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. 2019 Feb 1:133:130-137.
doi: 10.1016/j.appet.2018.10.032. Epub 2018 Oct 29.

Potentially addictive properties of sugar-sweetened beverages among adolescents

Jennifer Falbe  1 , Hannah R Thompson  2 , Anisha Patel  3 , Kristine A Madsen  4
Affiliations

Potentially addictive properties of sugar-sweetened beverages among adolescents

Jennifer Falbe et al. Appetite. .

Abstract

Sugar-sweetened beverages (SSBs) increase risk of cardiometabolic disease. Young people consume the largest amounts of SSBs and have experienced the greatest relative gains in obesity in the past several decades. There is evidence of addictive properties of both caffeine and sugar, the primary ingredients in SSBs, but little research into such properties of SSBs in naturally occurring consumption patterns. Thus, in this exploratory study, we sought to examine potentially addictive properties of SSBs during a 3-day SSB cessation intervention in overweight and obese adolescents who typically consume ≥3 SSBs daily. Participants (n = 25) were aged 13-18 years, mostly female (72%), and African American (56%) or Hispanic (16%) with a BMI≥95th percenttile (76%). Withdrawal symptoms and SSB craving were assessed approximately 1-week apart, during both regular SSB consumption and a 3-day period of SSB cessation in which participants were instructed to drink only plain milk and water. During SSB cessation, adolescents reported increased SSB cravings and headache and decreased motivation, contentment, ability to concentrate, and overall well-being (uncorrected Ps < 0.05). After controlling the false discovery rate, changes in motivation, craving, and well-being remained significant (corrected Ps < 0.05). Using 24-hr recalls and drink journals, participants reported lower total daily consumption of sugar (-80 g) and added sugar (-16 g) (Ps < 0.001) during cessation. This study provides preliminary evidence of withdrawal symptoms and increased SSB cravings during cessation in a diverse population of overweight or obese adolescents.

Keywords: Addiction; Adolescence; Craving; Obesity; Sugar-sweetened beverages; Withdrawal.

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Figures

Figure 1.
Figure 1.
Study timeline
Figure 2.
Figure 2.
Participant flow
Figure 3.
Figure 3.. Daily check-in questions assessing symptoms of withdrawal at regular intervals during usual intake and SSB cessation phases (n=24)
*P<0.05, **P<0.01, and ***P<0.01 uncorrected for multiplicity for differences between the usual intake and SSB cessation phases. ¥ Benjamini-Hochberg corrected P-value<0.05. Plots show average responses at each time point as well as error bars for 95% CIs. CIs and post hoc pairwise contrasts between each time point were estimated using the margins and pwcompare commands in STATA for postestimation after fitting generalized linear regression models containing indicators for each time point with robust (Huber-White sandwich) standard errors. Usual intake phase responses at each time were averaged across days to serve as the comparisons for each time/day of cessation. Full results are reported in Table S2. Questions and 10-point response scale anchors: (A) How do you feel? 1 (really bad) – 10 (really good); (B) How much do you want your favorite sugar-sweetened beverage right now? 1 (I don’t want at all) – (I really want); (C) How tired are you? 1 (not tired at all) – 10 (really tired); (D) How irritable are you? 1 (not at all irritable) – 10 (really irritable).
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