Sugar-sweetened beverages (SSBs) have emerged as a major public health concern, especially among children and adolescents. Over the past few decades, the consumption of these beverages has significantly increased, contributing to an alarming rise in childhood obesity rates worldwide. From 1990 to 2018, the global intake of SSBs among young people aged 3 to 19 rose by 23%. This trend has been accompanied by a corresponding increase in childhood obesity, which poses both immediate and long-term health risks. Unlike many other dietary trends, the rise in SSB consumption among young people has outpaced that observed in adults, highlighting the unique vulnerability of this demographic and the urgent need for effective interventions.
Childhood obesity is not just a short-term issue. Children who are overweight or obese are far more likely to carry this condition into adulthood, where it predisposes them to chronic health problems such as type 2 diabetes, cardiovascular disease, and even premature death. Beyond its direct health consequences, obesity also exerts a substantial economic burden. Global healthcare and productivity costs related to obesity are projected to rise dramatically, from £2 trillion in 2020 to a staggering £18 trillion by 2060. Reducing SSB consumption, therefore, is critical not only for improving individual health outcomes but also for mitigating the growing financial strain on healthcare systems worldwide.
Factors Driving Increased SSB Consumption
One of the primary drivers of increased SSB consumption is the globalisation of food markets. As multinational corporations expand their reach, highly processed and sugar-laden beverages have become more widely available, even in previously underserved regions. This global transformation of food systems has made unhealthy options more accessible and affordable than ever before. For many families, especially those in low and middle-income countries, SSBs are an attractive choice due to their low cost, long shelf life, and aggressive advertising campaigns.
Marketing strategies targeting children and adolescents are another major factor contributing to rising SSB consumption. Children are particularly susceptible to advertising, and companies have leveraged this to influence their preferences and consumption habits. The use of television, social media, and digital platforms to promote SSBs has proven to be highly effective, especially in regions like Latin America and the Middle East. In these areas, marketing campaigns are often specifically designed to appeal to young people, using colourful packaging, popular characters, and social influencers to create a sense of desirability around these products.
Furthermore, weak regulatory measures exacerbate the problem. In many countries, there are insufficient policies in place to limit the marketing and availability of SSBs to children. In regions with improving economies, such as sub-Saharan Africa and parts of Southeast Asia, the absence of strong regulations has allowed the food and beverage industry to flourish unchecked. As a result, SSBs have become a staple in the diets of children and adolescents, further contributing to the obesity epidemic.
Regional Trends in SSB Consumption
While SSB consumption has increased globally, there are significant variations between regions. Sub-Saharan Africa, for instance, experienced the largest rise in SSB intake between 1990 and 2018. This region’s rapid economic growth and urbanisation have contributed to a shift in dietary patterns, with processed foods and beverages becoming more prevalent. The lack of robust public health interventions in sub-Saharan Africa further exacerbates this trend, leaving populations vulnerable to the health impacts of increased SSB consumption.
In the Middle East and North Africa, the rise in SSB consumption among children and adolescents has been even more pronounced. By 2018, this region ranked second globally for SSB intake among young people. The cultural appeal of sweetened beverages, combined with aggressive marketing efforts and limited regulatory oversight, has fuelled this increase. These trends highlight the urgent need for targeted policies to address the growing public health crisis in these areas.
In contrast, Latin America and the Caribbean saw a more complex pattern. Between 1990 and 2005, SSB consumption in this region declined, likely due to economic crises and health awareness campaigns that promoted healthier eating habits. However, consumption began to rise again after 2005, driven by economic recovery and renewed marketing efforts from the beverage industry. The availability of SSBs increased dramatically, aided by multinational corporations and the transformation of local food systems. Today, the region’s high levels of SSB consumption reflect both the economic and cultural shifts that have occurred over the past three decades.
High-income countries, on the other hand, experienced a decline in SSB consumption from 2005 to 2018. This trend can be attributed to several factors, including increased public awareness about the health risks of SSBs, the introduction of taxation on sugary beverages, and the availability of non-caloric sweetened alternatives. These nations have also implemented stricter regulations on marketing and labelling, making it easier for consumers to make informed choices. However, despite these successes, challenges remain, particularly in reaching underserved and vulnerable populations within these countries.
