Beverage consumption and energy intake among Canadians: analyses of 2004 and 2015 national dietary intake data

Older Chinese adults' milk consumption habits: A study across 5 cities

Milk consumption in China has experienced a rapid growth over the past few decades. This study explored milk consumption habits of older Chinese adult regular milk consumers, by investigating what, where, when, with whom, why, and how milk was consumed. This study (n = 1,000) was conducted in 5 cities in China (first tier: Beijing, Shanghai and Guangzhou; second tier: Chengdu and Shenyang) with participants balanced by sex and age groups (45-55 and 65-75 yr old). Given different economies, general dietary habits, and lifestyles, differences in milk consumption habits between cities were hypothesized. The results showed that almost all participants consumed cow milk, at home and by direct drinking. Most participants consumed milk during breakfast, with their family and for nutrition and health purposes. However, variations by city were found in what type of, what fat level of, what brand of, when and how milk was consumed. Multiple factor analysis showed that "what" variable differentiated cities between tiers and among the first-tier cities, and that "when" and "how" variables also separated the 2 second-tier cities and from the first-tier cities. Although variation in how milk was consumed was also observed between sexes and age groups, hierarchical cluster analysis revealed that the 4 clusters of milk consumption habits derived were mainly differentiated by city: Beijing and Shanghai, Guangzhou, Chengdu, and Shenyang. This study provides comprehensive insights into the milk consumption habits of older Chinese adults and highlights the significant heterogeneity in milk consumption habits in China by city.

"Coke's not a food": A critical discourse analysis of sugar-sweetened beverage tax acceptability by white residents from an upper-middle class neighborhood in Winnipeg Manitoba

Increasing concerns about the health impacts of sugar consumption has led to the proposition of a sugar-sweetened beverage (SSB) tax in Canada. However, competing concerns related to stigma and equity remain and have not been explored in a Canadian context. As part of a broader study examining the perspectives of various populations on SSB tax acceptability, we examined how residents of an upper-middle class neighborhood conceptualize SSB tax acceptability, and we explored the discourses that inform their discussion. We conducted and analyzed qualitative, semi-structured interviews with residents of an upper-middle class neighborhood in Winnipeg, Manitoba, Canada. Recruitment criteria were residence, adults, and English speaking. Critical discourse analysis methodology was used, and healthism (health moralism) and tax psychology informed the analysis. Eighteen participants volunteered: 15 females and 3 males; all self-identified as white, and all spoke about (grand)parenting. Healthist discourse was utilized in supportive discussion of SSB taxation. With the mobilization of healthism, ideal citizens and parents were described as "health conscious" and those who might be likely to reduce SSB intake because of taxation. Healthism also contributed to their identification of beverages targeted by a tax, versus those they deemed as having redeeming nutritional qualities. Limits to SSB tax support were expressed as fairness concerns, with a focus on the procedural justice of the tax. Participants supported SSB taxation and the discourses they employed suggested support for the tax was perceived as contributing to their construction of the kind of ideal, health-valuing citizens they hoped to embody. However, participants were also concerned about the fairness of implementation, although this did not outweigh the prioritization of good health.

Perceptions of Beverages With Non-nutritive Sweeteners Among Indigenous Adults Living in Manitoba and Implications for Type 2 Diabetes

OBJECTIVES

The purpose of this study was to explore the perspectives of Indigenous adults on consuming beverages with non-nutritive sweeteners.

METHODS

In this work, we used a community-based, participatory design in partnership with National Indigenous Diabetes Association, Four Arrows Regional Health Authority, and Fearless R2W. We conducted 74 qualitative interviews with Indigenous adults living in Manitoba, including Island Lake First Nations (n=39), Flin Flon (n=15), and the North End neighbourhood of Winnipeg (n=20). Data were indexed in NVivo, and transcripts were analyzed thematically.

RESULTS

Participants exclusively discussed beverages with non-nutritive sweeteners (BNNSs) as an alternative to regular pop or sugary drinks, which were widely available, accessible, and consumed. Why or how BNNSs were viewed as an alternative comprised 3 subthemes: an alternative for health reasons; divergent taste preferences; and an alternative with mysterious but negative health effects. Participants who reported regular consumption of BNNSs largely described consuming them to manage type 2 diabetes. Fewer participants discussed BNNS as a means of weight management or as a preventive health behaviour. Participants who did not report regular BNNS consumption described not liking the taste of BNNSs. Finally, many participants described negative health impacts of consuming BNNSs, and specifically aspartame, although few articulated what those negative impacts were.

CONCLUSIONS

Divergent perspectives among Indigenous adults regarding the health implications of consuming BNNSs may reflect ongoing scholarly debates. These findings have implications for the prevention and dietary management of type 2 diabetes in Indigenous communities.

Dietary polyphenol intake in the Canadian population: Findings from the 2015 Canadian Community Health Survey-Nutrition

OBJECTIVES

This study aimed to estimate usual polyphenol intake among Canadians using the nationally representative 2015 Canadian Community Health Survey-Nutrition and to explore the main dietary contributors to polyphenol intake and the sociodemographic and lifestyle factors that may impact polyphenol intake.

METHODS

Dietary information was collected from 19,409 respondents using 24-h dietary recalls. The polyphenol content of foods was estimated using the Phenol-Explorer Database (version 3.6). Daily intake values for total polyphenols (adjusted to energy intake), main classes, and subclasses were calculated for each respondent and dietary recall. Usual intake was estimated by age/sex groups and by sociodemographic and lifestyle characteristics independently for adults and children using the National Cancer Institute method. Given-day arithmetic mean polyphenol intakes and mean proportions of main classes contributing to sum total polyphenol intakes were explored. Population proportions were used to determine dietary contributors.

RESULTS

Usual total polyphenol intake was 1119.3 mg/1000 kcal/day (95% CI: 1090.5, 1148.1) for adults ≥ 19 years and 473.0 mg/1000 kcal/day (95% CI: 454.9, 491.0) for children 2‒18 years. Generally, total polyphenol intakes differed by age, sex, ethnicity, and household education status and were higher among coffee and tea consumers. Most polyphenols came from flavonoids (40.0%) and phenolic acids (49.8%), with children consuming more flavonoids and other polyphenols and adults more phenolic acids. The top food contributors to polyphenol intake were coffee (26.8%), tea (8.9%), fruit juice (4.2%), banana (4.1%), and apple (3.8%).

CONCLUSION

Usual intake of total polyphenols among Canadians differed primarily by age. Non-alcoholic beverages were top contributors to total polyphenol intake.

Balancing on the redline: a qualitative study of the experiences purchasing sugar-sweetened beverages among Indigenous adults in a Canadian urban neighbourhood

OBJECTIVE

Growing evidence suggests that inner-city residents actively navigate their food landscape to meet a wide range of socio-economic needs. Given the increasing focus of health policies on sugar-sweetened beverages (SSB) through price-based strategies, it is critical to understand purchasing habits of populations with higher SSB intake. This study examined urban Indigenous adults' SSB shopping behaviour and experiences.

METHODS

We conducted a community-based participatory research study using semi-structured interviews with a purposive sample of Indigenous adults (≥ 18 years old) from the North End neighbourhood of Winnipeg. Interviews were audio recorded, transcribed verbatim, and thematically analyzed.

RESULTS

All 20 participants (women = 10; men = 8; two-spirit = 2) consumed SSB on a regular, daily basis either at the time of the interview or at a prior period in their lives. Themes defining residents' SSB shopping behaviour and experiences of shopping for SSB included balancing on the redline, specifically (1) balancing SSB purchasing constraints and facilitators with savvy shopping approaches and (2) balancing (stereo)typical reactions with resilient coping approaches. Residents procured SSB in various stores within and beyond the boundaries of the North End neighbourhood. SSB is a considerable, reoccurring expense, requiring savvy price-shopping strategies in order to access. Indigenous adults experience judgement and stereotyping when purchasing SSB, including intersecting racial, class, and weight stigma.

