Matt Kasman1, Ross A Hammond1,2,3, Rob Purcell1, Benjamin Heuberger1, Travis R Moore4,5, Anna H Grummon6,7, Allison J Wu6,8, Jason P Block6, Marie-France Hivert6,9, Emily Oken6,7, Ken Kleinman10. 1. Center on Social Dynamics and Policy, Brookings Institution, Washington, DC, USA. 2. Brown School at Washington University in St. Louis, St. Louis, MO, USA. 3. The Santa Fe Institute, Santa Fe, NM, USA. 4. ChildObesity180, Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA. 5. Department of Community Health, School of Arts and Sciences, Tufts University, Medford, MA, USA. 6. Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA. 7. Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA. 8. Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, MA, USA. 9. Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA. 10. Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts-Amherst, Amherst, MA, USA.
Abstract
BACKGROUND: A strong body of evidence links young children's intake of sugar-sweetened beverages (SSBs) with myriad negative outcomes. OBJECTIVES: Our research provides insight into whether and to what extent potential intervention strategies can reduce young children's consumption of SSBs. METHODS: We built an agent-based model (ABM) of SSB consumption representing participants in the Project Viva longitudinal study between ages 2 and 7 y. In addition to extensive data from Project Viva, our model used nationally representative data as well as recent, high-quality literature. We tested the explanatory power of the model through comparison to consumption patterns observed in the Project Viva cohort. Then, we applied the model to simulate the potential impact of interventions that would reduce SSB availability in 1 or more settings or affect how families receive and respond to pediatrician advice. RESULTS: Our model produced age-stratified trends in beverage consumption that closely match those observed in Project Viva cohort data. Among the potential interventions we simulated, reducing availability in the home-where young children spend the greatest amount of time-resulted in the largest consumption decrease. Removing access to all SSBs in the home resulted in them consuming 1.23 (95% CI: 1.21, 1.24) fewer servings of SSBs per week on average between the ages of 2 and 7 y, a reduction of ∼60%. By comparison, removing all SSB availability outside of the home (i.e., in schools and childcare) had a smaller impact (0.77; CI: 0.75, 0.78), a reduction of ∼40%. CONCLUSIONS: These results suggest that interventions reducing SSB availability in the home would have the strongest effects on SSB consumption.
BACKGROUND: A strong body of evidence links young children's intake of sugar-sweetened beverages (SSBs) with myriad negative outcomes. OBJECTIVES: Our research provides insight into whether and to what extent potential intervention strategies can reduce young children's consumption of SSBs. METHODS: We built an agent-based model (ABM) of SSB consumption representing participants in the Project Viva longitudinal study between ages 2 and 7 y. In addition to extensive data from Project Viva, our model used nationally representative data as well as recent, high-quality literature. We tested the explanatory power of the model through comparison to consumption patterns observed in the Project Viva cohort. Then, we applied the model to simulate the potential impact of interventions that would reduce SSB availability in 1 or more settings or affect how families receive and respond to pediatrician advice. RESULTS: Our model produced age-stratified trends in beverage consumption that closely match those observed in Project Viva cohort data. Among the potential interventions we simulated, reducing availability in the home-where young children spend the greatest amount of time-resulted in the largest consumption decrease. Removing access to all SSBs in the home resulted in them consuming 1.23 (95% CI: 1.21, 1.24) fewer servings of SSBs per week on average between the ages of 2 and 7 y, a reduction of ∼60%. By comparison, removing all SSB availability outside of the home (i.e., in schools and childcare) had a smaller impact (0.77; CI: 0.75, 0.78), a reduction of ∼40%. CONCLUSIONS: These results suggest that interventions reducing SSB availability in the home would have the strongest effects on SSB consumption.
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