverages with added sugars) are the food/beverage category most associated with dental caries.

Historically, fluoride has protected against caries through remineralization of the enamel. However, there has been some question as to whether fluoride’s ability to protect against caries is overwhelmed by the quantity of added sugars currently consumed.

Oral hygiene behaviors – brushing and flossing – are thought protect against caries by disrupting the oral bacteria on the tooth.

Most studies have investigated dietary factors and caries during early childhood, with less attention paid to caries during adolescence.

Our objective was to identify associations between longitudinal beverage intakes and adolescent caries experience, while also considering fluoride intake and tooth brushing behaviors.

We followed a group of children from birth through age 17 years; during this time period, we looked at their beverage intakes, fluoride intakes and brushing behaviors every 3-6 months. We calculated their average milk, 100% juice, SSB, water/water-based beverage and fluoride intakes from 6 months through 17 years, and daily tooth brushing from 1 through 17 years.

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Intake of Sugar-Sweetened Beverages By Both Partners Appears To Harm Fertility

MedicalResearch.com Interview with:

Dr-Elizabeth-Hatch

Dr. Hatch

Dr. Elizabeth E. Hatch, PhD
Professor, Epidemiology
School of Public Health
Boston University

MedicalResearch.com: What is the background for this study?  

Response: We are conducting a large, ongoing, preconception cohort study, PREgnancy STudy Online or PRESTO http://sites.bu.edu/presto/   in the U.S. and Canada of couples who are planning a pregnancy.  The overall goal of the study is to identify factors that affect fertility, measured by the time taken to conceive, and factors that affect the risk of miscarriage.  Since many women are postponing pregnancy until the later reproductive years, we would like to help find behavioral and environmental factors that might either help or harm fertility so that couples can avoid the stress and expense of infertility workups and treatment.  As part of the larger study, we looked at consumption of sugar-sweetened beverages (SSBs) by both the male and female partner, since some previous research suggested that sugar-sweetened beverages might harm semen quality and ovulation.

For this analysis, we included 3,828 women aged 21 to 45 and 1,045 of their male partners. We asked both males and females (in separate baseline questionnaires) about their usual consumption of SSBs over the last month, and we had a drop-down menu with names of individual sodas (both sugar-sweetened and diet) and energy drinks.  We also asked general questions about the frequency of fruit juice and ‘sports drink’ consumption.   In our analysis, we controlled for multiple factors that might ‘confound’ the associations, such as body mass index, education, caffeine, smoking and alcohol consumption, as well as a measure of overall diet quality.

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Sugar-Sweetened Beverages Play Large Role In Worldwide Obesity Epidemic

MedicalResearch.com Interview with:
“Soda” by Jannes Pockele is licensed under CC BY 2.0Maria Luger, MSc
SIPCAN
Special Institute for Preventive Cardiology And Nutrition
Spendenbegünstigte Einrichtung gem. FW 1914/19.3.2005
Vorstand: Univ.-Prof. Prim. Dr. Friedrich Hoppichler
Salzburg, Austria

MedicalResearch.com: What is the background for this study?

Response: Worldwide obesity has nearly tripled since 1975. Rising consumption of sugar-sweetened beverages (SSBs) has been a major contributor to the obesity epidemic and it increases the risk of diabetes or cardiovascular disease, as previous evidence has shown. Partly inconsistent findings from previous reviews have fueled discussions on the impact of SSBs on obesity development.

Therefore, the aim of our review was to systematically review the recent evidence in children and adults.

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Sustained Consumer Response Two Years After Implementing A Sugar-Sweetened Beverage Tax in Mexico

MedicalResearch.com Interview with:

Shu Wen Ng, Ph.D., FTOS Research Associate Professor, Department of Nutrition Gillings School of Global Public Health Fellow, Carolina Population Center Duke-UNC Center for Behavioral Economics and Healthy Food Choice Research University of North Carolina at Chapel Hill

Dr. Shu Wen Ng

Shu Wen Ng, Ph.D., FTOS
Research Associate Professor, Department of Nutrition
Gillings School of Global Public Health
Fellow, Carolina Population Center
Duke-UNC Center for Behavioral Economics and Healthy Food Choice Research
University of North Carolina at Chapel Hill

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The Mexican government enacted a 1 peso per liter tax on sugar sweetened beverages (SSB) after studies showed that more than 70 percent of the country’s population was overweight or obese, and that in excess of 70 percent of the added sugar calories in the Mexican diet were coming from SSBs. We were interested in learning how purchases of SSBs and other beverages changed in the 2 years after the tax was implemented in Mexico. The Health Affairs study titled “In Mexico, Evidence Of Sustained Consumer Response Two Years After Implementing A Sugar-Sweetened Beverage Tax” found that in the two-year period spanning 2014 to 2015, the tax resulted in a 5.5 percent reduction in the first year and continued to decline, averaging 9.7 percent the second year, with lower socioeconomic households, for whom health care costs are most burdensome, lowered their purchases of sweetened beverages the most. Meanwhile, purchases of untaxed beverages such as bottled water increased 2.1 percent.