CONCLUSION

Purchasing SSB is perceived as a source of judgement when outside of inner-city neighbourhoods. Policymakers should consider how policies directed at SSB, which are consumed by Indigenous and food-insecure populations in greater quantities, may magnify existing racial, class, and weight-based discrimination.

Effect of 100% Orange Juice and a Volume-Matched Sugar-Sweetened Drink on Subjective Appetite, Food Intake, and Glycemic Response in Adults

Dietary recommendations to reduce the consumption of free sugars often group 100% fruit juice with other sugar-containing beverages. The objective of this study was to determine the effect of consuming 100% orange juice compared to an orange drink on next-meal food intake (FI), glycemic response, average appetite, emotions, and sensory characteristics in normal-weight adults. Thirty-six normal-weight adults (age: 26.8 ± 0.9 years) consumed, in random order and at least 5 days apart, three 240 mL test beverages as follows: (a) 100% orange juice, (b) orange drink, or (c) water. Subjective sweetness and pleasantness were determined immediately after test beverage consumption. Glycemic response, average appetite, and subjective emotions were measured every 15 min for 60 min. Food intake was determined at a pizza lunch 60 min later. Rest-of-day glycemic response and energy intake (EI) were determined using a continuous glucose monitor and food record, respectively. Lunch FI (p = 0.054) and total EI (p = 0.01) were both lower after 100% orange juice compared with the orange drink. Caloric compensation was 84% after 100% orange juice and -25% after the orange drink (p = 0.047). Average appetite was not significantly different between the test beverages (p > 0.05). Blood glucose iAUC adjusted for available carbohydrate was lower after 100% orange juice compared with the orange drink (p < 0.001). Rest-of-day blood glucose concentrations were lower after 100% orange juice compared with the orange drink (p = 0.03) and water control (p < 0.001). In conclusion, consumption of 100% orange juice as a preload resulted in higher caloric compensation, lower total daily EI, and lower blood glucose concentrations compared to the orange drink.

Sugar-sweetened beverage intakes among adults between 1990 and 2018 in 185 countries

Sugar-sweetened beverages (SSBs) are associated with cardiometabolic diseases and social inequities. For most nations, recent estimates and trends of intake are not available; nor variation by education or urbanicity. We investigated SSB intakes among adults between 1990 and 2018 in 185 countries, stratified subnationally by age, sex, education, and rural/urban residence, using data from the Global Dietary Database. In 2018, mean global SSB intake was 2.7 (8 oz = 248 grams) servings/week (95% UI 2.5-2.9) (range: 0.7 (0.5-1.1) in South Asia to 7.8 (7.1-8.6) in Latin America/Caribbean). Intakes were higher in male vs. female, younger vs. older, more vs. less educated, and urban vs. rural adults. Variations by education and urbanicity were largest in Sub-Saharan Africa. Between 1990 and 2018, SSB intakes increased by +0.37 (+0.29, +0.47), with the largest increase in Sub-Saharan Africa. These findings inform intervention, surveillance, and policy actions worldwide, highlighting the growing problem of SSBs for public health in Sub-Saharan Africa.

Fluid intake at work in foresters working in different thermal conditions

The primary aim of this study was to assess the impact of fluid intake on hydration status indices in men at work. The secondary aim was to determine the type of fluids drunk at work in different thermal conditions. Fifty-nine male foresters were examined before and after one working day during summer, autumn, and winter. Before and after work, urine and blood samples were obtained from foresters. Immediately after a shift, participants completed a questionnaire regarding fluid intake during one working day. The amount of fluid consumed affects the hydration urine indices. Urine specific gravity and urine osmolality significantly decreased with increasing fluid intake (r = - 0.385 and r = - 0.405, respectively). Moreover, an impact of season on the type of fluids consumed by workers was observed. Tea was significantly more often chosen by workers to drink in winter (68%) than in summer (32%) (p = 0.026). The consumption of any non-alcoholic fluids contributes to the daily total water intake, but it is necessary to create individualized fluid replacement plans. Workers should know how much and what types of drinks to consume at work.

Validation d’un questionnaire mesurant la consommation de boissons sucrées, jus et eau auprès d’adolescents francophones

Purpose: To examine the temporal stability and relative validity of the adapted French version of an English self-reported questionnaire measuring the beverage intake (BEVQ) of adolescents.Methods: The French adaptation of the BEVQ (AF-BEVQ) included conversion from the imperial to the metric system and the adjustment of some formats to those available in Canada. Next, 60 adolescents from two regions in Quebec completed the AF-BEVQ and two web-based 24-hour dietary recalls (R24W) (one for a weekday and one for a weekend day) on two occasions, two weeks apart.Results: The AF-BEVQ had moderate intraclass correlation coefficients (ICC) for amounts of sugar-sweetened beverages (ICC: 0.68; 95% confidence interval [CI]: 0.46-0.81), fruit juice (ICC: 0.54; 95% CI: 0.23-0.72) and water (ICC: 0.66; 95% CI: 0.38-0.81) consumed. The amounts of sugar-sweetened beverages (rs = 0.49; p < 0.0001), fruit juice (rs = 0.38; p = 0.0024) and water (rs = 0.65; p < 0.0001) reported in the AF-BEVQ were significantly correlated with those of both R24Ws.Conclusions: For the most part, the AF-BEVQ had adequate metrological properties. It is an interesting tool to quickly measure the sugar-sweetened beverage, fruit juice and water intake of French-speaking adolescents.

Examining attitudes toward a proposed sugar-sweetened beverage tax among urban Indigenous adults: a qualitative study using a decolonizing lens

BACKGROUND

Sugar-sweetened beverage taxation has been proposed as a public health policy to reduce consumption, and compared with other ethnic or racialized groups in Canada, off-reserve Indigenous populations consume sugar-sweetened beverages at higher frequencies and quantities. We sought to explore the acceptability and anticipated outcomes of a tax on sugar-sweetened beverages among Indigenous adults residing in an inner-city Canadian neighbourhood.

METHODS

Using a community-based participatory research approach, we conducted semistructured interviews (November 2019-August 2020) with urban Indigenous adults using purposive sampling. Interviews were audio-recorded, transcribed verbatim and analyzed using theoretical thematic analysis.

RESULTS

All 20 participants (10 female, 8 male and 2 two-spirit) consumed sugar-sweetened beverages on a regular, daily basis at the time of the interview or at some point in their lives. Most participants were opposed to and concerned about the prospect of sugar-sweetened beverage taxation owing to 3 interconnected themes: government is not trustworthy, taxes are ineffective and lead to inequitable outcomes, and Indigenous self-determination is critical. Participants discussed government's mismanagement of previous taxes and lack of prioritization of their community's specific needs. Most participants anticipated that Indigenous people in their community would continue to consume sugar-sweetened beverages, but that a tax would result in fewer resources for other necessities, including foods deemed healthy.

INTERPRETATION

Low support for the tax among urban Indigenous people is characterized by distrust regarding the tax, policy-makers and its perceived effectiveness. Findings underscore the importance of self-determination in informing health policies that are equitable and nonstigmatizing.

Trends in Loss-Adjusted Availability of Added Sugars and Energy Contribution from Macronutrients and Major Food Groups in Canada and the United States

A clear understanding of changes in the consumption of sugars and other sugars-containing foods has become essential for dietary recommendations and nutrition policy considerations. This study aimed to estimate the consumption trends of added sugars, energy, macronutrients, and food categories using food supply data.

