Interventions to influence consumption of sugar-sweetened beverages

Evidence for higher intakes of sugar-sweetened beverages (SSBs) driving the risks of obesity, type 2 diabetes and cardiovascular disease is increasing. As a result, SSBs have been targeted across public health interventions worldwide, including Mexico- which has one of the highest levels of consumption of SSB and alarmingly high childhood obesity rates. This thesis aimed to determine the effectiveness of interventions and intervention’s components to reduce consumption of SSBs and to develop and implement an intervention in school-aged children in central Mexico. A systematic review and meta-analysis was undertaken to examine the impact that interventions have had to reduce SSB intake or increase water intake across all age groups. Identification and analysis of behavior change techniques used in interventions was also undertaken. Exploratory analyses on data from children in central Mexico indicated that 12% of 6 to 15 year olds met criteria for Metabolic Syndrome. Consequently, a 12-week school-based programme was developed to influence consumption of SSB through promotion of water intake. Sixteen classes in four schools were allocated to the intervention group (N= 2 schools, 8 classes) or control group (N= 2 schools, 8 classes). Participants were 337 children aged 7-12 years (222 in intervention and 115 in controls). Pooled estimates from meta-analyses indicated that interventions modestly influence SSB intakes in children (-92 mL/day (95% confidence interval [CI] -145 to -39; 18 studies, P