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含糖饮料的健康危害及控制策略研究进展

泰然健康网
2024-12-07 07:37

摘要:

近几十年来，全球含糖饮料（SSBs）生产和消费呈增长趋势。我国居民SSBs摄入量不断增加，儿童青少年群体更为普遍。随着研究的不断深入，除世界卫生组织（WHO）报道增加龋齿和超重肥胖风险外，研究发现SSBs摄入还可增加糖尿病、心血管疾病、痛风、癌症等慢性病发生和早死的风险，加重疾病负担。基于SSBs过多摄入的健康危害，世界许多国家采取相关措施控制其摄入。目前主要采取的措施为SSBs征税、限制SSBs市场宣传和营销、SSBs包装上使用正面标签标识以及减少学校内的SSBs供应等。我国目前主要的措施为学校环境内饮料售卖管控，有地区率先应用酒精饮料和碳酸饮料健康提示标识，将控制SSBs摄入措施扩展到了校园之外。

Abstract:

The global production and consumption of sugar-sweetened beverages (SSBs) has been on the rise in recent decades. The intake of SSBs has been increasing in China, and it is more prevalent among children and adolescents. As research continues to intensify, more and more studies have shown that, in addition to the increased risks of dental caries and obesity reported by the World Health Organization (WHO), SSBs intake can also increase risks of chronic diseases such as diabetes, cardiovascular disease, gout, and cancer, and early death, adding to the burden of disease. Due to the health risks associated with the overconsumption of SSBs, many countries around the world have taken measures to control the intake. The main measures currently in place are taxation of SSBs, restrictions on marketing and sales of SSBs, front-of-package labeling and reducing availability of SSBs in schools. In China, the main measures currently in place are to control the sales of beverages in schools, with Shenzhen taking the lead in implementing health warning labeling to alcoholic beverages and carbonated beverages, extending the measures to reduce SSBs intake beyond school grounds.

[1]

POPKIN B M, HAWKES C. Sweetening of the global diet, particularly beverages: patterns, trends, and policy responses[J]. Lancet Diabetes Endocrinol, 2016, 4(2): 174-186. doi: 10.1016/S2213-8587(15)00419-2

[2]

World Health Organization. Guideline: Sugars intake for adults and children[R]. Geneva: World Health Organization, 2015: 4-20.

[3] 张继国, 王志宏, 黄绯绯, 等. 1991~2018年中国儿童青少年膳食模式的变迁[J]. 营养学报, 2021, 43(3): 213-217. doi: 10.3969/j.issn.0512-7955.2021.03.002

ZHANG J G, WANG Z H, HUANG F F, et al. Changing trends in dietary patterns among Chinese children and adolescents from 1991 to 2018[J]. Acta Nutr Sin, 2021, 43(3): 213-217. doi: 10.3969/j.issn.0512-7955.2021.03.002

[4] 郑梦琪, 张建芬, 何海蓉, 等. 对我国含糖饮料征税的SWOT分析[J]. 中国食物与营养, 2017, 23(5): 38-41. doi: 10.3969/j.issn.1006-9577.2017.05.009

ZHENG M Q, ZHANG J F, HE H R, et al. SWOT analysis on tax on sugary beverages in China[J]. Food Nutr China, 2017, 23(5): 38-41. doi: 10.3969/j.issn.1006-9577.2017.05.009

[5] 郭海军赵丽云, 许晓丽, 等. 2010-2012年中国18岁及以上成人含糖饮料消费状况[J]. 卫生研究, 2018, 47(1): 22-26.

GUO H J, ZHAO L Y, XU X L, et al. Consumption of sugar-sweetened beverages among 18 years old and over adults in 2010-2012 in China[J]. J Hyg Res, 2018, 47(1): 22-26.

[6] 潘峰, 栾德春, 张彤薇, 等. 我国3岁及以上城市居民含糖饮料消费状况及其游离糖摄入评估[J]. 中国食品卫生杂志, 2022, 34(1): 126-130.

PAN F, LUAN D C, ZHANG T W, et al. Assessment of sugar-sweetened beverages consumption and free sugar intake among urban residents aged 3 and above in China[J]. Chin J Food Hyg, 2022, 34(1): 126-130.

[7] 中国营养学会. 中国居民膳食指南(2022)[M]. 北京: 人民卫生出版社, 2022: 103-104.

Chinese Nutrition Society. Dietary guidelines for Chinese residents (2022)[M]. Beijing: People's Health Press, 2022: 103-104.

