Teens Choose Water When Calorie Count of Sugary Beverages is Easier to Understand

Thirsty? You may be more inclined to reach for plain old H2O if you knew how many calories are in sugar-sweetened beverages; this is according to a new study led by researchers at the Johns Hopkins Bloomberg School of Public Health. They examined the effect of providing clear and visible caloric information about sugar-sweetened beverages such as soda and fruit juice on the number of sugar-sweetened beverage purchases at neighborhood stores, and found that providing easily understandable caloric information, specifically in the form of a physical activity equivalent, may reduce the likelihood of sugar-sweetened beverage purchases among adolescents by as much as half. The results are featured in a recent issue of the American Journal of Public Health. 

“People generally underestimate the number of calories in the foods and beverages they consume," said Sara Bleich, PhD, assistant professor with the Bloomberg School's Department of Health Policy and Management. "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.”

Researchers conducted the study at four corner stores located in low-income, predominately black neighborhoods in Baltimore, Md. For the intervention, one of three caloric information signs were randomly posted with the following information: "Did you know that a bottle of soda or fruit juice has about 250 calories?" (absolute caloric count); "Did you know that a bottle of soda or fruit juice has about 10 percent of your daily calories?" (percentage of total recommended daily intake); and "Did you know that working off a bottle of soda or fruit juice takes about 50 minutes of running?" (physical activity equivalent). They collected data for 1,600 beverage sales to black adolescents, aged 12-18 years, including 400 during a baseline period and 400 for each of the 3 caloric-condition interventions. Researchers found that providing participants with any caloric information significantly reduced the odds of sugar-sweetened beverage purchases by 40 percent relative to the baseline of no information.  Of the three caloric-condition interventions, the physical activity equivalent was most effective, reducing the odds of black adolescents purchasing a sugar-sweetened beverage by 50 percent.

Consumption of sugar-sweetened beverages such as soda, sport drinks, energy drinks and fruit drinks has been associated with obesity and is highest among minority and lower income adolescents. According to the Centers for Disease Control and Prevention (CDC), more than one third of U.S. adults and 17 percent of U.S children are obese. Obesity increases the risk of many adverse health conditions including type 2 diabetes, coronary heart disease, stroke, and high blood pressure.

"Because of the inclusion of mandatory calorie labeling in the recent health reform bill, it is critical to explore the most effective strategies for presenting caloric information to consumers on fast food restaurant menu boards,” suggest the study’s authors.

”Reduction in Purchases of Sugar-Sweetened Beverages Among Low-Income, Black Adolescents After Exposure to Caloric Information” was written by Sara N. Bleich, PhD, Bradley J. Herring, PhD, Desmond D. Flagg, MPH, and Tiffany L. Gary-Webb, PhD, MS.

The research was supported by grants from the Robert Wood Johnson Foundation and the National Heart, Lung, and Blood Institute.

Media contact for Johns Hopkins Bloomberg School of Public Health: Natalie Wood-Wright at 410-614-6029 or nwoodwri@jhsph.edu.