title: A systematic review investigating interventions that can help reduce consumption of sugar-sweetened beverages in children leading to changes in body fatness.
abstract: BACKGROUND
  Both the prevalence of childhood obesity and the consumption of sugar-sweetened beverages (SSBs) have increased globally. The present review describes interventions that reduce the consumption of SSBs in children and determines whether this leads to subsequent changes in body fatness.
  
  
  METHODS
  Three databases were searched from 2000 to August 2013. Only intervention control trials, ≥6 months in duration, which aimed to reduce the consumption of SSBs in >100 children aged 2-18 years, and reporting changes in body fatness, were included. The quality of selected papers was assessed.
  
  
  RESULTS
  Eight studies met inclusion criteria. Six interventions achieved significant (P < 0.05) reductions in SSB intake, although this was not always sustained. In the two interventions providing replacement drinks, significant differences in body mass index (12- or 18-month follow-up) were reported (P = 0.001 and 0.045). The risk of being overweight/obesity was reduced (P < 0.05) in three of the five education programmes but in one programme only for girls who were overweight at baseline and in one programme only for pupils perceived to be at greater risk at baseline. In the one study that included both provision of water and education, the risk of being overweight was reduced by 31% (P = 0.04) in the intervention group.
  
  
  CONCLUSIONS
  The evidence suggests that school-based education programmes focusing on reducing SSB consumption, but including follow-up modules, offer opportunities for implementing effective, sustainable interventions. Peer support and changing the school environment (e.g. providing water or replacement drinks) to support educational programmes could improve their effectiveness. Home delivery of more suitable drinks has a big impact on reducing SSB consumption, with associated reductions in body weight.
authors.affiliation: Division of Nutritional Sciences, University of Nottingham, Leics, UK.
authors.forename: A
authors.initials: A
authors.lastname: Avery
authors.forename: L
authors.initials: L
authors.lastname: Bostock
authors.forename: F
authors.initials: F
authors.lastname: McCullough
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism*; D001628:Beverages; D001823:Body Composition; D002648:Child; D004032:Diet; D019422:Dietary Sucrose / Q000008:administration & dosage* / Q000009:adverse effects; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000209:etiology / Q000517:prevention & control*; D012574:Schools; D013549:Sweetening Agents
chemical_list: D019422:Dietary Sucrose; D013549:Sweetening Agents
keywords: childhood obesity; dietary intervention; public health; sugar sweetened beverages; systematic review