Sugary drink warnings: A meta-analysis of experimental studies
Sugary drink warnings: A meta-analysis of experimental studies
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DOI：
10.1371/journal.pmed.1003120
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发表时间：
2020-05-01
期刊：
影响因子：
15.8
通讯作者：
Hall, Marissa G.
中科院分区：
文献类型：
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作者：
Grummon, Anna H.;Hall, Marissa G.
背景世界各地的政策制定者正在考虑要求对含糖饮料发出警告。越来越多的实验研究考察了含糖饮料警告的影响，但据我们所知，还没有研究综合这方面的文献。为了给正在进行的政策辩论提供信息，这项研究旨在确定含糖饮料警告与控制条件相比的影响。方法和发现我们系统地搜索了2019年6月21日和2019年10月25日的7个数据库。我们还搜索了相关文章的参考文献列表。两名研究人员独立筛选了标题、摘要和全文，以确定同行评议的文章，这些文章使用实验方案来检查含糖饮料警告与对照条件的影响。两名研究人员从所有相关全文文章中独立提取研究特征和效果大小。我们对至少2项研究中评估的任何结果进行了荟萃分析，使用随机效应荟萃分析程序结合了效应大小。Meta分析包括23个实验，数据涉及16,241个人(平均比例为女性，58%)。大多数研究是在拉丁美洲(35%)或美国或加拿大(46%)进行的；32%的研究对象是儿童。与对照条件相比，含糖饮料警示引起了更强烈的负面情绪反应(d=0.69；95%CI：0.25，1.13；p=0.002)，并引发了更多关于含糖饮料对健康影响的思考(d=0.65；95%CI：0.29，1.01；p<；0.001)。含糖饮料警示也导致较低的健康感知(d=-0.22；95%CI：-0.27，-0.17；p<；0.001)和较强的疾病可能性感知(d=0.15；95%CI：0.06，0.24；p=0.001)。此外，含糖饮料警告减少了假想(d=-0.32；95%CI：-0.44，-0.21；p<；0.001)和实际消费和购买行为(d=-0.17；95%CI：-0.3，-0.04；p=0.012)。对于添加糖或积极的含糖饮料态度，没有观察到统计学上的显著影响(P‘s>；0.10)。适度分析显示，健康警示(例如，“含糖饮料会导致肥胖”)导致的假设性含糖饮料购买量比营养警示(例如，“高糖”；d=-0.35对-0.18；q(B)=4.04；p=0.04)的降幅更大。这项研究的局限性包括我们没有回顾灰色文献，而且由于研究数量不足，我们无法对几个预先指定的主持人进行适度分析。结论这一国际性的实验文献支持将含糖饮料警告作为改变行为以及情绪、感知和意图的人群水平的策略。
BackgroundPolicymakers worldwide are considering requiring warnings for sugary drinks. A growing number of experimental studies have examined sugary drink warnings' impacts, but no research to our knowledge has synthesized this literature. To inform ongoing policy debates, this study aimed to identify the effects of sugary drink warnings compared with control conditions.Methods and findingsWe systematically searched 7 databases on June 21, 2019, and October 25, 2019. We also searched reference lists of relevant articles. Two investigators independently screened titles, abstracts, and full texts to identify peer-reviewed articles that used an experimental protocol to examine the effects of sugary drink warnings compared to a control condition. Two investigators independently extracted study characteristics and effect sizes from all relevant fulltext articles. We meta-analyzed any outcome assessed in at least 2 studies, combining effect sizes using random effects meta-analytic procedures. Twenty-three experiments with data on 16,241 individuals (mean proportion female, 58%) were included in the meta-analysis. Most studies took place in Latin America (35%) or the US or Canada (46%); 32% included children. Relative to control conditions, sugary drink warnings caused stronger negative emotional reactions (d = 0.69; 95% CI: 0.25, 1.13; p = 0.002) and elicited more thinking about the health effects of sugary drinks (d = 0.65; 95% CI: 0.29, 1.01; p < 0.001). Sugary drink warnings also led to lower healthfulness perceptions (d = -0.22; 95% CI: -0.27, -0.17; p < 0.001) and stronger disease likelihood perceptions (d = 0.15; 95% CI: 0.06, 0.24; p = 0.001). Moreover, sugary drink warnings reduced both hypothetical (d = -0.32; 95% CI: -0.44, -0.21; p < 0.001) and actual consumption and purchasing behavior (d = -0.17; 95% CI: -0.30, -0.04; p = 0.012). Statistically significant effects were not observed for perceptions of added sugar or positive sugary drink attitudes (p's > 0.10). Moderation analyses revealed that health warnings (e.g., "Beverages with added sugar contribute to obesity") led to greater reductions in hypothetical sugary drink purchases than did nutrient warnings (e.g., "High in sugar"; d = -0.35 versus -0.18; Q(b) = 4.04; p = 0.04). Limitations of this study include that we did not review grey literature and that we were unable to conduct moderation analyses for several prespecified moderators due to an insufficient number of studies.ConclusionsThis international body of experimental literature supports sugary drink warnings as a population-level strategy for changing behavior, as well as emotions, perceptions, and intentions.