Sugar-sweetened beverage intake and relative weight gain among South African adults living in resource-poor communities: longitudinal data from the STOP-SA study

Okop, K. J. and Lambert, E. V. and Alaba, O. and Levitt, N. S. and Luke, A. and Dugas, L. and Dover, R. V. H. and Kroff, J. and Micklesfield, L. K. and Kolbe-Alexander, T. L. and Warren, Smit and Dugmore, H. and Bobrow, K. and Odunitan-Wayas, F. A. and Puone, T. (2018) Sugar-sweetened beverage intake and relative weight gain among South African adults living in resource-poor communities: longitudinal data from the STOP-SA study. International Journal of Obesity. ISSN 0307-0565


Objectives: This study examines the prospective association between sugar-sweetened beverages (SSB) consumption and change in body weight over a 4–5-year period in a socio-economically disadvantaged South African population.

Methods: This is a longitudinal study involving 800 adults (212 men, 588 women); 247 from the original METS (Modelling the Epidemiological Transition Study) cohort (N=504) and 553 of the original 949 members of the PURE (Prospective Urban and Rural Epidemiology) Study. Both cohorts were drawn from low-income, socio-economically disadvantaged communities. Mean follow-up duration and age were 4.5 (SD 0.45) and 50.0 (SD 11.8) years, respectively. Harmonised measurements included body mass index, self-reported moderate-to-vigorous physical activity, and intake of meat, snacks and ‘take-aways’, fruits and vegetables and SSB (in servings/week). Multivariate logistic regression models were developed to determine the extent to which SSB consumption predicted relative weight gain, after controlling for potential confounders and known predictors.

Results: Nearly a third (29%) of participants had a relative weight change ≥5.0%; higher in the non-obese compared to the obese group (32% vs. 25%; p = 0.026). The average SSB consumption was 9.9 servings/week and was higher in the food insecure compared to the food secure group (11.5 vs. 9.0 servings/week; p = 0.006); but there were no differences between women and men (10.3 vs. 9.1 servings/week; p = 0.054). Mean SSB consumption was higher in the group who gained ≥5% weight compared to those who did not (11.0 vs. 8.7; p = 0.004). After adjustment, SSB consumption of 10 or more servings/week was associated with a 50% greater odds of gaining at least 5% body weight (AOR: 1.50, 95% CI (1.05–2.18)).

Conclusion: These results show that higher intake of SSB predicts weight gain in a sample of South Africans drawn from low income settings. Comprehensive, population-wide interventions are needed to reduce SSB consumption in these settings.

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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Additional Information: Published online: 03 October 2018. Permanent restricted access to ArticleFirst version, in accordance with the copyright policy of the publisher.
Faculty/School / Institute/Centre: Current - Faculty of Health, Engineering and Sciences - School of Health and Wellbeing
Date Deposited: 26 Feb 2019 07:46
Last Modified: 28 Feb 2019 04:21
Uncontrolled Keywords: beverages; fructose; fructose intake
Fields of Research : 11 Medical and Health Sciences > 1111 Nutrition and Dietetics > 111199 Nutrition and Dietetics not elsewhere classified
Socio-Economic Objective: C Society > 92 Health > 9204 Public Health (excl. Specific Population Health) > 920401 Behaviour and Health
Identification Number or DOI: 10.1038/s41366-018-0216-9

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