[8]

PARK S, LIN M, ONUFRAK S, et al. Association of sugar-sweetened beverage intake during infancy with dental caries in 6-year-olds[J]. Clin Nutr Res, 2015, 4(1): 9-17. doi: 10.7762/cnr.2015.4.1.9

[9]

HOOLEY M, SKOUTERIS H, MILLAR L. The relationship between childhood weight, dental caries and eating practices in children aged 4-8 years in Australia, 2004-2008[J]. Pediatr Obes, 2012, 7(6): 461-470. doi: 10.1111/j.2047-6310.2012.00072.x

[10] 韩霞, 严菊花, 罗晓明, 等. 昆山市3305名学龄前儿童龋齿影响因素分析[J]. 中国儿童保健杂志, 2010, 18(8): 659,680.

HAN X, YAN J H, LUO X M, et al. Analysis of the factors affecting dental caries in 3305 preschool children in Kunshan[J]. Chin J Child Health, 2010, 18(8): 659,680.

[11]

BERNABÉ E, VEHKALAHTI M M, SHEIHAM A, et al. Sugar-sweetened beverages and dental caries in adults: a 4-year prospective study[J]. J Dent, 2014, 42(8): 952-958. doi: 10.1016/j.jdent.2014.04.011

[12] 丁彩翠, 郭海军, 宋超, 等. 含糖饮料消费与肥胖及体重改变关系的Meta分析[J]. 中国慢性病预防与控制, 2015, 23(7): 506-511.

DING C C, GUO H J, SONG C, et al. Relationship between intake of sugar-sweetened beverages and obesity or weight gain: A Meta-analysis[J]. Chin J Prev Contr Chron Dis, 2015, 23(7): 506-511.

[13]

LUGER M, LAFONTAN M, BES-RASTROLLO M, et al. Sugar-sweetened beverages and weight gain in children and adults: a systematic review from 2013 to 2015 and a comparison with previous studies[J]. Obes Facts, 2017, 10(6): 674-693. doi: 10.1159/000484566

[14]

MALIK V S, PAN A, WILLETT W C, et al. Sugar-sweetened beverages and weight gain in children and adults: a systematic review and meta-analysis[J]. Am J Clin Nutr, 2013, 98(4): 1084-1102. doi: 10.3945/ajcn.113.058362

[15]

WOLF A, BRAY G A, POPKIN B M. A short history of beverages and how our body treats them[J]. Obes Rev, 2008, 9(2): 151-164. doi: 10.1111/j.1467-789X.2007.00389.x

[16]

SAEEDI P, PETERSOHN I, SALPEA P, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition[J]. Diabetes Res Clin Pract, 2019, 157: 107843. doi: 10.1016/j.diabres.2019.107843

[17]

SCHULZE M B, LIU S M, RIMM E B, et al. Glycemic index, glycemic load, and dietary fiber intake and incidence of type 2 diabetes in younger and middle-aged women[J]. Am J Clin Nutr, 2004, 80(2): 348-356. doi: 10.1093/ajcn/80.2.348

[18]

IMAMURA F, O'CONNOR L, YE Z, et al. Consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice and incidence of type 2 diabetes: systematic review, meta-analysis, and estimation of population attributable fraction[J]. BMJ, 2015, 351: h3576.

[19]

MALIK V S, POPKIN B M, BRAY G A, et al. Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes: a meta-analysis[J]. Diabetes Care, 2010, 33(11): 2477-2483. doi: 10.2337/dc10-1079

[20]

DROUIN-CHARTIER J P, ZHENG Y, LI Y P, et al. Changes in consumption of sugary beverages and artificially sweetened beverages and subsequent risk of type 2 diabetes: results from three large prospective U. S. cohorts of women and men[J]. Diabetes Care, 2019, 42(12): 2181-2189. doi: 10.2337/dc19-0734

[21]

SHANGGUAN S, MOZAFFARIAN D, SY S, et al. Health impact and cost-effectiveness of achieving the national salt and sugar reduction initiative voluntary sugar reduction targets in the United States: a microsimulation study[J]. Circulation, 2021, 144(17): 1362-1376. doi: 10.1161/CIRCULATIONAHA.121.053678

[22]

PACHECO L S, LACEY J V JR, MARTINEZ M E, et al. Sugar-sweetened beverage intake and cardiovascular disease risk in the california teachers study[J]. J Am Heart Assoc, 2020, 9(10): e014883. doi: 10.1161/JAHA.119.014883

[23]

MALIK V S, HU F B. The role of sugar-sweetened beverages in the global epidemics of obesity and chronic diseases[J]. Nat Rev Endocrinol, 2022, 18(4): 205-218. doi: 10.1038/s41574-021-00627-6

[24]

HUR J, OTEGBEYE E, JOH H K, et al. Sugar-sweetened beverage intake in adulthood and adolescence and risk of early-onset colorectal cancer among women[J]. Gut, 2021, 70(12): 2330-2336. doi: 10.1136/gutjnl-2020-323450

[25]

CHAZELAS E, SROUR B, DESMETZ E, et al. Sugary drink consumption and risk of cancer: results from NutriNet-Santé prospective cohort[J]. BMJ, 2019, 366: l2408.