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Better-Beverage Campaign Reduced Sugary Drink Consumption

MedicalResearch.com Interview with:

Marlene B. Schwartz PhD Director, Rudd Center for Obesity & Food Policy (Principal Investigator) Professor, Department of Human Development and Family Studies University of Connecticut Hartford, CT 06103

Dr. Schwartz

Marlene B. Schwartz PhD
Director, Rudd Center for Obesity & Food Policy (Principal Investigator)
Professor, Department of Human Development and Family Studies
University of Connecticut
Hartford, CT 06103

MedicalResearch.com: What is the background for this study? 

Response: The aim of this study was to evaluate the impact of a community-wide campaign to reduce consumption of sugary beverages in Howard County, Maryland. We measured the retail sales of sugary drinks in supermarkets in the target community and a set of matched control supermarkets in another state. The campaign included multiple components over three years, including television advertising, digital marketing, direct mail, outdoor advertising, social media and earned media, creating 17 million impressions. The community partners successfully advocated for public policies to encourage healthy beverage consumption in schools, child care, health care and government settings.

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Sugar Sweetened Beverages Linked to Increased Coronary Artery Calcium Deposits

MedicalResearch.com Interview with:
Yoosoo Chang MD PhD
Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine
Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine
Department of Clinical Research Design & Evaluation, SAIHST,
Sungkyunkwan University
Seoul, Korea

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Chang: Sugar-sweetened carbonated beverage consumption has been linked to obesity, metabolic syndrome, type 2 diabetes, and clinically manifest coronary heart disease (CHD), but its association with subclinical CHD has been largely unexplored.

We performed a cross-sectional study of 22,210 apparently healthy, asymptomatic Korean adults who underwent image scans to determine how much calcium had built up in their heart arteries. We found that people who drank 5 cups or more of sugar-sweetened carbonated beverage per day on average had the greater prevalence and higher degree of calcium deposits in the arteries compared to non-drinkers. This association persisted after controlling other factors and was observed across various subgroups, supporting an independently harmful effect of sugar-sweetened carbonated beverage on the cardiovascular health.

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Young Adults, Southeners, Drink Most Sugar-Sweetened Beverages

MedicalResearch.com Interview with:

Sohyun Park, PhD Epidemiologist Epidemiology and Surveillance Team Obesity Prevention and Control Branch Division of Nutrition, Physical Activity, and Obesity National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention Atlanta, Georgia

Dr. Sohyun Park

Sohyun Park, PhD
Epidemiologist
Epidemiology and Surveillance Team
Obesity Prevention and Control Branch
Division of Nutrition, Physical Activity, and Obesity
National Center for Chronic Disease Prevention and Health Promotion
Centers for Disease Control and Prevention
Atlanta, Georgia 

Medical Research: What is the background for this study? What are the main findings?

Dr. Park: The 2013 BRFSS provides the most recent state data for this behavior using a short screener which showed that about 1 in 3 adults consumed sugar-sweetened beverages (SSBs) at least once per day, and SSB intake differed by state and by certain subgroups.

The main findings of the study showed the following among the 23 states and DC surveyed the prevalence of adults who consumed sugar-sweetened beverages at least once daily was:

  • Aged 18-24 years (43.3%)
  • Men (34.1%)
  • Non-Hispanic Blacks (39.9%)
  • Unemployed (34.4%)
  • Had less than a high school education (42.4%)
  • Adult sugar-sweetened beverages intake was highest in Mississippi (47.5%), followed by Louisiana (45.5%) and West Virginia (45.2%).
  • The prevalence of  sugar-sweetened beverages intake one or more times per day among younger adults (18–24 years) was 2.3 times the prevalence among the older adults (aged 55 years and older)—43.3% versus 19.1%, respectively.