Policies and Interventions
Policy interventions have proven to be effective tools for reducing SSB consumption among children and adolescents. One of the most widely implemented strategies is taxation on sugary beverages. Countries that have introduced such taxes have seen measurable declines in SSB intake, as higher prices deter consumers from purchasing these products. Front-of-package labelling is another successful approach, providing clear and accessible information about the nutritional content of beverages. This helps consumers make healthier choices and discourages the consumption of high-sugar products.
Restrictions on food marketing are particularly important for protecting children and adolescents from the influence of aggressive advertising campaigns. In countries where marketing restrictions have been enforced, there has been a noticeable reduction in SSB consumption among young people. Similarly, regulations within school environments, such as banning the sale of SSBs and promoting access to healthier beverage options, have been effective in curbing intake.
Despite these successes, gaps remain in the implementation and enforcement of policies. Many low and middle-income countries lack the infrastructure and resources to enforce regulations, leaving children and adolescents exposed to the harmful effects of SSBs. Additionally, industry opposition to public health policies poses a significant challenge, as beverage companies often lobby against measures that could reduce their profits. Overcoming these obstacles requires strong political will and international collaboration to ensure that effective interventions are implemented.
Public Health Implications of Rising SSB Consumption
The rise in SSB consumption among children and adolescents has far-reaching implications for public health. Obesity and other diet-related diseases, such as type 2 diabetes and hypertension, are directly linked to high sugar intake. These conditions not only reduce quality of life but also increase the risk of severe outcomes during health crises. For example, during the COVID-19 pandemic, individuals with cardiometabolic conditions, including obesity, were more likely to experience severe symptoms, hospitalisations, and mortality. Addressing the root causes of these conditions, including excessive SSB consumption, is therefore critical for improving resilience to future pandemics.
Reducing SSB consumption also aligns with broader sustainability goals, such as those outlined in the United Nations’ 2030 Agenda for Sustainable Development. By promoting healthier dietary patterns, governments can improve population health, reduce healthcare costs, and create more equitable food systems. These efforts also support goals related to responsible consumption, poverty reduction, and access to clean water, all of which are interconnected with the issue of SSB consumption.
Need for Better Data and Research
One of the major challenges in addressing SSB consumption is the lack of comprehensive data. While this study provides valuable insights into global trends, significant gaps remain, particularly in low-income regions such as South Asia and sub-Saharan Africa. National and subnational estimates of SSB intake are essential for understanding the scope of the problem and designing effective interventions. Without reliable data, it is difficult to assess trends over time or evaluate the impact of policies.
Efforts to improve data collection should focus on demographic factors such as age, sex, education, and urbanicity. These factors play a crucial role in shaping dietary behaviours and can provide valuable insights into the specific needs of different populations. Incorporating other social determinants of health, such as income, access to healthcare, and racial and ethnic disparities, can further enhance our understanding of the issue. Improved surveillance systems are needed to track SSB consumption and evaluate the effectiveness of interventions at both national and subnational levels.
Conclusion
The global increase in SSB consumption among children and adolescents is a pressing public health issue that demands immediate attention. With consumption trends varying significantly across regions and demographic groups, personalised policies and interventions are essential to curb this growing problem. Strategies such as taxation, marketing restrictions, and school-level regulations have shown promise, but more comprehensive efforts are required to address the root causes of rising SSB intake.
Addressing SSB consumption is not just about reducing sugar intake; it is about protecting the health and well-being of future generations. By implementing evidence-based policies and closing data gaps, governments and public health organisations can take meaningful steps to reduce the burden of diet-related diseases. These efforts will not only improve individual health outcomes but also contribute to broader goals of sustainability and equity.
As the economic and health costs of obesity continue to rise, reducing SSB consumption must remain a global priority. Tackling this issue requires collaboration across sectors and borders, as well as a commitment to protecting the most vulnerable populations. Only through coordinated and sustained efforts can we create a healthier, more sustainable future for all.
Reference
Lara-Castor, L., Micha, R., Cudhea, F., Miller, V., Shi, P., Zhang, J., Sharib, J. R., Erndt-Marino, J., Cash, S. B., Barquera, S., Mozaffarian, D., & Global Dietary Database. (2024). Intake of sugar sweetened beverages among children and adolescents in 185 countries between 1990 and 2018: population based study. BMJ (Clinical Research Ed.), 386, e079234. https://doi.org/10.1136/bmj-2024-079234