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The shifting beverage landscape
Physiology & Behavior 100 (2010) 10–14
Contents lists available at ScienceDirect
Physiology & Behavior j o u r n a l h o m e p a g e : w w w. e l s ev i e r. c o m / l o c a t e / p h b
The shifting beverage landscape Maureen Storey ⁎ American Beverage Association 1101 16th Street, NW Washington, D.C. 20036, United States
a r t i c l e
i n f o
Article history: Received 8 January 2010 Received in revised form 8 February 2010 Accepted 10 February 2010 Keywords: Beverages School beverage guidelines Obesity Soft drinks Sweetened beverages Sugar intake Soda Childhood obesity
a b s t r a c t STOREY, M.L. The shifting beverage landscape. PHYSIOL BEHAV, 2010. — Simultaneous lifestyle changes have occurred in the last few decades, creating an imbalance in energy intake and energy expenditure that has led to overweight and obesity. Trends in the food supply show that total daily calories available per capita increased 28% since 1970. Total energy intake among men and women has also increased dramatically since that time. Some have suggested that intake of beverages has had a disproportional impact on obesity. Data collected by the Beverage Marketing Corporation between 1988–2008 demonstrate that, in reality, fewer calories per ounce are being produced by the beverage industry. Moreover, data from the National Cancer Institute show that soft drink intake represents 5.5% of daily calories. Data from NHANES 1999–2003 vs. 2003–06 may demonstrate a shift in beverage consumption for age/gender groups, ages 6 to N 60 years. The beverages provided in schools have significantly changed since 2006 when the beverage industry implemented School Beverage Guidelines. This voluntary action has removed full-calorie soft drinks from participating schools across the country. This shift to lower-calorie and smaller-portion beverages in school has led to a significant decrease in total beverage calories in schools. These data support the concept that to prevent and treat obesity, public health efforts should focus on energy balance and that a narrow focus on sweetened beverages is unlikely to have any meaningful impact on this complex problem. © 2010 Elsevier Inc. All rights reserved.
1. Introduction This paper discusses trends in food and beverage production, energy intake, food and beverage consumption, as well as the progress made in the nationwide implementation of voluntary School Beverage Guidelines, which removed full-calorie soft drinks from vending machines in schools.
2. Trends In Energy Production In The Food Supply Beginning in 1909, the U.S. Department of Agriculture's (USDA) Economic Research Service (ERS) has tracked food and nutrients “available for consumption” at the national level. The food availability (per capita) data system serves as an upper-bound proxy for actual food intake by consumers. The agency adjusts its estimates of total food availability for non-edible food parts and food lost through spoilage, plate waste, and other losses in the home and throughout the marketing system. A recent paper by Hall and associates describes a ∼50% increase in food waste since the 1970s. [1] During the last three decades, data from the USDA ERS suggest that, adjusted for spoilage and other waste, total kilocalorie avail⁎ Tel.: +1 202 463 6759; fax: +1 202 463 8172. E-mail address: [email protected]. 0031-9384/$ – see front matter © 2010 Elsevier Inc. All rights reserved. doi:10.1016/j.physbeh.2010.02.009
ability per capita per day increased almost 28% from 1970 to 2006, going from 2,172 available kilocalories per capita per day (available kcal/cap/d) in 1970 to 2,775 available kcal/cap/d in 2007 — a difference of 600 available kcal/cap/d. [2] Examining the various food commodities that have contributed to the increase in available energy, added fats and oils increased 73% (411 to 710 available kcal/cap//d) between 1970 and 2007, followed by grains1 that increased by 45% (432 to 629 kcal/cap/d) in this same time period. Available kcal/cap/d from added sugars2 increased 14% (402 to 459 available kcal/cap/d) and (the combined category of) meat, eggs, and nuts increased 6% (448 to 476 available kcal/cap/d). Percent of available energy from added fats increased 35%, but percent of available energy from added sugars declined 11% (Fig. 1).
3. Trends In Energy Consumption While food availability data are only upper-bound proxies for actual consumption, total daily energy intake has increased since the 1970s. [3] Using data from the National Health and Nutrition 1 Defined by ERS as wheat flour (white and whole wheat flour, durum flour, and wheat flour); rice flour; corn products (flour and meal, hominy and grits, cornstarch, and corn products); oat products; barley products; and flour and cereal products. 2 Added sugars are defined by ERS as refined cane and beet sugar, corn sweeteners, edible syrups, and honey.
