Teens Shun High Calorie Drinks

Teen education

By Kristina Fiore, Staff Writer, MedPage Today Published: December 15, 2011 Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston and Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner

Telling kids just how far they'll have to run in order to burn off that can of soda made them think twice about buying it, researchers found. In low-income black areas, publicizing the physical activity equivalent of calories from sugar-sweetened beverages at the point of purchase reduced the likelihood of teens buying the drinks by nearly half, Sara Bleich, PhD, of Johns Hopkins Bloomberg School of Public Health, and colleagues reported online in the American Journal of Public Health. "Providing easily understandable caloric information -- particularly in the form of a physical activity equivalent, such as running -- may reduce calorie intake from sugar-sweetened beverages and increase water consumption among low-income black adolescents," Bleich said in a statement. Action Points   Explain that a study of purchasing habits among black adolescents frequenting four corner stories in Baltimore found that providing information about how far one would have to run to burn off a sugar-sweetened beverage led to fewer purchases. Note that providing an actual calorie count for the drink was less effective. Some studies have suggested that giving consumers nutrition information can influence their buying behavior, especially if it's done at the point of purchase, but Bleich said the literature is inconsistent. For instance, the effectiveness of the information may relate to how it's presented, she said. Giving consumers relative caloric information -- presenting it in terms of its effect, such as the number of minutes of running needed to burn off a sugary drink -- rather than absolute information on the number of calories in the beverage, may make more of an impact on their purchases, she said. So to assess various strategies for influencing adolescents' beverage choices, Bleich and colleagues collected data on 1,600 beverage sales at four neighborhood stores in low-income areas of Baltimore. They looked specifically at sales to black adolescents ages 12 to 18, and assessed 400 baseline purchases before attempting any intervention, then 400 purchases for each of three specific interventions. All interventions involved posting a sign with one of three pieces of information: Absolute calorie count Calorie count as a percentage of daily recommended caloric intake A physical activity equivalent needed to burn off the calories The signs were brightly colored, 8.5-inch-by-12-inches, and placed in a prominent location on the beverage case in each store. The information for each intervention was phrased in the form of a question: "Did you know that a bottle of soda or fruit juice has about 250 calories?" "Did you know that a bottle of soda or fruit juice has about 10% of your daily calories?" "Did you know that working off a bottle of soda or fruit juice takes about 50 minutes of running?" Bleich and colleagues found that after adjustment, offering any caloric information at all was associated with a reduced likelihood of kids buying sugary drinks compared with no intervention (OR 0.56, 95% CI 0.36 to 0.89). But only when kids were given a physical activity equivalent were they significantly more likely to shun the sugary drinks (OR 0.51, 95% CI 0.31 to 0.85). Highlighting the daily percentage of total calories was associated with only a marginally significant reduction in the likelihood that kids would buy the soda, Bleich and colleagues reported, and there was no association with absolute calorie information. These findings lend support to inconsistent findings in the literature thus far that providing information on total calories isn't necessarily an effective means of influencing buying behaviors, the researchers wrote. They added that when the findings were assessed by specific beverages, kids drank less iced tea and sports drinks (P=0.01 and P=0.04, respectively), but more water (P=0.003). The study was limited because it may not be applicable outside low-income black communities, and because the physical activity equivalents may have been imprecisely estimated. Also, the researchers noted, they couldn't get an accurate total on how many kids actually noticed the calorie information provided, nor could they measure actual sugar-sweetened beverage consumption. They added that future work should focus on whether using the physical activity equivalent affects sugary drink purchases among other groups at risk for obesity. The study was supported by grants from the Robert Wood Johnson Foundation and the National Heart, Lung and Blood Institute. No conflict-of-interest disclosures were given.

Primary source: American Journal of Public Health Source reference: Bleich SN, et al "Reduction in purchases of sugar-sweetened beverages among low-income black adolescents after exposure to caloric information" Am J Public Health 2011.