Individual- and Population-Level Impacts of Sugar-Sweetened Beverage Health Warnings
Public Deposited- Last Modified
- September 17, 2019
- Creator
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Grummon, Anna H
- Affiliation: Gillings School of Global Public Health, Department of Health Behavior
- Abstract
- Introduction. Implementing health warnings on sugar-sweetened beverages (SSBs) could reduce consumption of these products and associated diseases. This dissertation aimed to design effective SSB warnings, evaluate their impact on actual SSB purchases, and model the expected effects of a national SSB health warning policy. Methods. In the first study, a national sample of U.S. adults (n=1,360) completed an online randomized experiment investigating their responses to SSB health warnings with different characteristics. In the second study, I conducted a randomized controlled trial in a naturalistic replica of a convenience store to evaluate the impact of SSB health warnings on adults’ (n=400) beverage purchases. The third study applied a microsimulation model of dietary behaviors and body weight to quantify the effects of a national SSB health warning policy on U.S. adults’ SSB intake, total energy intake, body mass index (BMI), and obesity status over five years. Results. In the first study, SSB health warnings that described the health effects of SSB consumption, began with the marker word “WARNING,” and were displayed on an octagon-shaped (vs. rectangular) labels were perceived to be more effective than warnings without these characteristics (ps<0.001). In the second study, SSB health warnings reduced SSB purchases by 32.4 calories/transaction, a 22.4% reduction over the control arm (p=0.019). The third study found that implementing a national SSB health warning policy would reduce U.S. adults’ average SSB intake by 26.2 calories/day (95% uncertainty interval [UI]: -28.3, -24.1) and total energy intake by 32.4 calories/day (95% UI: -34.2, -30.5). If sustained over five years, these dietary changes would reduce average BMI by 0.61 kg/m2 (95% UI: -0.64, -0.57) and obesity prevalence by 2.1 percentage points (95% UI: -2.4%, -1.7%). Conclusions. Small changes in the design of SSB health warnings will likely enhance their impact on SSB consumption and obesity. Implementing health warnings could improve population health.
- Date of publication
- 2019
- Keyword
- DOI
- Resource type
- Advisor
- Brewer, Noel T
- Fisher, Edwin B
- Golden, Shelley D
- Smith Taillie, Lindsey
- Frerichs, Leah
- Degree
- Doctor of Philosophy
- Degree granting institution
- University of North Carolina at Chapel Hill Graduate School
- Graduation year
- 2019
- Language
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