M. Storey / Physiology & Behavior 100 (2010) 10–14
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Fig. 1. Percent of total daily per capita calories from U.S. food availability, adjusted for spoilage and other waste.
Examination Survey (NHANES) series,3 Kant and Graubard found that since the 1970s, total energy intake among adult men and women increased by approximately 200 and 300 kilocalories per day (kcal/d), respectively. In addition, energy intake per eating episode also increased by approximately 60 kilocalories. It should be noted that the methodologies used by the National Center for Health Statistics to assess food intake has improved; nevertheless, some of the increase in energy intake appears to be real as opposed to being the result of improved data collection methods. Scientists from the National Cancer Institute (NCI) of the National Institutes of Health analyzed data from NHANES to identify the contributions of various foods to intake of energy and selected nutrients in the US population age 2 years and older. [4] Their findings were presented to the 2010 Dietary Guideline Advisory Committee in April, 2009. Briefly, the analysis examined over 4,000 foods providing a broad snapshot of foods and food categories contributing energy, sodium, choline, cholesterol, and selected fatty acids to the American diet. [5] Using dietary intake data from NHANES 2005–06, the scientists catalogued 4,069 discrete food codes representing similar foods — such as, various types of pasta dishes — that were combined to indicate the contribution of distinct food items to intake of the nutrients being studied. The food codes then were sorted into 96 mutually exclusive food categories. Although grain-based desserts, dairy-based desserts, and candy were segregated into separate categories, the NCI scientists reported that grain-based desserts are the number one source of calories in the American diet, contributing 6.5% of energy (Fig. 2). The combination of grain-based desserts, dairy-based desserts (2.8%), and candy (2.1%) contributes over 11% of energy in the American diet. Yeast breads; chicken and chicken mixed dishes contributed 5.9 and 5.6% of the calories in the diet, respectively. Importantly, the combined category of sodas, sports drinks, sweetened bottled water (such as, vitamin waters), and energy drinks, contributed 5.5% of the energy. These data show that 94.5% of energy intake comes from foods and beverages other than the category of soft drinks — as defined by NCI. 4. Trends In Beverage Production The U.S. non-alcoholic liquid refreshment beverage (LRB) market has evolved dramatically in the past 20 years with the introduction of a broader range of caloric options. The Beverage Marketing Corporation (BMC) tracks production of beverages from numerous sources including Adams Business Media; Distilled Spirits Council of the United States; Florida Department of Citrus; International Dairy Foods Association; and U.S. Tea Association. The non-alcoholic LRB catego3 National Health and Nutrition Examination Survey (NHANES) is a series of studies conducted by the National Center for Health Statistics of the Centers for Disease Control and Prevention that assess the health and nutritional status of adults and children in the United States.
ries tracked by BMC include: full-calorie and diet carbonated soft drinks; bottled water; fruit beverages (100% juice and juice drinks); sports beverages; ready-to-drink teas and coffees; value-added water (enhanced and flavored water); and energy drinks. According to BMC data collected between 1988–2008, the share of volume of carbonated soft drinks declined from about 70% to less than 50% between 1988 and 2008. The largest decline in share of volume occurred in the full-calorie carbonated soft drinks market, while share of volume of bottled water rose from 11.1% in 1988 to 29.1% in 2008, representing a 162% increase. With the emergence of the bottled water market and the decline in full-calorie carbonated soft drinks, calories per ounce (cal/oz) produced decreased from 9.0 cal/oz to 6.8 cal/oz, representing a 24.4% decrease over the past 20 years (Fig. 3). [6] The decline in full-calorie carbonated soft drink volume foreshadows the decline in daily calories per capita per day produced (cal/ cap/d). In 2008, cal/cap/d from the carbonated soft drink segment fell below 1988 levels, providing 141.6 cal/cap/d (Fig. 4). This represents less than one 12-ounce can of full-calorie carbonated soft drinks. “Niche” markets of non-alcoholic beverages, such as ready-todrink teas and sports drinks, are consumed less frequently and/or by fewer consumers, therefore, these beverages provide few calories on a per capita per day basis. For example, in 2008, the ready-to-drink tea category provided, on average, less than 12 cal/cap/d; sports drinks