Annual food availability data were obtained from Statistics Canada "Food Available in Canada" database and compared to the equivalent data from Canadian Community Health Survey 2004/2015 and USDA "Food Availability (Per Capita) Data System".

There was a 17% decline in the loss-adjusted per capita consumption of added sugars (%energy) in Canada over the past two decades, largely attributed to reduced intakes of refined sugar and sugars from soft drinks. Added sugars consumption was generally 30% less than that in the US. There was also a consistent decline in total energy intake and %energy from carbohydrates, accompanied by increased %energy derived from fats particularly during the most recent 10 years.

The observed trends in added sugars availability are similar to findings from the Canadian Community Health Surveys, demonstrating the potential application of annual loss-adjusted food availability data in monitoring trends in food and macronutrient intakes over time to complement dietary survey data in informing public policy development.

Canadian Free Sugar Intake and Modelling of a Reformulation Scenario

Recommendations suggest limiting the intake of free sugar to under 10% or 5% of calories in order to reduce the risk of negative health outcomes. This study aimed to examine Canadian free sugar intake and model how intakes change following the implementation of a systematic reformulation of foods and beverages to be 20% lower in free sugar. Additionally, this study aimed to examine how calorie intake might be impacted by this reformulation scenario. Canadians' free sugar and calorie intakes were determined using free sugar and calorie data from the Food Label Information Program (FLIP) 2017, a Canadian branded food composition database, and applied to foods reported as being consumed in Canadian Community Health Survey-Nutrition (CCHS-Nutrition) 2015. A "counterfactual" scenario was modelled to examine changes in intake following the reformulation of foods to be 20% lower in free sugar. The overall mean free sugar intake was 12.1% of calories and was reduced to align with the intake recommendations at 10% of calories in the "counterfactual" scenario (p < 0.05). Calorie intake was reduced by 3.2% (60 calories) in the "counterfactual" scenario (p < 0.05). Although the overall average intake was aligned with the recommendations, many age/sex groups exceeded the recommended intake, even in the "counterfactual" scenario. The results demonstrate a need to reduce the intake of free sugar in Canada to align with dietary recommendations, potentially through reformulation. The results can be used to inform future program and policy decisions related to achieving the recommended intake levels of free sugar in Canada.

The association of maternal sugary beverage consumption during pregnancy and the early years with childhood sugary beverage consumption

OBJECTIVES

A woman's food choices during pregnancy may be associated with her offspring's food choices. Several studies support an association between childhood sugary beverage (SB) consumption and poor cardiometabolic health. This study aimed to assess the association of maternal SB consumption during pregnancy and later, with her offspring's SB consumption in early infancy and childhood.

METHODS

A total of 1945 women and 1595 children participating in 3 Canadian studies reported SB consumption during pregnancy, at 2 years of age, and/or at school age (5 to 8 years old). Mother and offspring SB intakes were self-reported by mothers. Multivariable linear regression analyses were conducted within each cohort and cohort data were combined using fixed effect meta-analyses.

RESULTS

Maternal SB consumption during pregnancy was associated with higher offspring SB consumption at 2 years of age (standardized β = 0.19 predicted change in the number of standard deviations of offspring SB intake for an increase of 1 standard deviation in maternal serving [95% CI: 0.16 to 0.22]). Concurrent maternal SB consumption was associated with higher offspring SB intake when children were aged 5 to 8 years (standardized β= 0.25 [95% CI: 0.10 to 0.40]).

CONCLUSION

Maternal SB consumption during pregnancy is associated with a marginally higher SB intake among their offspring at age 2, and concurrent maternal consumption is associated with a higher SB intake among school-aged offspring (5 to 8 years old). Future interventions tailored for pregnancy and early childrearing years to reduce SB intakes of mothers may reduce young children's SB intake.

Rationale, Design and Participants Baseline Characteristics of a Crossover Randomized Controlled Trial of the Effect of Replacing SSBs with NSBs versus Water on Glucose Tolerance, Gut Microbiome and Cardiometabolic Risk in Overweight or Obese Adult SSB Consumer: Strategies to Oppose SUGARS with Non-Nutritive Sweeteners or Water (STOP Sugars NOW) Trial and Ectopic Fat Sub-Study

BACKGROUND

Health authorities are near universal in their recommendation to replace sugar-sweetened beverages (SSBs) with water. Non-nutritive sweetened beverages (NSBs) are not as widely recommended as a replacement strategy due to a lack of established benefits and concerns they may induce glucose intolerance through changes in the gut microbiome. The STOP Sugars NOW trial aims to assess the effect of the substitution of NSBs (the "intended substitution") versus water (the "standard of care substitution") for SSBs on glucose tolerance and microbiota diversity.

DESIGN AND METHODS

The STOP Sugars NOW trial (NCT03543644) is a pragmatic, "head-to-head", open-label, crossover, randomized controlled trial conducted in an outpatient setting. Participants were overweight or obese adults with a high waist circumference who regularly consumed ≥1 SSBs daily. Each participant completed three 4-week treatment phases (usual SSBs, matched NSBs, or water) in random order, which were separated by ≥4-week washout. Blocked randomization was performed centrally by computer with allocation concealment. Outcome assessment was blinded; however, blinding of participants and trial personnel was not possible. The two primary outcomes are oral glucose tolerance (incremental area under the curve) and gut microbiota beta-diversity (weighted UniFrac distance). Secondary outcomes include related markers of adiposity and glucose and insulin regulation. Adherence was assessed by objective biomarkers of added sugars and non-nutritive sweeteners and self-report intake. A subset of participants was included in an Ectopic Fat sub-study in which the primary outcome is intrahepatocellular lipid (IHCL) by 1H-MRS. Analyses will be according to the intention to treat principle.

BASELINE RESULTS

Recruitment began on 1 June 2018, and the last participant completed the trial on 15 October 2020. We screened 1086 participants, of whom 80 were enrolled and randomized in the main trial and 32 of these were enrolled and randomized in the Ectopic Fat sub-study. The participants were predominantly middle-aged (mean age 41.8 ± SD 13.0 y) and had obesity (BMI of 33.7 ± 6.8 kg/m²) with a near equal ratio of female: male (51%:49%). The average baseline SSB intake was 1.9 servings/day. SSBs were replaced with matched NSB brands, sweetened with either a blend of aspartame and acesulfame-potassium (95%) or sucralose (5%).

CONCLUSIONS

Baseline characteristics for both the main and Ectopic Fat sub-study meet our inclusion criteria and represent a group with overweight or obesity, with characteristics putting them at risk for type 2 diabetes. Findings will be published in peer-reviewed open-access medical journals and provide high-level evidence to inform clinical practice guidelines and public health policy for the use NSBs in sugars reduction strategies.

TRIAL REGISTRATION

ClinicalTrials.gov identifier, NCT03543644.

Association between social jetlag and sugar-sweetened beverages (SSBs) in adolescents in Western Canada

Background

Sleep debt is linked to poor health behaviours, and adolescents may be especially vulnerable to deficit from the mismatch of their late chronotype with socially determined sleep timing. We aimed to investigate the potential association between social jetlag and sugar-sweetened beverages (SSBs) consumption among adolescents.

Methods

Cross-sectional data from 1031 adolescents (13–18 years) who participated in the population-based British Columbia Adolescent Substance Use Survey in 2012. Regression analysis using interaction terms estimated the associations between social jetlag (using self-reported weekday/weekends sleep times) and odds of SSB intake in girls and boys.

