Abstract
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.
| Original language | English |
|---|---|
| Article number | 5957 |
| Journal | Nature Communications |
| Volume | 14 |
| Issue number | 1 |
| Early online date | 3 Oct 2023 |
| DOIs | |
| Publication status | Published - Dec 2023 |
Bibliographical note
Funding Information:The investigators did not receive funding from a pharmaceutical company or other agency to write this report. L.L.C reports research funding from the Gates Foundation, the American Heart Association, and Consejo Nacional de Ciencia y Tecnología in Mexico, outside of the submitted work. R.M. reports research funding from the Gates Foundation; and (ended) the U.S. National Institutes of Health, Danone, and Nestle. She also reports consulting from Development Initiatives and as IEG chair for the Global Nutrition Report, outside of the submitted work. F.C., J.Z., and P.S. report research funding from the Gates Foundation, as well as the National Institutes of Health, outside of the submitted work. V.M. reports research funding from the Canadian Institutes of Health Research and from the American Heart Association, outside the submitted work. J.R.S. reports research funding from the Gates Foundation, as well as the National Institutes of Health, Nestlé, Rockefeller Foundation, and Kaiser Permanent Fund at East Bay Community Foundation, outside of the submitted work. S.B.C. reports research funding from the U.S. National Institutes of Health, the U.S. Department of Agriculture, the Rockefeller Foundation, the U.S. Agency for International Development, and the Kaiser Permanente Fund at East Bay Community Foundation, outside the submitted work. D.M. reports research funding from the U.S. National Institutes of Health, the Gates Foundation, the Rockefeller Foundation, Vail Innovative Global Research, and the Kaiser Permanente Fund at East Bay Community Foundation; personal fees from Acasti Pharma, Barilla, Danone and Motif FoodWorks; is on the scientific advisory board for Beren Therapeutics, Brightseed, Calibrate, Elysium Health, Filtricine, HumanCo, Instacart, January Inc., Perfect Day, Tiny Organics, and (ended) Day Two, Discern Dx, and Season Health; has stock ownership in Calibrate and HumanCo; and receives chapter royalties from UpToDate, all outside the submitted work. J.E.M. declares no competing interests.
Funding Information:
This research was supported by the Gates Foundation (grant OPP1176682 to D.M.), the American Heart Association (grant 903679 to L.L.C), and Consejo Nacional de Ciencia y Tecnología in Mexico (to L.L.C.). We acknowledge the Tufts University High-Performance Computing Cluster (https://it.tufts.edu/high-performance-computing), which was used for the research reported in this paper. This material is based upon work supported by the National Science Foundation under grant number 2018149. The computational resource is under active development by Research Technology, Tufts Technology Services. The funding agencies had no role in the design of the study; collection, management, analysis, or interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit for publication.
Data Availability Statement
The individual SSB intake estimate distribution data used in this as means and uncertainty (SE) for each strata in the analysis are available freely online at the Global Dietary Database (GDD, Download 2018 Final Estimates: https://www.globaldietarydatabase.org/data-download). GDD data were utilized in agreement with the database guidelines. GDD data collapsed for 85+ and by age categories 20–39, 40–59, and 60+, as well as the absolute and relative differences by strata and by year presented in this analysis, were calculated using the 4000 simulations corresponding to the stratum level intake data derived from the Bayesian model. The derived source data are provided with this paper. The 4000 simulations files can be made available to researchers upon request. Eligibility criteria for such requests include utilization for nonprofit purposes only, for appropriate scientific use based on a robust research plan, and by investigators from an academic institution. If you are interested in requesting access to the data, please submit the following documents: (1) proposed research plan (please download and complete the proposed research plan form: https://www.globaldietarydatabase.org/sites/default/files/manual_upload/research-proposal-template.pdf), (2) data-sharing agreement (please download this form https://www.globaldietarydatabase.org/sites/default/files/manual_upload/tufts-gdd-data-sharing-agreement.docx and complete the highlighted fields, have someone who is authorized to enter your institution into a binding legal agreement with outside institutions sign the document. Note that this agreement does not apply when protected health information or personally identifiable information are shared), (3) email items (1) and (2) to info@globaldietarydatabase.org. Please use the subject line “GDD Code Access Request”. Once all documents have been received, the GDD team will be in contact with you within 2–4 weeks regarding subsequent steps. Data will be shared as.csv or.xlsx files, using a compressed format when appropriate. Population weights for each strata and year were derived from the United Nations Population Division (https://population.un.org/wpp/), supplemented with data for education and urban or rural status from Barro (DOI: 0.3386/w15902) and Lee and the United Nations (https://population.un.org/wup/Download/). Source data are provided with this paper.Code availability
Custom code was developed using R (Version 4.0.0) for analyzing the data including aggregation of the 4000 simulations to the desired strata categories, calculation of absolute and relative differences, and summary of mean intakes globally, regionally, and nationally jointly stratified by sociodemographic group, and data visualizations including tables and figures. Given the computational size, the data aggregation, calculation of absolute and relative differences, and summary of mean intakes were run on the Tufts University High-Performance Computing Cluster (https://it.tufts.edu/high-performance-computing), supported by the National Science Foundation (grant:2018149) under active development by Research Technology, Tufts Technology Services. The statistical code can be made available to researchers upon request. Eligibility criteria for such requests include utilization for nonprofit purposes only, for appropriate scientific use based on a robust research plan, and by investigators from an academic institution. GDD will nominate co-authors to be included in any papers generated using GDD-generated statistical code. If you are interested in requesting access to the statistical code, please submit the following documents: (1) proposed research plan (please download and complete the proposed research plan form: https://www.globaldietarydatabase.org/sites/default/files/manual_upload/research-proposal-template.pdf), (2) data-sharing agreement (please download this form https://www.globaldietarydatabase.org/sites/default/files/manual_upload/tufts-gdd-data-sharing-agreement.docx and complete the highlighted fields, have someone who is authorized to enter your institution into a binding legal agreement with outside institutions sign the document. Note that this agreement does not apply when protected health information or personally identifiable information are shared), (3) email items (1) and (2) to info@globaldietarydatabase.org. Please use the subject line “GDD Code Access Request”. Once all documents have been received, the GDD team will be in contact with you within 2–4 weeks regarding subsequent steps. Data will be shared as.csv or.xlsx files, using a compressed format when appropriate.
Keywords
- Developing World
- Epidemiology
- Risk Factors
- scientific community
Access to Document
- Lara-Castor_Etal_NC_Sugar-sweetened_Beverage_Intakes_VOR
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