contributed 1.6 cal/cap/d in 1988 compared with 9.1 cal/cap/d. 5. Trends In Beverage Consumption Dietary intake data confirm what is being observed in the BMC data and the NCI analyses. Americans of all ages are beginning to change their beverage consumption habits. [7] Using dietary intake data from NHANES 2003–2006, we contrasted those data with those of a similar study published in the Journal of the American Dietetic Association in 2006 using data from NHANES 1999–2002. [8] The methods of analysis, age/gender categories, and beverage categories in both studies were similar and are described in detail in the 2006 published paper. The data were from the Public-Use Data Files of the Center for Disease Control and Prevention's National Center for Health Statistics for NHANES 2003–2004 and 2005–2006 and were analyzed for the following age–gender categories: 6–11 years (y), 12–19 y, 20– 39 y, 40–59 y, and 60+ y for males and females. Beverage consumption was calculated using individual food files. Based on the U.S. Department of Agriculture coding system, each beverage was identified with a code corresponding to the following beverage categories: fruit juices, fluid milk, coffee, tea, regular (full-calorie) fruit drinks and ades, low-energy fruits drinks and ades, full-calorie carbonated soft drinks, and diet carbonated soft drinks. The beverages were then aggregated to the individual level and merged with the demographic data. The updated analysis showed that, in contrast with NHANES 1999– 2002, average intake of full-calorie (or regular) carbonated soft
12
M. Storey / Physiology & Behavior 100 (2010) 10–14
Fig. 2. Food sources of energy, based on analysis conducted by the National Cancer Institute.
drinks, fruit juices, and milk products decreased among most age/ gender groups; however, in many age-gender groups, average intakes of diet carbonated soft drinks and regular and low-energy fruit drinks and ades increased (manuscript in preparation).
6. School Beverage Guidelines In 2006, a voluntary nationwide policy was adopted by the American Beverage Association and its member companies (The Coca Cola Company, Pepsico, and Dr Pepper Snapple Group [formerly, Cadbury Schweppes]) and their bottlers to change the product mix of beverages sold in vending machines in schools (www.schoolbeverages.com). These three companies and their bottlers represent about 90% of the
Fig. 3. Calories per ounce produced in the U.S. non-alcoholic liquid refreshment beverage market.
school market that nationwide consists of 125,000 schools and over 54 million students. Specifically, the national School Beverage Guidelines call for the removal of full-calorie carbonated soft drinks in elementary, middle, and high schools (Table 1). The guidelines provide for only bottled water, 100% juice, and low- or no-fat milk for elementary and middle school students in portion-controlled sizes. For example, in elementary schools, up to eight ounces of fat-free and low-fat milk and 100% juice may be sold, whereas up to 10 ounces of these beverages may be sold in middle schools. In high schools, low calorie and diet beverages are permitted as well as some beverages that are below a calorie cap. Fat-free and low-fat milk, 100% juices, and certain other calorie-controlled beverages may be sold in containers up to 12 ounces. At the completion of the second year of the three-year implementation, Keybridge Research, LLC — an independent economics firm — evaluated the changes in calories, volume of beverages accessible to students, and product mix of beverages shipped to U.S. schools using the 2004 as the baseline and tracking implementation in the 2006–07 and 2007–08 school years. [9] The data show that the beverage producers and their bottlers exceeded the agreed-upon commitments during the first two years of the three-year implementation of the School Beverage Guidelines. Total shipments of beverages to schools declined 43% between 2004 and the 2007–08 school year. Total calories from all beverages and calories from full-calorie carbonated soft drinks delivered to schools declined by 58% and 65%, respectively, during that time period (Fig. 5). Considering the agreed-upon three-year implementation timeline, the gains made during the first two years are particularly noteworthy given the challenges associated with educating and training bottlers and school administrators, revising financial arrangements between bottlers and schools, reconfiguring product lines, and retrofitting equipment to accept smaller container sizes. These results confirm that beverage companies and their bottlers are committed to promoting a
M. Storey / Physiology & Behavior 100 (2010) 10–14
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Fig. 4. Calories per capita per day produced of carbonated soft drinks and fruit beverages.