Results

On average, adolescents reported 1.59 (SD 0.73) hours of social jetlag, but girls had significantly more social jetlag (1.64) than boys (1.52). Most adolescents (84%) reported consuming SSBs, and significantly more boys (87%) than girls (81%); median SSB intake in boys was 1–2 times per week and in girls less than once per week. Significant differences in girls consuming any SSB were seen across levels of social jetlag. The odds of any SSB intake were significantly higher in adolescents with social jetlag between 1 and 2 h [odds ratio (OR): 1.6 (1.14–2.38)] and over 2 h [OR 1.87 (1.11–3.14)], compared with 1 h or less; associations were stronger and only significant in girls.

Conclusions

This study is the first to show social jetlag is a common sleep deficit that is associated with SSB intake in adolescents, particularly among teen girls.

The influence of social norms in the context of reducing sugar-sweetened beverages consumption

OBJECTIVES

This study aimed to examine the factors associated with low sugar-sweetened beverage (SSB) consumption and intention to avoid these products as well as investigate the role of different types of social norms in the adoption of this behaviour.

STUDY DESIGN

This study reports the results of a secondary data analysis from a cross-sectional telephone survey.

METHODS

A total of 1000 adults were randomly recruited in the province of Québec, Canada, using a random-digit dialling procedure. Eligibility criteria were to be aged between 18 and 64 years; able to answer a questionnaire in French or English; and to reside in the province of Québec. SSB consumption, social norms and variables from the theory of planned behaviour were assessed by means of a questionnaire. Logistic regression analyses were conducted to examine factors associated with behaviour and intention.

RESULTS

Consuming <1 SSB per day was significantly associated with intention, perceived behavioural control, and risk perception about tooth decay. Descriptive (perceived prevalence in the close surroundings of one person) and perceived societal norms (perceived broad societal approval/disapproval of the behaviour) were associated with behaviour. All theory of planned behaviour variables (including injunctive norm) and risk perception pertaining to chronic diseases predicted intention to avoid the consumption of ≥1 SSB per day. Sex, age, income, and risk perception pertaining to chronic diseases were associated with perceived societal disapproval of SSB consumption.

CONCLUSIONS

This study confirms the importance of social norms in the prediction of SSB consumption but also highlights the need to address motivation and capacities in public health interventions to reduce SSB consumption.

Healthy beverages may reduce the genetic risk of abdominal obesity and related metabolic comorbidities: a gene-diet interaction study in Iranian women

BACKGROUND & AIMS

The nutrition transition in developing countries like Iran causes the increasing rise of obesity and abdominal obesity rates. However, it is not yet well proven that environmental modifications like improving the quality of beverage intake can be effective in people who have a genetic predisposition to obesity. So, in the present study, we examine the interaction between genetic predisposition and healthy beverage index (HBI) with abdominal obesity and obesity-related metabolic risk factors in overweight and obese women.

METHOD

Based on inclusion and exclusion criteria, 202 overweight or obese females were chosen for this cross-sectional study. Body composition, anthropometric measures, physical activity, and beverage intake data were collected and analyzed using recognized and trustworthy methodologies. Biochemical tests were performed on serum samples. A genetic risk score (GRS) was calculated based on the results of genetic tests. The predetermined HBI was calculated based on previous studies. A generalized linear model was used to estimate the interactions between GRS and HBI (GLM).

RESULTS

We found significant interactions between GRS and HBI on WHR (β = - 0.39, CI: -0.07 to 0.001, P = 0.05) and WC (β = - 6.18, CI: - 13.41 to 1.05, P = 0.09). Also, there were significant gene-diet interactions for HBI and GRS on HDL (β = 7.09, CI: - 0.73 to 14.92, P = 0.07) and FBS (β = - 9.07, CI: - 18.63 to 0.47, P = 0.06).

CONCLUSIONS

These findings emphasize the HBI considering genetics appears to protect against the risks of abdominal obesity and metabolic associated obesity markers.

Total water intake and its contributors in infants and young children

Hydration is a particular concern for infants and young children due to their greater risk of dehydration. However, studies on their water intakes are scarce. The current survey aimed to analyse total water intake (TWI) in non-breastfed children aged 0·5-35 months compared with the adequate intake (AI) for the same age group set by the European Food Safety Authority and to examine the different contributors to TWI as well as beverage consumption patterns. Nationally representative data from the Nutri-Bébé cross-sectional survey were used to assess food, beverage and plain water consumption by age group over three non-consecutive days. With age, median TWI in 1035 children increased from 732 to 1010 ml/d, without differences between sexes, but with a great inter-individual variation, and the percentage of children who did not meet the AI increased from 10 to 88 %. Median weight-related TWI decreased from 136·6 to 69·0 ml/kg per d. Among infants, 90 % had a ratio of water:energy below the AI, similarly for about 75 % of toddlers. Milk and milk products were the main contributors to TWI, while the part of plain water increased gradually to be 25 % in the older toddlers, half of which was tap water. The beverage consumption pattern varied in types and timing, with little consumption of juices and sweetened beverages. Vegetables and fruits accounted for 20 % of TWI after the age of 6 months. These initial results, showing strong discrepancies between actual and recommended water intakes in young children, should help identify ways to increase children's water consumption.

Estimating the lagged effect of price discounting: a time-series study on sugar sweetened beverage purchasing in a supermarket

Background

Price discount is an unregulated obesogenic environmental risk factor for the purchasing of unhealthy food, including Sugar Sweetened Beverages (SSB). Sales of price discounted food items are known to increase during the period of discounting. However, the presence and extent of the lagged effect of discounting, a sustained level of sales after discounting ends, is previously unaccounted for. We investigated the presence of the lagged effect of discounting on the sales of five SSB categories, which are soda, fruit juice, sport and energy drink, sugar-sweetened coffee and tea, and sugar-sweetened drinkable yogurt.

Methods

We fitted distributed lag models to weekly volume-standardized sales and percent discounting generated by a supermarket in Montreal, Canada between January 2008 and December 2013, inclusive (n = 311 weeks).

Results

While the sales of SSB increased during the period of discounting, there was no evidence of a prominent lagged effect of discounting in four of the five SSB; the exception was sports and energy drinks, where a posterior mean of 28,459 servings (95% credible interval: 2661 to 67,253) of excess sales can be attributed to the lagged effect in the target store during the 6 years study period.

Conclusion

Our results indicate that studies that do not account for the lagged effect of promotions may not fully capture the effect of price discounting for some food categories.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13928-w.

Trajectories of beverage consumption during adolescence

Beverages contribute substantially to daily energy and nutrient intakes. However, little is known about the co-development of beverage consumption throughout adolescence. This study aimed to investigate the presence of naturally occurring sub-groups of girls and boys following distinct trajectories of various types of beverage consumption (i.e. sugary beverages, tea and coffee, water, and milk) throughout adolescence. During the Monitoring Activities for Teenagers to Comprehend their Habits study, data were collected from 744 Canadian youths followed for six years (2013-2019). The participants were asked yearly (start-age 10-11 years old) to report how many times they consumed sugary beverages, tea and coffee, water, and milk in a week. Trajectories of beverage consumption were identified from age 11 to 18 using a person-centred approach, namely group-based multi-trajectory modelling. For girls, three different groups were identified: 'Water consumers' (62.7%), 'High beverage consumers' (20.9%), and 'Water and milk consumers' (16.4%). For boys, four different groups were identified: 'Water consumers' (39.1%), 'Water and milk consumers' (30.5%), 'Sugary drinks, coffee and tea consumers' (20.1%), and 'High beverage consumers' (10.4%). This study illustrates the complexity of beverage consumption patterns in adolescence. Various types of public health messaging and interventions may be required to promote healthier beverage consumption patterns among all adolescents.

Intake of Fruits, Vegetables, and Sugar-Sweetened Beverages among a Sample of Children in Rural Northern Ontario, Canada

There is evidence to suggest that dietary intake of children differs by rural/urban place of residence: rural children may have a higher intake of foods high in fat and sugar than those living in urban environments. The aim of this study was to examine the intake of fruits and vegetables (FV) and the frequency of sugar-sweetened beverage (SSB) consumption, among a sample of rural children in Northern Ontario, Canada, in two different seasons. Sociodemographic factors and children’s FV and SSB intake were measured using two repeated cross-sectional surveys, and seasonal information was based on the month of data collection. Logistic regressions were used to examine the odds of children eating five or more FVs, and the odds of ‘frequently or always’ consuming SSBs. During the fall, children reported eating five or more FV more often, when compared to winter (53.9% vs. 48.3%). In the fall, 25.8% of children reported ‘frequently or always’ drinking SSB, compared with 16.9% in winter. Indigenous children were less likely to eat five or more FV (OR 0.34 (95% CI 0.12–0.95)) in the fall when compared to non-Indigenous children. Findings indicate that intake of FV among rural students in this region is low, and the frequency of SSB is high, when compared with national recommendations.

Sugar Is the Key Cause of Overweight/Obesity in Sugar-Sweetened Beverages (SSB)

To evaluate association between overweight/obesity and sugar-sweetened beverages (SSB) types, SSB sugar, among children and adolescents. A total of 1,068 children and 751 adolescents were identified from a provincial survey conducted in Shandong, China. χ2 tests, logistic regression, restricted cubic spline (RCS), mediation analysis, pathway analysis, and ordinary least square (OLS) regression were applied to test association among overweight/obesity, SSB sugar, SSB types, and a set of factors. The mean daily SSB intake for children and adolescents was 210.7 and 208 ml, respectively. The threshold of SSB sugar consumption causing overweight/obesity was around 25 g/day and verified by RCS based on logistic regression. Approximately, 44.8% of the study subjects consumed more than 25 g/day of SSB sugar. SSB sugar intake above 25 g/day resulted in higher risk of overweight/obesity (OR = 1.391, 95% CI, 1.115–1.734). The effects of all types of SSBs on overweight/obesity were fully mediated by SSB sugar (p &lt; 0.05), except for milk. Consumption of any types of SSBs had a positive impact on SSB sugar intake in both children and adolescents. Any type of SSB intake was a risk factor in excessive intake of SSB sugar (OR &gt; 1, p &lt; 0.05). In particular, milk powder, tea, and tea-flavored drinks, and carbonated have greater ORs for excessive intake of SSB sugar (OR = 76.08, 8.879, 4.355, p &lt; 0.05, respectively). It was found that the effect of SSB on overweight/obesity was mediated by the intake of SSB sugar, and the effects of various SSBs were different according to multiple linear regression and pathway analysis (p &lt; 0.05, respectively).

Socioeconomic position and consumption of sugary drinks, sugar-sweetened beverages and 100% juice among Canadians: a cross-sectional analysis of the 2015 Canadian Community Health Survey–Nutrition

Objective

The aim of this study was to describe sugary drink (beverages with free sugars), sugar-sweetened beverage (beverages with added sugars, SSB) and 100% juice (beverages with natural sugars) consumption across socioeconomic position (SEP) among Canadians.

Methods

We conducted a cross-sectional analysis of 19,742 respondents of single-day 24-h dietary recalls in the nationally representative 2015 Canadian Community Health Survey–Nutrition. Poisson regressions were used to estimate the prevalence of consuming each beverage type on a given day. Among consumers on a given day, linear regressions were used to estimate mean energy intake. Models included household education, food security and income quintiles as separate unadjusted exposures. Sex-specific models were estimated separately for children/adolescents (2–18 years) and adults (19 +).

Results

Among female children/adolescents, the prevalence of consuming sugary drinks and, separately, SSB ranged from 11 to 21 and 8 to 27 percentage-points higher among lower education compared to ‘Bachelor degree or above’ households. In female adults, the prevalence of consuming sugary drinks and, separately, SSB was 10 (95% CI: 1, 19) and 14 (95% CI: 2, 27) percentage-points higher in food insecure compared to secure households. In males, the prevalence of consuming 100% juice was 9 (95% CI: − 18, 0) percentage-points lower among food insecure compared to secure households. Social inequities in energy intake were observed in female adult consumers, among whom mean energy from sugary drinks was 27 kcal (95% CI: 3, 51) higher among food insecure compared to secure and 35 kcal (95% CI: 2, 67) higher from 100% juice among ‘less than high school’ education compared to ‘Bachelor degree or above’ households.

Conclusion

Social inequities in sugary drink consumption exist in Canada. The associations differed by SEP indicator. Equitable interventions to reduce consumption are warranted.

The role of sugar-sweetened beverages in the global epidemics of obesity and chronic diseases

Sugar-sweetened beverages (SSBs) are a major source of added sugars in the diet. A robust body of evidence has linked habitual intake of SSBs with weight gain and a higher risk (compared with infrequent SSB consumption) of type 2 diabetes mellitus, cardiovascular diseases and some cancers, which makes these beverages a clear target for policy and regulatory actions. This Review provides an update on the evidence linking SSBs to obesity, cardiometabolic outcomes and related cancers, as well as methods to grade the strength of nutritional research. We discuss potential biological mechanisms by which constituent sugars can contribute to these outcomes. We also consider global trends in intake, alternative beverages (including artificially-sweetened beverages) and policy strategies targeting SSBs that have been implemented in different settings. Strong evidence from cohort studies on clinical outcomes and clinical trials assessing cardiometabolic risk factors supports an aetiological role of SSBs in relation to weight gain and cardiometabolic diseases. Many populations show high levels of SSB consumption and in low-income and middle-income countries, increased consumption patterns are associated with urbanization and economic growth. As such, more intensified policy efforts are needed to reduce intake of SSBs and the global burden of obesity and chronic diseases.

Feasibility and measurement error in using food supply data to estimate diet costs in Canada

OBJECTIVE

The cost of food is a key influence on diet. The majority of diet cost studies match intake data from population-based surveys to a single source of food supply prices. Our aim was to examine the methodological significance of using food supply data to price dietary intakes.

METHODS

Nationally representative 24-hour dietary recall data from the 2015 Canadian Community Health Survey-Nutrition (CCHS-N) was matched to the 2015 Canadian Consumer Price Index (CPI) food price list. Proportions and means of reported intakes covered by the 2015 CPI price list were used to compare reported intakes of food groups and food components of interest and concern overall, and by quartile of CPI coverage.

SETTING

Canada.

PARTICIPANTS

20,487 Canadians ages one and older.

RESULTS

The CPI covered on average 76.3% of total dietary intake (g) without water. Staple food groups that were more commonly consumed had better CPI price coverage than those less commonly consumed. Yet some food groups (vegetables, additions, sweets) that were also commonly consumed by Canadians were not well covered by price data. Individuals in the poorest CPI coverage quartile reported consuming significantly greater fibre (g), gram weight (g), dietary fibre (g), and energy (kcal) as compared to those with the best coverage.

CONCLUSIONS

Differential CPI price coverage exists among food components and commonly consumed food groups; additionally dietary intake differs significantly in the population by CPI coverage. Methodological refinements are needed to better account for error when using prices from food supply data to estimate diet costs.

