A systematic review of the effectiveness of promoting water intake to reduce sugar‐sweetened beverage consumption

Abstract

Objective: To examine whether the promotion of water intake could reduce sugarsweetened beverage (SSB) consumption or purchases independent of interventions that target SSBs.Methods: Seven databases were systematically searched. Included studies used water promotion as the primary intervention; used a controlled trial, single group pre-post, or prospective cohort study design; included a measure of SSB consumption or purchase; enrolled human participants of any age who lived in highincome or middle-income countries; contained original data; and appeared in a peer-The search yielded 7068 publications, from which 108 were chosen for full-text review. Seventeen were included in this review.Results: Nine of the 17 studies were randomized controlled trials, six were nonrandomized controlled trials, and 2 were single-group pre-post studies. Participants were primarily children and adolescents. Interventions included water provision, education or promotion activities. Ten of 17 studies were at low or some/moderate risk of bias. Seven studies showed a statistically significant decrease in SSB consumption of which only 2 were at low or some/moderate risk of bias.Conclusions: This review found limited evidence that interventions aimed solely at increasing water consumption reduce SSB intake. Further research is needed to investigate whether interventions that combine water promotion and SSB reduction strategies could be synergistic for reducing SSB intake. K E Y W O R D Swater promotion, sugar-sweetened beverage, sugar-sweetened beverage consumption reduction

The Outcomes of Thirsty? Choose Water! A Randomised Controlled Trial to Determine The Effects of A Behavioural and an Environmental Intervention on Water and Sugar Sweetened Beverage Consumption in Adolescents.

“…Furthermore, Moghadam et al (2019) suggest that 'a randomized controlled trial that uses a factorial design to examine the independent and combined effects of water promotion and SSB reduction strategies on both water and SSB consumption and/or purchases would be a useful addition to the literature.' 11 This study has achieved this, adding a valuable contribution to demonstrate effective strategies to address water and SSB consumption and the interaction and synergy of these interventions.…”

“…The authors thus identi ed a need for further investigation into studies that combine both water promotion and SSB reduction strategies. 11 Rhaman et al (2017) reported on 12 school based interventions, which included educational components, lesson delivery, and alternate water sources. They concluded that when compared to no intervention, these interventions had an impact on reducing SSB intake which approached statistical signi cance (p = 0.06).…”

“…14 Of note, each of these systematic reviews called for further studies that utilise stronger study designs including randomised controlled trials, validated self-report data and objective measures, longer term follow-up and the capacity to determine the individual or combined effects of interventions. [10][11][12] Furthermore, of the studies included in these systematic reviews only three were Australian studies, of which two were conducted in secondary schools. Both these studies addressed broader healthy eating/physical activity interventions, which demonstrated a positive effect on SSB consumption.…”

Using a Community-Based Participatory Mixed Methods Research Approach to Develop, Evaluate, and Refine a Nutrition Intervention to Replace Sugary Drinks with Filtered Tap Water among Predominantly Central-American Immigrant Families with Infants and Toddlers: The Water Up @Home Pilot Evaluation Study

“…The existing reviews in the field of SSB and water underscore the need to better understand how strategies may work in low-income communities and among parents of very young children [ 49 , 57 , 58 ]. CBPMMR approaches are crucial to complete this work.…”

The Modeling Impact of Different Food Policy Scenarios on Incidence and Mortality from type 2 Diabetes in Azar Cohort Population

“…Meanwhile, the ndings of several studies have shown that by providing education on nutrition and counselling, and especially improving access to water through family-based interventions for example by sending free water to homes, success can be achieved in this regard. Also, a review study has concluded that educational interventions and providing water to increase water consumption by reducing its prices or multiple community-based interventions in this eld have been more successful in reducing SSB consumption (32) .…”