healthy school environment. Data from the third and final year of implementation will be released in early March, 2010. 7. Conclusions Collectively, the food availability data show that total energy production and, in particular, added fats and oils have increased dramatically since the 1970s. Added sugars availability has increased to a lesser extent and the percent calories from added sugars has
Table 1 The national School Beverage Guidelines provide the following beverages. Elementary Schools • Bottled water; • Up to 8 ounce servings of milk and 100% juice. ° Fat-free or low-fat regular and flavored milk and nutritionally equivalent (per USDA) milk alternatives with up to 150 calories/ 8 ounces ° 100% juice with no added sweeteners, up to 120 calories / 8 ounces, and with at least 10% of the recommended daily value for three or more vitamins and minerals Middle Schools • Same as elementary school, except juice and milk may be sold in 10 ounce servings; • As a practical matter, if middle school and high school students have shared access to areas on a common campus or in common buildings, then the school community has the option to adopt the high school standard.
declined while obesity has continued to rise. Total energy intake among adults has increased over the last few decades. Grain-based desserts are the number one source of energy and all desserts (grainand dairy-based desserts and candy) contribute over 11% of energy to the American diet. Importantly, full-calorie carbonated soft drink production has decreased with a concomitant decrease in calories per unit produced. Publicly available NHANES data suggest that consumption of full-calorie carbonated soft drinks among most age and gender groups has declined while obesity has risen. For its part, the non-alcoholic beverage industry has created new reduced and zero calorie products that are changing what consumers choose to drink. To deal with the special case of beverages consumed in the school environment, the non-alcoholic beverage industry established, implemented, tracked, and publicly reported on the voluntary changes that effectively reduced beverage calories available during the school day.
Acknowledgement The author is employed by the American Beverage Association, which is a trade association representing the non-alcoholic refreshment beverage industry. The product categories represented by ABA include: carbonated soft drinks; fruit juices and juice drinks; ready-todrink teas and coffees; sports drinks; energy drinks; flavored and vitamin-enhanced waters; and bottled water.
High Schools • Bottled water; • No- or low-calorie beverages with up to 10 calories / 8 ounces; • Up to 12 ounce servings of milk, 100% juice and certain other drinks; ° Fat-free or low-fat regular and flavored milk and nutritionally equivalent (per USDA) milk alternatives with up to 150 calories / 8 ounces ° 100% juice with no added sweeteners, up to 120 calories / 8 ounces, and with at least 10% of the recommended daily value for three or more vitamins and minerals ° Other drinks with no more than 66 calories / 8 ounces • At least 50% of non-milk beverages must be water and no- or low-calorie options. Time of Day • These guidelines apply to all beverages sold on school grounds during the regular and extended school day; • The extended school day includes before and after school activities like clubs, yearbook, band, student government, drama and childcare/latchkey programs; • These guidelines do not apply to school-related events where parents and other adults are part of an audience or are selling beverages as boosters during intermission, as well as immediately before or after an event. Examples of these events include school plays and band concerts.
Fig. 5. Percent change in beverage calories and calories from full-calorie CSDs shipped to schools: 2004 vs. 2006–07 and 2007–08 school years.
