Association of a Workplace Sales Ban on Sugar-Sweetened Beverages With Employee Consumption of Sugar-Sweetened Beverages and Health.

Importance Reductions in sugar-sweetened beverage (SSB) intake can improve health, but are difficult for individuals to achieve on their own. Objectives To evaluate whether a workplace SSB sales ban was associated with SSB intake and cardiometabolic health among employees and whether a brief motivational intervention provides added benefits to the sales ban. Design, Setting, and Participants This before-after study and additional randomized trial conducted from July 28, 2015, to October 16, 2016, at a Northern California university and hospital assessed SSB intake, anthropometrics, and cardiometabolic biomarkers among 214 full-time English-speaking employees who were frequent SSB consumers (≥360 mL [≥12 fl oz] per day) before and 10 months after implementation of an SSB sales ban in a large workplace, with half the employees randomized to receive a brief motivational intervention targeting SSB reduction. Interventions The employer stopped selling SSBs in all workplace venues, and half the sample was randomized to receive a brief motivational intervention and the other half was a control group that did not receive the intervention. This intervention was modeled on standard brief motivational interventions for alcohol used in the workplace that promote health knowledge and goal setting. Main Outcomes and Measures Outcomes included changes in SSB intake, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), and measures of abdominal adiposity. The primary associations tested were the correlation between changes in SSB intake and changes in HOMA-IR. Results Among the 214 study participants, 124 (57.9%) were women, with a mean (SD) age of 41.2 (11.0) years and a baseline mean (SD) body mass index of 29.4 (6.5). They reported a mean daily intake of 1050 mL (35 fl oz) of SSBs at baseline and 540 mL (18 fl oz) at follow-up-a 510-mL (17-fl oz) (48.6%) decrease (P < .001). Reductions in SSB intake correlated with improvements in HOMA-IR (r = 0.16; P = .03). Those not randomized to receive the brief intervention reduced their SSB intake by a mean (SD) of 246.0 (84.0) mL (8.2 [2.8] fl oz), while those also receiving the brief intervention reduced SSB intake by 762.0 (84.0) mL (25.4 [2.8] fl oz). From baseline to follow-up, there were significant reductions in mean (SE) waist circumference (2.1 [2.8] cm; P < .001). Conclusions and Relevance This study's findings suggest that the workplace sales ban was associated with a reduction in SSB intake and a significant reduction in waist circumference among employees within 10 months. The randomized clinical trial portion of this study found that targeting those at high risk with a brief motivational intervention led to additional improvements. Workplace sales bans may offer a promising new private-sector strategy for reducing the health harms of SSB intake. Trial Registration ClinicalTrials.gov identifier: NCT02585336.

[1]  D. Lovinger,et al.  National Institute on Alcohol Abuse and Alcoholism , 2020, Definitions.

[2]  S. Noworolski,et al.  Effects of Dietary Fructose Restriction on Liver Fat, De Novo Lipogenesis, and Insulin Kinetics in Children With Obesity. , 2017, Gastroenterology.

[3]  A. J. Goodell,et al.  Health and economic benefits of reducing sugar intake in the USA, including effects via non-alcoholic fatty liver disease: a microsimulation model , 2017, BMJ Open.

[4]  S. Noworolski,et al.  Short-term isocaloric fructose restriction lowers apoC-III levels and yields less atherogenic lipoprotein profiles in children with obesity and metabolic syndrome. , 2016, Atherosclerosis.

[5]  A. Knight,et al.  Workplace interventions for preventing job loss and other work related outcomes in workers with alcohol misuse , 2016 .

[6]  Kristine A. Madsen,et al.  Added sugar intake and metabolic syndrome in US adolescents: cross-sectional analysis of the National Health and Nutrition Examination Survey 2005–2012 , 2016, Public Health Nutrition.

[7]  S. Noworolski,et al.  Isocaloric fructose restriction and metabolic improvement in children with obesity and metabolic syndrome , 2016, Obesity.

[8]  A. Moran,et al.  Use of Nutrition Standards to Improve Nutritional Quality of Hospital Patient Meals: Findings from New York City's Healthy Hospital Food Initiative. , 2015, Journal of the Academy of Nutrition and Dietetics.

[9]  A. Reichelt,et al.  Why is obesity such a problem in the 21st century? The intersection of palatable food, cues and reward pathways, stress, and cognition , 2015, Neuroscience & Biobehavioral Reviews.

[10]  Stephen S. Lim,et al.  Estimated Global, Regional, and National Disease Burdens Related to Sugar-Sweetened Beverage Consumption in 2010 , 2015, Circulation.

[11]  T. C. Rodrigues,et al.  Shift work and its association with metabolic disorders , 2015, Diabetology & Metabolic Syndrome.

[12]  A. Drewnowski,et al.  Consumption of added sugars among US children and adults by food purchase location and food source. , 2014, The American journal of clinical nutrition.

[13]  J. Mann,et al.  Dietary sugars and cardiometabolic risk: systematic review and meta-analyses of randomized controlled trials of the effects on blood pressure and lipids. , 2014, The American journal of clinical nutrition.

[14]  F. Chaloupka,et al.  Banning all sugar-sweetened beverages in middle schools: reduction of in-school access and purchasing but not overall consumption. , 2012, Archives of pediatrics & adolescent medicine.

[15]  Douglas E Levy,et al.  A 2-phase labeling and choice architecture intervention to improve healthy food and beverage choices. , 2012, American journal of public health.

[16]  J. Mann,et al.  Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies , 2012, BMJ.

[17]  Harold D. Holder,et al.  Alcohol: No Ordinary Commodity: Research and Public Policy , 2010 .

[18]  Pedro Rada,et al.  Evidence for sugar addiction: Behavioral and neurochemical effects of intermittent, excessive sugar intake , 2008, Neuroscience & Biobehavioral Reviews.

[19]  S. Yusuf,et al.  Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study , 2004, The Lancet.

[20]  W. Evans,et al.  Do Workplace Smoking Bans Reduce Smoking? , 1996 .

[21]  S Chapman,et al.  Effects of workplace smoking bans on cigarette consumption. , 1990, American journal of public health.

[22]  L. Powell,et al.  Consumption patterns of sugar-sweetened beverages in the United States. , 2013, Journal of the Academy of Nutrition and Dietetics.

[23]  I. Zakeri,et al.  Improvements in middle school student dietary intake after implementation of the Texas Public School Nutrition Policy. , 2008, American journal of public health.