Consumption of Milk and alternatives decreased among Canadians from 2004 to 2015: evidence from the Canadian community health surveys

Background

Milk and milk products make important contributions to the diet of Canadians. The aim of this study was to examine trends in Milk & Alternatives consumption among Canadians (≥2 years) from 2004 to 2015.

Methods

We used nutrition data from 2 nationally representative cross-sectional surveys conducted in 2004 and 2015 [Canadian Community Health Survey (CCHS) 2004 Cycle 2.2 and CCHS-Nutrition 2015] to compare Milk & Alternatives consumption between 2004 and 2015. Data from 24-h dietary recalls were collected using the Automated Multiple-Pass Method (AMPM).

Result

From 2004 to 2015, the proportion of Canadians consuming Milk & Alternatives food group significantly decreased from 89.5 to 87.7% and the number of servings consumed per day dropped from 1.9 to 1.7. Despite their low energy contribution (12.3% of energy), Milk & Alternatives contributed 45.8% of calcium, 39.9% of vitamin D, and 36.0% of vitamin B12 to the diet of the Canadian population in 2015. Milk & Alternatives were among the top sources of vitamin A, phosphorus and riboflavin. Milk & Alternatives food group was a major contributor to saturated fat intake in both 2004 (31.2%) and 2015 (28.6%). In 2015, dietary intakes of calcium and vitamin D among Milk & Alternatives consumers were 137.8, and 59.4% higher, respectively, than those of non-consumers.

Conclusion

Daily intake of Milk & Alternatives has decreased in the Canadian population over time, which may adversely affect the nutritional profile of the diet.

Nutrition Care Practices of Dietitians and Oral Health Professionals for Oral Health Conditions: A Scoping Review

Background: Oral health conditions, such as dental caries, pose a substantial burden worldwide. Although there are many risk factors for poor oral health, diet is often implicated as a cause of these issues. The purpose of this scoping review was to identify and map studies that have captured information on the “real-world” nutrition care practices of oral health professionals (OHPs) and dietitians to optimize oral health, and specifically the dentition and periodontium. Methods: A search of peer-reviewed articles was conducted using MEDLINE, CINAHL, and Embase. Articles that addressed the review objective and met the following criteria were included: English language, published since 2000, and study conducted in a high-income country. Results: Overall, 70 articles were included. Most articles reported on cross-sectional survey studies and provided self-reported data on OHP practices; few articles reported on dietitians. Most articles reported only general/unspecific information on assessment and intervention practices, such as dietary analysis, nutrition counselling, and diet advice, and lacked specific information about the care provided, such as the dietary assessment tools used, type of information provided, and time spent on these activities. Barriers to the provision of nutrition care by OHPs were common and included time and lack of remuneration. Few studies reported on collaboration between dietitians and OHPs. Conclusions: Several studies have captured self-reported information on nutrition care practices of OHPs related to oral health; however, there is limited information available on the details of the care provided. Few studies have examined the practices of dietitians.

Comparing the Effects of Four Front-of-Package Nutrition Labels on Consumer Purchases of Five Common Beverages and Snack Foods: Results from a Randomized Trial

BACKGROUND

Front-of-package (FOP) nutrition labeling systems differ in how they rate food and beverage products. There is a need to examine the implications of these differences, including their focus on nutrients of public health concern.

OBJECTIVE

Our aim was to examine the impacts of 4 common FOP labels on consumers' purchases of products that received conflicting ratings across FOP systems.

DESIGN

In an experimental marketplace, participants were randomized to complete a series of purchases under 1 of 5 FOP conditions: no label, "high in" nutrient labels, multiple traffic light, Health Star Rating, or a 5-color nutrition grade.

PARTICIPANTS/SETTING

A final sample of 3,584 Canadians (13 years and older) were recruited from shopping centers in March to May 2018.

MAIN OUTCOME MEASURES

Probability of purchasing was assessed for 5 product categories (100% fruit juice, plain milk, chocolate milk, cheese snacks, and diet beverages), which received conflicting ratings across the FOP conditions.

STATISTICAL ANALYSES

Separate generalized linear mixed models estimated the influence of FOP condition on 5 binary outcomes (1 = purchased, 0 = not purchased) corresponding to the product categories.

RESULTS

Few differences were observed among the full sample. Among participants who noticed the labels (n = 1,993), those in the Health Star Rating condition were 4.5 percentage points (95% CI -7.0 to -1.9) more likely to purchase 100% fruit juice (compared to multiple traffic light) and 3.3 (95% CI 0.4 to 6.2) and 3.0 percentage points (95% CI 0.1 to 6.1) more likely to purchase cheese snacks (compared to no label and "high in"). "High in" labels produced fewer purchases of chocolate milk than no label.

CONCLUSIONS

Despite some similarities, existing FOP systems differ in the extent to which they promote or dissuade purchases of common product categories. Although the Health Star Rating might encourage purchases of products with certain positive nutritional attributes, "high in" and multiple traffic light systems might more effectively discourage purchases of products contributing nutrients of public health concern.

Food and Nutrient Intakes of Nova Scotian Children in Home and Childcare Environments

Purpose: To describe the energy (E), sodium, saturated fat, sugar, and fibre intakes of a sample of children attending regulated childcare (RCC) in Nova Scotia.Methods: Nutrient analyses from 79 food records were compiled and grouped by intakes in and outside of RCC, age, sex, location of the RCC (urban or rural), and nutrient intake data. Descriptive statistics and independent t tests were conducted.Results: Mean E and macronutrients were within recommended ranges and, for days attending RCC, 45%E was consumed in RCC. Saturated fat intake was 12%E on average. Mean sodium intake exceeded or approached the tolerable upper limit for 3-year olds (1726 mg/day) and 4-5-year olds (1770 mg/day), respectively. Total sugar was 27%E intake and significantly more sugar was consumed outside RCC and by boys compared to girls. Mean daily dietary fibre intake was below recommended levels (15 g/day).Conclusions: On average dietary intakes of children exceeded recommendations for sodium, saturated fat, and sugar with higher intakes outside RCC. The foods provided by RCC have a positive influence on children's intakes, but given the pervasiveness of sugar and sodium in the food environment and the challenges of feeding children, support is needed for both RCC and families to encourage healthy eating behaviours for positive growth and development.

Dietary sugar intake among preschool-aged children: a cross-sectional study

BACKGROUND

Excessive intake of sugar in young children is a public health concern. Our study objectives were to examine intakes of total, free and added sugar among preschool-aged children and to investigate their associations with body weight, body mass index Z-scores, percent fat mass and waist circumference.

METHODS

The cross-sectional cohort study included preschool-aged children between 1.5 and 5 years of age, enrolled in pilot studies of the Guelph Family Health Study, Guelph, Ontario, from 2014 to 2016. Daily intake of total sugar was determined using a food processor software; daily intakes of free and added sugar, and food sources were determined through manual inspection of 3-day food records. Anthropometric measures were completed by trained research staff. We used linear regression models with generalized estimating equations to estimate associations between sugar intakes and anthropometric measures.

RESULTS

We included 109 children (55 girls and 54 boys) in 77 families. Mean daily intakes were 86 (standard deviation [SD] 26) g for total sugar, 31 (SD 15) g for free sugar and 26 (SD 13) g for added sugar. Of participants, 80% (n = 87) had intakes of free sugar greater than 5% of their daily energy intake. The most frequent food sources of free and added sugar were bakery products. A weak inverse association between free sugar intake (kcal/1000 kcal) and waist circumference (cm) (β = -0.02, 95% confidence interval -0.04 to -0.0009) was found, but no significant associations were noted between sugar intake and other anthropometric measures.