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M. Storey / Physiology & Behavior 100 (2010) 10–14
References [1] Hall KD, Guo J, Dore M, Chow CC. The progressive increase of food waste in America and its environmental impact. PLoS 2009;4(11):1–6. [2] U.S. Department of Agriculture, Economic Research Service. Data Sets, Loss-Adjusted Food Availability. http://www.ers.usda.gov/Data/FoodConsumption/FoodGuideIndex. htm accessed August 4, 2009. [3] Kant AK, Graubard BI. Secular trends in patterns of self-reported food consumption of adult Americans: NHANES 1971–1975 to NHANES 1999–2002. Am J Clin Nutr 2006;84:1215–23. [4] U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics. http://www.cdc.gov/nchs/nhanes. htm. Accessed December 10, 2009. [5] Bosire C, Reedy J, Krebs-Smith SM. Sources of Energy and Selected Nutrient Intakes among the US Population, 2005–06. April 22 A Report Prepared for the 2010 Dietary
[6]
[7] [8] [9]
Guidelines Advisory Committee National Cancer Institute (NCI); 2009. http://www. cnpp.usda.gov/Publications/DietaryGuidelines/2010/Meeting3/AdditionalResources/ Mtg3-SourcesofEnergyandSelectedNutrients.pdf. Beverage Marketing Corporation; Adams Business Media; Distilled Spirits Council of the United States; Florida Department of Citrus; International Dairy Foods Association; U.S. Tea Association. 1998–2008. http://www.beveragemarketing.com. Storey ML, Anderson PA. Beverage consumption patterns in the U.S. population. FASEB J 2009;23:229.4. Storey ML, Forshee RA, Anderson PA. Beverage consumption in the US population. J Am Diet Assoc 2006;106:1992–2000. Westcott, R. American Beverage Association. School Beverage Guidelines Progress Report: 2007–2008. Keybridge Research, LLC. Washington DC. http://www.ameribev. org/files/240_SBG%20Exec%20Summary%202007-2008.pdf.
Contents lists available at ScienceDirect
Physiology & Behavior j o u r n a l h o m e p a g e : w w w. e l s ev i e r. c o m / l o c a t e / p h b
The shifting beverage landscape Maureen Storey ⁎ American Beverage Association 1101 16th Street, NW Washington, D.C. 20036, United States
a r t i c l e
i n f o
Article history: Received 8 January 2010 Received in revised form 8 February 2010 Accepted 10 February 2010 Keywords: Beverages School beverage guidelines Obesity Soft drinks Sweetened beverages Sugar intake Soda Childhood obesity
a b s t r a c t STOREY, M.L. The shifting beverage landscape. PHYSIOL BEHAV, 2010. — Simultaneous lifestyle changes have occurred in the last few decades, creating an imbalance in energy intake and energy expenditure that has led to overweight and obesity. Trends in the food supply show that total daily calories available per capita increased 28% since 1970. Total energy intake among men and women has also increased dramatically since that time. Some have suggested that intake of beverages has had a disproportional impact on obesity. Data collected by the Beverage Marketing Corporation between 1988–2008 demonstrate that, in reality, fewer calories per ounce are being produced by the beverage industry. Moreover, data from the National Cancer Institute show that soft drink intake represents 5.5% of daily calories. Data from NHANES 1999–2003 vs. 2003–06 may demonstrate a shift in beverage consumption for age/gender groups, ages 6 to N 60 years. The beverages provided in schools have significantly changed since 2006 when the beverage industry implemented School Beverage Guidelines. This voluntary action has removed full-calorie soft drinks from participating schools across the country. This shift to lower-calorie and smaller-portion beverages in school has led to a significant decrease in total beverage calories in schools. These data support the concept that to prevent and treat obesity, public health efforts should focus on energy balance and that a narrow focus on sweetened beverages is unlikely to have any meaningful impact on this complex problem. © 2010 Elsevier Inc. All rights reserved.
1. Introduction This paper discusses trends in food and beverage production, energy intake, food and beverage consumption, as well as the progress made in the nationwide implementation of voluntary School Beverage Guidelines, which removed full-calorie soft drinks from vending machines in schools.
2. Trends In Energy Production In The Food Supply Beginning in 1909, the U.S. Department of Agriculture's (USDA) Economic Research Service (ERS) has tracked food and nutrients “available for consumption” at the national level. The food availability (per capita) data system serves as an upper-bound proxy for actual food intake by consumers. The agency adjusts its estimates of total food availability for non-edible food parts and food lost through spoilage, plate waste, and other losses in the home and throughout the marketing system. A recent paper by Hall and associates describes a ∼50% increase in food waste since the 1970s. [1] During the last three decades, data from the USDA ERS suggest that, adjusted for spoilage and other waste, total kilocalorie avail⁎ Tel.: +1 202 463 6759; fax: +1 202 463 8172. E-mail address: [email protected]. 0031-9384/$ – see front matter © 2010 Elsevier Inc. All rights reserved. doi:10.1016/j.physbeh.2010.02.009
ability per capita per day increased almost 28% from 1970 to 2006, going from 2,172 available kilocalories per capita per day (available kcal/cap/d) in 1970 to 2,775 available kcal/cap/d in 2007 — a difference of 600 available kcal/cap/d. [2] Examining the various food commodities that have contributed to the increase in available energy, added fats and oils increased 73% (411 to 710 available kcal/cap//d) between 1970 and 2007, followed by grains1 that increased by 45% (432 to 629 kcal/cap/d) in this same time period. Available kcal/cap/d from added sugars2 increased 14% (402 to 459 available kcal/cap/d) and (the combined category of) meat, eggs, and nuts increased 6% (448 to 476 available kcal/cap/d). Percent of available energy from added fats increased 35%, but percent of available energy from added sugars declined 11% (Fig. 1).
