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The sugar-sweetened beverage wars: public health and the role of the beverage industry

Welsh, Jean A.a; Lundeen, Elizabeth A.b; Stein, Aryeh D.c

Current Opinion in Endocrinology, Diabetes and Obesity: October 2013 - Volume 20 - Issue 5 - p 401–406
doi: 10.1097/
OBESITY AND NUTRITION: Edited by Caroline M. Apovian and Jeffrey I. Mechanick

Purpose of review To discuss the current data on sugar-sweetened beverage (SSB) consumption trends, evidence of the health impact, and the role of industry in efforts to reduce the consumption.

Recent findings Previously rising SSB consumption rates have declined recently, but continue to contribute added sugars beyond the limit advised by the American Heart Association. A recent meta-analysis concluded that SSBs likely increase body weight and recent long-term studies support the previous findings of increased risk of diabetes, dyslipidemia, and hypertension. Beverage companies have played an active role in some SSB reduction efforts by reducing the sale of SSBs in schools, limiting television advertising to children, and increasing the availability of smaller portion-size options. Industry has opposed efforts to restrict the availability of large portion sizes and implement an excise tax. Current industry efforts include the promotion of alternative beverages perceived to be healthier as well as SSBs through Internet and social media.

Summary Continuing high SSB consumption and associated health risks highlight the need for further public health action. The beverage industry has supported some efforts to reduce the consumption of full sugar beverages, but has actively opposed others. The impact of industry efforts to promote beverage alternatives perceived as healthier is unknown.

aChildren's Healthcare of Atlanta, Emory University School of Medicine

bNutrition and Health Sciences, Graduate Division of Biological and Biomedical Sciences, Laney Graduate School, Emory University

cRollins School of Public Health, Emory University, Atlanta, Georgia, USA

Correspondence to Aryeh D. Stein, PhD, Hubert Department of Global Health, 1518 Clifton Road North East, Atlanta, GA 30322, USA. Tel: +1 404 727 4255; e-mail:

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins