A new review of the latest evidence on sugar-sweetened beverages (SSBs) – which includes 30 new studies published between 2013 and 2015 – none of which were industry sponsored – concludes that a frequent SSB consumption is associated with overweight and obesity, and that countries that have not already done so should take action to reduce the consumption of the so-called ‘empty calories’ that these drinks contain. The review was published in the journal Obesity Facts, the journal of the European Association for the Study of Obesity (EASO). It was written by a team of authors including EASO President Elect Dr Nathalie Farpour-Lambert (University Hospitals of Geneva, Switzerland) and Dr Maira Bes-Rastrollo, University of Navarra, Spain, and Carlos III Institute of Health, Spain. Here we speak with Dr Maria Luger, principle author of the review, which includes a quarter of a million people.
Dr Luger, it’s great to speak with you. Can you tell us a bit about this research?
(Impetus for the review, length of time it took, partners involved, etc)
The impetus for this review was the opportunity to join the EASO Healthy Hydration Working Group with an EASO New Investigator United grant in 2015. This working group was established with the aim of identifying and coordinating key projects on the topic of hydration and obesity.
When I joined the working group, my objective was to fuel the group with the latest insights on the relationship between fluid intake and obesity, and more specifically, to review the state-of-the-art data about beverage-related calorie intake and obesity. So I started a literature search and found the latest publication on this topic by Malik and his colleagues which was from from 2013. That led me to consider preparing a systematic review of recently published studies – between 2013 and 2015.
We started the literature search in October and screened 1,612 citations – so it took a while. At the beginning of 2016, I was able to show and discuss the first draft of the review with the working group. We decided to present our findings at the European Obesity Summit in May 2016 in Gothenburg, Sweden. It was very exciting for me to present our results in front of such a large scientific audience. The next step for me was to draft a manuscript to make the results available to the public. In addition to that, I had the opportunity to present our systematic review at the ECO 2017 in Porto, at the Hydration for Health Academy 2017 in Evian, which included participants from the EASO Train the Trainer annual summer school, and also at the EFAD Conference 2017 in Rotterdam. Overall, it was a pleasure for me to conduct this research with my colleagues from the EASO Healthy Hydration Working Group and I am so grateful to have had their support.
I would also like to thank my colleagues from the Special Institute for Preventive Cardiology and Nutrition (SIPCAN) and from the Medical University of Vienna for their understanding and support.
The Review was published in advance of the festive period, traditionally a time of celebratory eating and drinking and seems to have had excellent uptake by media.
That is true; our research was published mid-December in the Journal Obesity Facts at a time when sugar consumption increases!. I was very impressed by the media uptake; the Review received coverage from 50 international news outlets and on social media, was shared via about 130 tweeters, blogs and Facebook pages. The news stories ranged from Australia, across Europe to the U.S, including The New York Times and The West Australian, to name but a few major news outlets covering the story. I had a look at the Altmetric website and people from Spain, the UK, Canada, and the U.S. were particularly involved in sharing our research via Twitter. I believe this shows that people are interested in this kind of research and that our work is very important.
What do you see as the potential policy implications for the review?
Our research adds to growing evidence around the negative health effects of frequent intake of sugar-sweetened beverages and I think it provides reasons and impetus for urgent policy action. Many countries across the world demonstrate high levels of sugar-sweetened beverage consumption, and even those with lower levels of SSB intake are seeing sharp increases. To date, approaches to reduce this consumption in many countries are limited or simply not available. public health policies should aim to support reducing consumption and encouraging healthy alternatives such as water. For these strategies, we need both political willingness to consider regulation and the cooperation of the beverage industry to achieve a reduction in both consumption and in the formulation, which could address the levels of free sugar content of beverages in the near future.