3. Trends In Energy Consumption While food availability data are only upper-bound proxies for actual consumption, total daily energy intake has increased since the 1970s. [3] Using data from the National Health and Nutrition 1 Defined by ERS as wheat flour (white and whole wheat flour, durum flour, and wheat flour); rice flour; corn products (flour and meal, hominy and grits, cornstarch, and corn products); oat products; barley products; and flour and cereal products. 2 Added sugars are defined by ERS as refined cane and beet sugar, corn sweeteners, edible syrups, and honey.
M. Storey / Physiology & Behavior 100 (2010) 10–14
11
Fig. 1. Percent of total daily per capita calories from U.S. food availability, adjusted for spoilage and other waste.
Examination Survey (NHANES) series,3 Kant and Graubard found that since the 1970s, total energy intake among adult men and women increased by approximately 200 and 300 kilocalories per day (kcal/d), respectively. In addition, energy intake per eating episode also increased by approximately 60 kilocalories. It should be noted that the methodologies used by the National Center for Health Statistics to assess food intake has improved; nevertheless, some of the increase in energy intake appears to be real as opposed to being the result of improved data collection methods. Scientists from the National Cancer Institute (NCI) of the National Institutes of Health analyzed data from NHANES to identify the contributions of various foods to intake of energy and selected nutrients in the US population age 2 years and older. [4] Their findings were presented to the 2010 Dietary Guideline Advisory Committee in April, 2009. Briefly, the analysis examined over 4,000 foods providing a broad snapshot of foods and food categories contributing energy, sodium, choline, cholesterol, and selected fatty acids to the American diet. [5] Using dietary intake data from NHANES 2005–06, the scientists catalogued 4,069 discrete food codes representing similar foods — such as, various types of pasta dishes — that were combined to indicate the contribution of distinct food items to intake of the nutrients being studied. The food codes then were sorted into 96 mutually exclusive food categories. Although grain-based desserts, dairy-based desserts, and candy were segregated into separate categories, the NCI scientists reported that grain-based desserts are the number one source of calories in the American diet, contributing 6.5% of energy (Fig. 2). The combination of grain-based desserts, dairy-based desserts (2.8%), and candy (2.1%) contributes over 11% of energy in the American diet. Yeast breads; chicken and chicken mixed dishes contributed 5.9 and 5.6% of the calories in the diet, respectively. Importantly, the combined category of sodas, sports drinks, sweetened bottled water (such as, vitamin waters), and energy drinks, contributed 5.5% of the energy. These data show that 94.5% of energy intake comes from foods and beverages other than the category of soft drinks — as defined by NCI. 4. Trends In Beverage Production The U.S. non-alcoholic liquid refreshment beverage (LRB) market has evolved dramatically in the past 20 years with the introduction of a broader range of caloric options. The Beverage Marketing Corporation (BMC) tracks production of beverages from numerous sources including Adams Business Media; Distilled Spirits Council of the United States; Florida Department of Citrus; International Dairy Foods Association; and U.S. Tea Association. The non-alcoholic LRB catego3 National Health and Nutrition Examination Survey (NHANES) is a series of studies conducted by the National Center for Health Statistics of the Centers for Disease Control and Prevention that assess the health and nutritional status of adults and children in the United States.