INTERPRETATION

Most of the preschool-aged children in this study had free sugar intakes greater than current recommendations; overall, their total, free and added sugar intakes were not associated with the anthropometric measures. This study can be used to inform policy development for sugar intake in young children and apprise early intervention programs.

Perceived Healthiness of Sweeteners among Young Adults in Canada

Purpose: To compare the perceived healthiness of different sweeteners relative to table sugar and examine efforts to consume less sugars and sweeteners.Methods: As part of the 2017 Canada Food Study online survey, 1000 youth and young adults were randomized to rate the healthiness of 1 of 6 sweeteners (aspartame, sucralose, stevia, agave, high-fructose corn syrup, "raw" sugar) or 1 sweetener brand name (Splenda) compared with "table sugar".Results: Perceptions of sweeteners varied widely. For example, the majority of respondents perceived high-fructose corn syrup (63.9%) and aspartame (52.4%) as less healthy than table sugar, whereas almost half (47.8%) perceived raw sugar as being healthier than table sugar. No assessed socio-demographic variables were significantly associated with perceived healthiness of sweeteners compared with table sugar (P ≥ 0.05). More consumers had attempted to consume less sugar (65.4%) compared with less "artificial" (31.2%) or "natural" (24.0%) low-calorie sweeteners.Conclusions: Perceptions of sweetener healthiness may be related to sweeteners' perceived level of "naturalness" rather than energy content. This has important implications for understanding consumer preferences, particularly given greater use of low-calorie sweeteners in the food supply and policy developments such as sugar taxes and enhanced sugar labelling.

A Systematic Review of the Recent Consumption Levels of Sugar-Sweetened Beverages in Children and Adolescents From the World Health Organization Regions With High Dietary-Related Burden of Disease

This review aimed to investigate national estimates of sugar-sweetened beverage (SSB) consumption in children and adolescents aged 2 to 18 years, from countries in regions particularly burdened by dietary-related chronic illnesses. The most recent studies or reports from included countries (n = 73) with national-level consumption data of SSBs in children and adolescents, collected between January 2010 and October 2019, were considered for inclusion. A random effects meta-analysis was used to calculate pooled estimates of the mean consumption of SSB in millimeters per day. Heterogeneity between national estimates was assessed using the I² statistic and explored via subgroup analyses by the World Health Organization region, age groups, and country-level income. Forty-eight studies were included in the review reporting national estimates of consumption for 51 countries. The highest estimate of daily consumption was in China at 710.0 mL (95% confidence interval [CI] = 698.8-721.2), while the lowest was in Australia at 115.1 mL (95% CI = 111.2-119.1). Pooled synthesis of daily SSB consumption of the 51 countries was 326.0 mL (95% CI = 288.3-363.8), although heterogeneity was high, and was not explained by subgroup analyses. While there is considerable variability between countries, intake of SSB remains high among children and adolescents internationally underscoring the need for public health efforts to reduce SSBs consumption.

Trends in Sales and Industry Perspectives of Package Sizes of Carbonates and Confectionery Products

Discretionary food package sizes are an important environmental cue that can affect the amount of food consumed. The aim of this study was to determine sales trends and reported food industry perspectives for changing food package sizes of carbonates and confectionery between 2005 and 2019. Changes in package sizes of carbonates and confectionery were investigated in Australia, the USA, Canada, and the UK. Sales data (units per capita and compound annual growth rate between 2005 and 2019) were extracted from the Euromonitor database. Qualitative data (market research reports) on industry perspectives on package size changes were extracted from industry and marketing databases. Carbonate sales data showed increased growth of smaller package sizes (<300 mL) and a decrease in sales of larger package sizes (≥2000 mL) in all four countries. In contrast, confectionery sales data showed no consistent trends across the selected countries. No growth was observed for smaller confectionery package sizes but an increase in growth of larger package sizes (50–99 g, >100 g), including share packages, was observed in Australia. Qualitative data (n = 92 articles) revealed key reasons identified by industry for changes in package size related to consumer health awareness, portion size control, convenience, market growth, and government or industry initiatives. Monitoring of discretionary food package sizes provides additional insights into consumers’ food environment.

Trajectories of Eating Behaviour Changes during Adolescence

Adolescence represents a critical transition phase during which individuals acquire eating behaviours that can track into adulthood. This study aims to characterise trends in eating behaviours throughout adolescence by investigating the presence of sub-groups of individuals presenting distinct trajectories of vegetable and fruit, sugary beverage, breakfast and fast-food consumption. Data from 744 MATCH study Canadian participants followed from 11 to 18 Years old (2013-2019) were included in the analyses. Participants reported how often they ate breakfast and consumed vegetables and fruits, sugary beverages and fast foods. Trajectories of eating behaviours over seven years were identified using group-based multi-trajectory modelling. For girls, three different groups were identified, namely 'stable food intake with a decline in daily breakfast consumption' (39.9%), 'moderate food intake and worsening in overall eating behaviours' (38.0%) and 'stable high food intake' (22.1%). For boys, five different groups were identified, namely 'low food intake with stable daily breakfast consumption' (27.3%), 'breakfast-skippers and increasing fast food intake' (27.1%), 'low food intake with a decline in daily breakfast consumption' (23.9%), 'high food intake with worsening of eating behaviours' (13.3%) and 'average food intake with consistently high breakfast consumption' (8.4%). Eating behaviours evolve through various distinct trajectories and sub-group-specific strategies may be required to promote healthy eating behaviours among adolescents.

Sex Differences in Oral Health and the Consumption of Sugary Diets in a Saudi Arabian Population

BACKGROUND AND PURPOSE

Adolescence is a crucial period for developing healthy lifestyle and dietary habits. The growing consumption of high-sugar foods and beverages constitutes a serious public health concern. The aim of this study was to evaluate sex differences in the consumption of a sugary diet and oral health among Saudi adolescents.

SUBJECTS AND METHODS

This cross-sectional study was conducted in the Eastern Province of the Kingdom of Saudi Arabia between January and February 2019. A multistage sampling technique was used to recruit 2265 middle-school children aged 12-16 years. Data were collected via the Food Frequency Questionnaire and via an oral health examination, using the WHO criteria. The chi-squared test, Student's t-test, and Mann-Whitney U-test were used to investigate the associations between the study variables.

RESULTS

The most consumed foods and beverages reported were water, juices, and biscuits (90%), while the least consumed were energy drinks and jams. A significant difference was found between males and females in the frequency of consumed sugary foods (P=0.01) and the quantity of consumed sugary beverages (P=0.000); males over all consumption were greater than their counterpart. However, no differences were found between sexes in the frequency of sugary drink consumption (P=0.2). The decayed-missing-filled index score was significantly higher in females (4.29 ± 3.44) than in males (3.61 ± 3.14; P=0.001). The mean plaque index among males and females was 1.72 (±0.79) and 1.20 (±0.78), respectively, while the mean gingival index was 1.31 (±0.77) in males and 0.69 (±0.73) in females-a statistically significant difference (P=0.001).

CONCLUSION

Sex differences were found in sugary diet consumption and oral health status. Thus, policy makers are encouraged to consider sex-based differences when planning preventative programs and initiatives. Nevertheless, further research is needed on the dietary intake patterns of young adults.