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Sugar Sweetened Soda Linked To Chronic Kidney Disease

Wisit Cheungpasitporn, MD Nephrology Fellow Departments of Nephrology and Hypertension Mayo Clinic, Rochester, MNMedicalResearch.com Interview with:
Wisit Cheungpasitporn, MD
Nephrology Fellow
Departments of Nephrology and Hypertension
Program director: Suzanne Norby, MD
Co-authors: Charat Thongprayoon, MD, Oisin A O’Corragain, MD, Peter J Edmonds, BS, Wonngarm Kittanamongkolchai, MD, Stephen B Erickson, MD
Project mentor: Stephen B. Erickson, MD Departments of Nephrology and Hypertension
Mayo Clinic, Rochester, MN

Medical Research: What is the background for this study?

Dr. Cheungpasitporn: High-fructose corn syrup consumption in the form of sugar-sweetened soda has dramatically increased worldwide and associated with risk factors for chronic kidney disease (CKD) including diabetes mellitus (DM) and metabolic syndrome. Recently, artificial sweeteners have become commonly used in soda marketed as ‘diet’ alternatives. Recent studies have demonstrated that diet soda consumption may also be associated with weight gain, metabolic syndrome and cardiovascular disease. The risks of CKD in individuals with sugar-sweetened or diet soda consumption, however, were conflicting. We therefore conducted a meta-analysis to assess the associations between CKD and the consumption of sugar sweetened and diet soda. The findings of our study were recently published in Nephrology (Carlton). 2014; 19(12):791-7.

Medical Research: What are the main findings?

Dr. Cheungpasitporn: Five studies (2 prospective cohort studies, 2 cross-sectional studies and a case-control study) were included in our analysis of the association between consumption of sugar-sweetened soda (≥1-2 drinks of sugary soda/day) and CKD. We found an overall 1.58-fold increase CKD risk in individuals who regularly consumed sugar-sweetened soda with the pooled risk ratio (RR) of 1.58 (95% CI 1.00–2.49). Four studies (2 prospective cohort studies, a cross-sectional studies and a case-control study) were included to assess the association between CKD and diet soda consumption (≥1-2 drinks of diet soda/day). Despite a trend of chronic kidney disease risk in individuals with diet soda consumption with the pooled RR of 1.33 (95% CI 0.82–2.15), this association was not statistically significant.

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Sugar Sweetened Beverages Linked To Overall Unhealthy Diet

Louise Brunkwall Nutritionist, MPH and Phd-student Diabetes and Cardiovascular Disease, Genetic Epidemiology Lund University, Clinical Sciences Malmö, Sweden

MedicalResearch.com Interview with:
Louise Brunkwall
Nutritionist, MPH and Phd-student
Diabetes and Cardiovascular Disease, Genetic Epidemiology
Lund University, Clinical Sciences
Malmö, Sweden

 Medical Research: What is the background for this study? What are the main findings?

Response: There has been a huge interest for sugar sweetened beverages (SSB) the last years and SSB has been associated with various diseases like type 2 diabetes and obesity, while juice for example which have approximately the same amount of energy have not. We find this very interesting and wanted to know more about who the people were that consumed a lot of these different beverages. We started of by looking at diet and found that the different beverages were associated with different dietary patterns. Sugar sweetened beverages were associated with a more unhealthy diet while juice was associated with a more healthy diet. We see the same for tea which is a beverage previously associated with a lower risk of several diseases, that it is associated with an overall very healthy diet. Therefore we draw the conclusions that beverages are a part of the overall diet which might contribute to the previous findings of associations with different diseases. This also tells us that it is of great importance to know more about the overall diet than just consumption of a single product when investigating beverages-dieases association studies.

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Replacing Sugary Drinks With Plain Coffee Or Tea May Reduce Diabetes Risk

Dr Nita Forouhi, MRCP, PhD, FFPHM MRC Programme Leader and Consultant Public Health Physician MRC Epidemiology Unit University of Cambridge School of Clinical Medicine Cambridge Biomedical Campus Cambridge UKMedicalResearch.com Interview with:
Dr Nita Forouhi, MRCP, PhD, FFPHM
MRC Programme Leader and Consultant Public Health Physician
MRC Epidemiology Unit
University of Cambridge School of Clinical Medicine
Cambridge Biomedical Campus
Cambridge UK

Medical Research: What is the background for this study? What are the main findings?

Dr. Forouhi: Consumption of soft drinks is known to cause obesity and may contribute to the development of type 2 diabetes. We had previously published findings from the EPIC-InterAct study in 8 European countries that habitual consumption of sugar sweetened beverages increases the risk of developing type 2 diabetes, and we now wanted to probe deeper to understand more about this relationship between sweet beverages and diabetes.