ries tracked by BMC include: full-calorie and diet carbonated soft drinks; bottled water; fruit beverages (100% juice and juice drinks); sports beverages; ready-to-drink teas and coffees; value-added water (enhanced and flavored water); and energy drinks. According to BMC data collected between 1988–2008, the share of volume of carbonated soft drinks declined from about 70% to less than 50% between 1988 and 2008. The largest decline in share of volume occurred in the full-calorie carbonated soft drinks market, while share of volume of bottled water rose from 11.1% in 1988 to 29.1% in 2008, representing a 162% increase. With the emergence of the bottled water market and the decline in full-calorie carbonated soft drinks, calories per ounce (cal/oz) produced decreased from 9.0 cal/oz to 6.8 cal/oz, representing a 24.4% decrease over the past 20 years (Fig. 3). [6] The decline in full-calorie carbonated soft drink volume foreshadows the decline in daily calories per capita per day produced (cal/ cap/d). In 2008, cal/cap/d from the carbonated soft drink segment fell below 1988 levels, providing 141.6 cal/cap/d (Fig. 4). This represents less than one 12-ounce can of full-calorie carbonated soft drinks. “Niche” markets of non-alcoholic beverages, such as ready-todrink teas and sports drinks, are consumed less frequently and/or by fewer consumers, therefore, these beverages provide few calories on a per capita per day basis. For example, in 2008, the ready-to-drink tea category provided, on average, less than 12 cal/cap/d; sports drinks contributed 1.6 cal/cap/d in 1988 compared with 9.1 cal/cap/d. 5. Trends In Beverage Consumption Dietary intake data confirm what is being observed in the BMC data and the NCI analyses. Americans of all ages are beginning to change their beverage consumption habits. [7] Using dietary intake data from NHANES 2003–2006, we contrasted those data with those of a similar study published in the Journal of the American Dietetic Association in 2006 using data from NHANES 1999–2002. [8] The methods of analysis, age/gender categories, and beverage categories in both studies were similar and are described in detail in the 2006 published paper. The data were from the Public-Use Data Files of the Center for Disease Control and Prevention's National Center for Health Statistics for NHANES 2003–2004 and 2005–2006 and were analyzed for the following age–gender categories: 6–11 years (y), 12–19 y, 20– 39 y, 40–59 y, and 60+ y for males and females. Beverage consumption was calculated using individual food files. Based on the U.S. Department of Agriculture coding system, each beverage was identified with a code corresponding to the following beverage categories: fruit juices, fluid milk, coffee, tea, regular (full-calorie) fruit drinks and ades, low-energy fruits drinks and ades, full-calorie carbonated soft drinks, and diet carbonated soft drinks. The beverages were then aggregated to the individual level and merged with the demographic data. The updated analysis showed that, in contrast with NHANES 1999– 2002, average intake of full-calorie (or regular) carbonated soft
12
M. Storey / Physiology & Behavior 100 (2010) 10–14
Fig. 2. Food sources of energy, based on analysis conducted by the National Cancer Institute.
drinks, fruit juices, and milk products decreased among most age/ gender groups; however, in many age-gender groups, average intakes of diet carbonated soft drinks and regular and low-energy fruit drinks and ades increased (manuscript in preparation).
6. School Beverage Guidelines In 2006, a voluntary nationwide policy was adopted by the American Beverage Association and its member companies (The Coca Cola Company, Pepsico, and Dr Pepper Snapple Group [formerly, Cadbury Schweppes]) and their bottlers to change the product mix of beverages sold in vending machines in schools (www.schoolbeverages.com). These three companies and their bottlers represent about 90% of the
Fig. 3. Calories per ounce produced in the U.S. non-alcoholic liquid refreshment beverage market.