Efficiency the Utilization of Folow up Palm Plants foor Increasing Production Beef Cattle in District Pasaman Barat

The main problem in the development of cattle business people in palm plantation, one exeption availibility of forage animal feed whether in quantity n quality. Other side the existence of palm leaves the midrib has been waste of a disturbing and not been utilized by farmers. To the touch technological innovations feed in te form of silage then palm leaves the midrib has been animal feed worthy of in eating of cattle. The purpose of this research is identify the effects the provisio of feed based silage palm leaves midrib increased body weight on cattle beef and analyzing efficiency the cost of animal feed. Research in farmer group Tanjung Keramat in district Kinali, Pasaman Barat in february until april 2017. Respondent are set down in purposive sampling. This research used 18 tail local bulls created the average 2 until 2, 5 years. Treatment provides was P1 control grass field is 10% from body weght (25 Kg) + bran is 10% from body weght (2,5 Kg) , P2 granting of silage then palm leaves (10 kg) + bran (1,5 Kg) + gliserida ( 2 Kg). In an analysis using t tableindependent sample t-testα=5%. Result of research shows P1 increase body weight cattle 0,68 kg/tail/day and P2 0,81 kg/ tail/ day . Provision of feed based silage then palm leaves significant compared feed control t test (-6,9) > t tabel (2,4). With efficiency cost feed during 90 days P1 (Rp. 967.500,-/cattle) and P2 (Rp. 675.500,-/cattle). So, with provision palm leaves besides increasing body weight cattle, can also reducing the grass that drain time dan energy can reduce the cost daily cattle feed.

Sugar-containing beverages and their association with risk of breast, endometrial, ovarian and colorectal cancers among Canadian women

BACKGROUND

The association of sugar containing beverages (SCBs) with risk of breast, endometrial, ovarian and colorectal cancers is unclear. Therefore, we investigated these associations in the Canadian Study of Diet, Lifestyle, and Health.

METHODS

The study population comprised an age-stratified subcohort of 3185 women and 848, 161, 91 and 243 breast, endometrial, ovarian and colorectal cancer cases, respectively. We used Cox proportional hazards regression models modified for the case-cohort design to assess the associations of SCBs with risk of the aforementioned cancers.

RESULTS

Compared to SCB intake in the lowest tertile, SCB intake in the highest tertile was positively associated with endometrial cancer risk (HR_{T3 vs T1} = 1.58, 95 % CI = 1.08-2.33 and 1.78, 95 % CI = 1.12-2.81 for overall and Type 1 endometrial cancer, respectively) and ovarian cancer (HR_{T3 vs T1} = 1.76, 95 % CI: 1.09-2.83). Fruit juice intake was also positively associated with risk of Type 1endometrial (HR_{T3 vs T1} = 1.63, 95 % CI = 1.03-2.60). After excluding women with diabetes or cardiovascular diseases, we also observed sugar-sweetened beverages (SSBs) intake in the highest tertile was associated with higher risk of Type 1 endometrial cancer (HR _{T3 vs T1} = 1.65; 95 % CI: 1.03-2.64). None of the beverages was associated with risk of breast or colorectal cancer.

CONCLUSION

We conclude that, in this cohort, relatively high SCB intake was associated with higher risk of endometrial and ovarian cancers, but not of breast or colorectal cancers. Our findings also suggest that relatively high SSB and fruit juice intake are associated with higher risk of Type 1 endometrial cancer.

Assessment of beverage consumption by young adults in Saudi Arabia

Objective

The primary objective was to assess beverage consumption pattern and calorie intake among undergraduate students on weekly and daily basis. Secondary objectives were to determine the relationship between demographic variables and beverage intake, assess mean differences in calorie intake between students’ groups and, report the predictors of beverage consumption.

Methods

A cross-sectional study was conducted for 3 months (January–March 2019) among currently enrolled undergraduate students studying in 8 colleges of a public sector university in Dammam, Saudi Arabia. The study used the Arabic version of Beverage Frequency Questionnaire (BFQ) and collected data through purposive stratified sampling. Total intake in ml and calories in kcals were calculated. Data was analyzed through SPSS version 23 and the study was approved from ethics committee of the university (IRB‐2019‐05‐021).

Results

A total of 507 students responded to the survey. The average volume of sugar sweetened beverages (SSBs), caffeine containing beverage (CCBs) and carbonated beverages (CarBs) consumed was 4.2 L, 4 L and 1.5 L per week and 650.6 ml, 575.2 ml and 224.6 ml per day, respectively. Average daily calorie intake from SSBs, CCBs and CarBs was 187.6 kcals, 87.6 kcals and 52.5 kcals, respectively. Body mass index (BMI) was significantly related to CCB (ρ = 0.130) and CarBs (ρ = 0.100) intake (mL) (p < 0.05). Mean difference in calorie intake was mostly significant (p < 0.05) when accounted for students’ demographics, gender, BMI, residence, illness and, examination time, in case of SSBs, CCBs, CarBs and, all beverages. Averge % contribution towards total daily energy expenditure (TDEE) for SSBs, CCBs and CarBs were 10.2%, 6.3% and 2.8%, respectively. Year of study, BMI, residence and illness were predictors of SSBs consumption while BMI, residence and examination time were predictors of CCBs consumption. Gender and BMI were predictors of CarBs intake.

Conclusion

There was a high consumption of beverages in students that was related to their demographic characteristics. There is a need to create awareness among the students regarding the detrimental effects of chronic consumption of these beverages.

Non-Alcoholic Beverages, Old and Novel, and Their Potential Effects on Human Health, with a Focus on Hydration and Cardiometabolic Health

The Beverage Guidance System has established dietary recommendations for daily intake of commonly consumed beverages including water, tea, coffee, milk, non-calorically sweetened beverages, and calorically sweetened beverages. As obesity in America continues to be a growing problem, this guidance becomes of increasing importance due to many beverages' potential links to Type 2 Diabetes Mellitus (T2DM), Cardiovascular disease (CVD), and numerous other harmful health effects. However, the growing popularity of "better for you" beverages is causing a shift in the market, with consumers pushing for healthier beverage alternatives. Beverages simultaneously present advantages while posing concerns that need to be evaluated and considered. In this review, health effects of nonalcoholic beverages are discussed including various aspects of consumption and current trends of the beverage market such as the novel Soft Seltzer category as an alternative to Hard Seltzer and various mashups. A variety of advisory boards and agencies responsible for dietary guidelines in various countries suggest drinking water as the preferred practice for hydration.

Trends in sugary drinks in Canada, 2004 to 2015: a comparison of market sales and dietary intake data

OBJECTIVE

The current study aimed to examine the correspondence between sales data and dietary recall data for sugary drinks in Canada.

DESIGN

Repeat cross-sectional analysis of sales data for sugary drinks sold in Canada from 2004 to 2015 from two sources: GlobalData (GD) and Euromonitor (EM). Sugary drinks included ten beverage categories containing free sugars. Analyses examined sales volumes over time, with adjustment for population growth. National intake estimates were drawn from the 2004 and 2015 Canadian Community Health Survey (CCHS) Nutrition.

SETTING

Canada.

PARTICIPANTS

Not applicable.

RESULTS

In 2015, daily per capita sugary drinks consumption was estimated as 356 ml (GD) and 443 ml (EM) from sales data sources, and as 277 ml from dietary recall data. Both sales data sources and dietary recall data indicated that per capita sugary drinks consumption decreased from 2004 to 2015, although the magnitude of this change differed: -23 % (GD), -17 % (EM) and -32 % (CCHS Nutrition). Market sales data showed similar trends among categories of sugary drinks, with decreases in sales of traditional beverage categories (e.g. carbonated soft drinks) and increases in novel categories (e.g. sugar-sweetened coffee).

CONCLUSIONS

All data sources indicate a declining trend in sugary drinks consumption between 2004 and 2015, but with considerable differences in magnitude. Consumption estimates from sales data were substantially higher than estimates from dietary recall data, likely due to under-reporting of beverage intake through dietary recall and the inability of sales data to account for beverages sold but not consumed. Despite the observed decline, sugary drinks sales volumes remain high in Canada.