We conducted research in the large EPIC-Norfolk study which included more than 25,000 men and women aged 40–79 years living in Norfolk, UK. Study participants recorded everything that they ate and drank for 7 consecutive days covering weekdays and weekend days, with particular attention to type, amount and frequency of consumption, and whether sugar was added by the participants. During approximately 11 years of follow-up, 847 study participants were diagnosed with new-onset type 2 diabetes.

By using this detailed information on diet, we were able to study several different types of sugary beverages, including sugar-sweetened soft drinks, sweetened tea or coffee and sweetened milk drinks as well as artificially sweetened beverages (ASB) – such as diet soft drinks – and fruit juice, and to examine what would happen if plain water, unsweetened tea or coffee or artificially sweetened beverages were substituted for sugary drinks.

Our study provided three main findings:

First, there was an approximately 22% increased relative risk of developing type 2 diabetes per extra serving per day habitually of each of soft drinks, sweetened milk beverages and ASB consumed, even after accounting for a range of important factors including other lifestyle and social factors and for total energy intake. However, after further accounting for body mass index and waist girth as markers of obesity, there remained a higher risk of diabetes associated with consumption of both soft drinks and sweetened milk drinks, but the link with ASB consumption no longer remained, possibly because artificially sweetened beverages was likely to be consumed by those who were already overweight or obese.

Second, when we estimated the likely effects of replacing a habitual serving of soft drinks with a serving of water or unsweetened tea or coffee, we found that the risk of diabetes could have been cut by 14%; and by replacing a habitual serving of sweetened milk beverage with water or unsweetened tea or coffee, that reduction could have been 20%–25%.  However, consuming ASB instead of any sugar-sweetened drink was not likely to reduce the risk of diabetes, when accounting for baseline obesity and total energy intake.

Third, we found that each 5% of higher intake of energy (as a proportion of total daily energy intake) from total sweet beverages (soft drinks, sweetened tea or coffee, sweetened milk beverages, fruit juice) was associated with a 18% higher risk of diabetes. We estimated that if study participants had reduced the energy they obtained from sweet beverages to below 10%, 5% or 2% of total daily energy, 3%, 7% or 15% respectively of new-onset type 2 diabetes cases could have been potentially avoided.

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Calorie Posting Reduced Adolescent Sugary Drink Purchases

Sara N. Bleich, Ph.D. Associate Professor Department of Health Policy and Management Johns Hopkins Bloomberg School of Public Health Baltimore, MD 21205  MedicalResearch.com Interview with:
Sara N. Bleich, Ph.D.
Associate Professor Department of Health Policy and Management
Johns Hopkins Bloomberg School of Public Health
Baltimore, MD 21205

Medical Research: What are the main findings of the study?

Dr. Bleich: Providing easily understandable calorie information — particularly in the form of miles of walking — makes adolescents more likely to buy a beverage with fewer calories, a healthier beverage or a smaller size beverage. Adolescents were also more likely to not buy any drink at all after seeing the signs with calorie information.
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Public Support For Taxes on Sugar-Sweetened Beverages Still Low

MedicalResearch.com Interview with:
JeffJeff Niederdeppe Assistant Professor Department of Communication Cornell University. Niederdeppe
Assistant Professor Department of Communication
Cornell University.

 

MedicalResearch.com: What are the main findings of the study?

Answer: We conducted an Internet-based survey (N = 1319) with a nationally-representative sample of U.S. adults aged 18–64 during the fall of 2012. Americans voiced the highest levels of support for calorie labeling (65%) and removing drinks from schools (62%), and the lowest support for taxes (22%) or portion size restrictions (26%). Americans were evenly split on whether or not they support restricting sugary drink to children (50%) and requiring TV stations to air ads promoting healthy eating and exercise equal to the time used to advertise for sugary drinks (51%). Democrats and those with negative views of soda companies are more likely to support each of these policies.

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Sugar-Sweetened Beverage Sodabriety: School Based Intervention to Reduce Consumption

Laureen Smith, PhD Associate Professor College of Nursing, The Ohio State University Columbus, OH 43210MedicalResearch.com Interview with:
Laureen Smith, PhD
Associate Professor
College of Nursing, The Ohio State University
Columbus, OH 43210


MedicalResearch.com: What are the main findings of the study?

Dr. Smith: Daily sugar-sweetened beverage decreased significantly by about 1 serving per day. Also weekly consumption decreased from an average of over 4 days per week to about 2 ½ days per week. Generally, the teens were drinking the beverages fewer days per week and less servings on the days they did consume them. These changes were maintained on their own for a month after the intervention ended. Water consumption increased nearly 20 percent immediately post intervention and continued to increase at 30 days post-intervention.

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