school market that nationwide consists of 125,000 schools and over 54 million students. Specifically, the national School Beverage Guidelines call for the removal of full-calorie carbonated soft drinks in elementary, middle, and high schools (Table 1). The guidelines provide for only bottled water, 100% juice, and low- or no-fat milk for elementary and middle school students in portion-controlled sizes. For example, in elementary schools, up to eight ounces of fat-free and low-fat milk and 100% juice may be sold, whereas up to 10 ounces of these beverages may be sold in middle schools. In high schools, low calorie and diet beverages are permitted as well as some beverages that are below a calorie cap. Fat-free and low-fat milk, 100% juices, and certain other calorie-controlled beverages may be sold in containers up to 12 ounces. At the completion of the second year of the three-year implementation, Keybridge Research, LLC — an independent economics firm — evaluated the changes in calories, volume of beverages accessible to students, and product mix of beverages shipped to U.S. schools using the 2004 as the baseline and tracking implementation in the 2006–07 and 2007–08 school years. [9] The data show that the beverage producers and their bottlers exceeded the agreed-upon commitments during the first two years of the three-year implementation of the School Beverage Guidelines. Total shipments of beverages to schools declined 43% between 2004 and the 2007–08 school year. Total calories from all beverages and calories from full-calorie carbonated soft drinks delivered to schools declined by 58% and 65%, respectively, during that time period (Fig. 5). Considering the agreed-upon three-year implementation timeline, the gains made during the first two years are particularly noteworthy given the challenges associated with educating and training bottlers and school administrators, revising financial arrangements between bottlers and schools, reconfiguring product lines, and retrofitting equipment to accept smaller container sizes. These results confirm that beverage companies and their bottlers are committed to promoting a
M. Storey / Physiology & Behavior 100 (2010) 10–14
13
Fig. 4. Calories per capita per day produced of carbonated soft drinks and fruit beverages.
healthy school environment. Data from the third and final year of implementation will be released in early March, 2010. 7. Conclusions Collectively, the food availability data show that total energy production and, in particular, added fats and oils have increased dramatically since the 1970s. Added sugars availability has increased to a lesser extent and the percent calories from added sugars has
Table 1 The national School Beverage Guidelines provide the following beverages. Elementary Schools • Bottled water; • Up to 8 ounce servings of milk and 100% juice. ° Fat-free or low-fat regular and flavored milk and nutritionally equivalent (per USDA) milk alternatives with up to 150 calories/ 8 ounces ° 100% juice with no added sweeteners, up to 120 calories / 8 ounces, and with at least 10% of the recommended daily value for three or more vitamins and minerals Middle Schools • Same as elementary school, except juice and milk may be sold in 10 ounce servings; • As a practical matter, if middle school and high school students have shared access to areas on a common campus or in common buildings, then the school community has the option to adopt the high school standard.
declined while obesity has continued to rise. Total energy intake among adults has increased over the last few decades. Grain-based desserts are the number one source of energy and all desserts (grainand dairy-based desserts and candy) contribute over 11% of energy to the American diet. Importantly, full-calorie carbonated soft drink production has decreased with a concomitant decrease in calories per unit produced. Publicly available NHANES data suggest that consumption of full-calorie carbonated soft drinks among most age and gender groups has declined while obesity has risen. For its part, the non-alcoholic beverage industry has created new reduced and zero calorie products that are changing what consumers choose to drink. To deal with the special case of beverages consumed in the school environment, the non-alcoholic beverage industry established, implemented, tracked, and publicly reported on the voluntary changes that effectively reduced beverage calories available during the school day.
Acknowledgement The author is employed by the American Beverage Association, which is a trade association representing the non-alcoholic refreshment beverage industry. The product categories represented by ABA include: carbonated soft drinks; fruit juices and juice drinks; ready-todrink teas and coffees; sports drinks; energy drinks; flavored and vitamin-enhanced waters; and bottled water.
High Schools • Bottled water; • No- or low-calorie beverages with up to 10 calories / 8 ounces; • Up to 12 ounce servings of milk, 100% juice and certain other drinks; ° Fat-free or low-fat regular and flavored milk and nutritionally equivalent (per USDA) milk alternatives with up to 150 calories / 8 ounces ° 100% juice with no added sweeteners, up to 120 calories / 8 ounces, and with at least 10% of the recommended daily value for three or more vitamins and minerals ° Other drinks with no more than 66 calories / 8 ounces • At least 50% of non-milk beverages must be water and no- or low-calorie options. Time of Day • These guidelines apply to all beverages sold on school grounds during the regular and extended school day; • The extended school day includes before and after school activities like clubs, yearbook, band, student government, drama and childcare/latchkey programs; • These guidelines do not apply to school-related events where parents and other adults are part of an audience or are selling beverages as boosters during intermission, as well as immediately before or after an event. Examples of these events include school plays and band concerts.
Fig. 5. Percent change in beverage calories and calories from full-calorie CSDs shipped to schools: 2004 vs. 2006–07 and 2007–08 school years.
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