[26]

BASSETT J K, MILNE R L, ENGLISH D R, et al. Consumption of sugar-sweetened and artificially sweetened soft drinks and risk of cancers not related to obesity[J]. Int J Cancer, 2020, 146(12): 3329-3334. doi: 10.1002/ijc.32772

[27]

CHOI H K, WILLETT W, CURHAN G. Fructose-rich beverages and risk of gout in women[J]. JAMA, 2010, 304(20): 2270-2278. doi: 10.1001/jama.2010.1638

[28]

CHOI H K, CURHAN G. Soft drinks, fructose consumption, and the risk of gout in men: prospective cohort study[J]. BMJ, 2008, 336(7639): 309-312. doi: 10.1136/bmj.39449.819271.BE

[29]

AYOUB-CHARETTE S, LIU Q, KHAN T A, et al. Important food sources of fructose-containing sugars and incident gout: a systematic review and meta-analysis of prospective cohort studies[J]. BMJ Open, 2019, 9(5): e024171. doi: 10.1136/bmjopen-2018-024171

[30]

MALIK V S, LI Y P, PAN A, et al. Long-term consumption of sugar-sweetened and artificially sweetened beverages and risk of mortality in US adults[J]. Circulation, 2019, 139(18): 2113-2125. doi: 10.1161/CIRCULATIONAHA.118.037401

[31]

MULLEE A, ROMAGUERA D, PEARSON-STUTTARD J, et al. Association between soft drink consumption and mortality in 10 European countries[J]. JAMA Intern Med, 2019, 179(11): 1479-1490. doi: 10.1001/jamainternmed.2019.2478

[32]

HE Y N, LI Y P, YANG X G, et al. The dietary transition and its association with cardiometabolic mortality among Chinese adults, 1982-2012: a cross-sectional population-based study[J]. Lancet Diabetes Endocrinol, 2019, 7(7): 540-548. doi: 10.1016/S2213-8587(19)30152-4

[33]

LI M, LI X J, ZHAO Y F, et al. The burden of ischemic heart disease and type 2 diabetes mellitus attributable to diet high in sugar-sweetened beverages in China: An analysis for the Global Burden of Disease Study 2017[J]. J Diabetes, 2021, 13(6): 482-493. doi: 10.1111/1753-0407.13132

[34]

IANG Y Y, XU T L, DONG W L, et al. Study on the death and disease burden caused by high sugar-sweetened beverages intake in China from 1990 to 2019[J]. Eur J Public Health, 2022, 32(5): 773-778. doi: 10.1093/eurpub/ckac067

[35]

HÄNDEL M N, HEITMANN B L, ABRAHAMSEN B. Nutrient and food intakes in early life and risk of childhood fractures: a systematic review and meta-analysis[J]. Am J Clin Nutr, 2015, 102(5): 1182-1195. doi: 10.3945/ajcn.115.108456

[36]

KREMER P A, LAUGHLIN G A, SHADYAB A H, et al. Association between soft drink consumption and osteoporotic fractures among postmenopausal women: the Women's Health Initiative[J]. Menopause, 2019, 26(11): 1234-1241. doi: 10.1097/GME.0000000000001389

[37]

WHO. Tackling NCDs: 'best buys' and other recommended interventions for the prevention and control of noncommunicable diseases[R]. Geneva: World Health Organization, 2017.

[38]

World Cancer Research Fund International. Building momentum: lessons on implementing a robust sugar sweetened beverage tax[EB/OL]. 2018. https://www.wcrf.org/policy/our-publications/building-momentum-series/lessons-implementing-robust-sugar-sweetened-beverage-tax.

[39] 付齐齐, 刘爱玲. 关于含糖饮料征税的税种、税率及其影响的分析[J]. 中国食物与营养, 2018, 24(4): 9-13. doi: 10.3969/j.issn.1006-9577.2018.04.002

FU Q Q, LIU A L. The tax types, tax rates and its impact on sugar-sweetened beverages[J]. Food Nutr China, 2018, 24(4): 9-13. doi: 10.3969/j.issn.1006-9577.2018.04.002

[40]

COLCHERO M A, RIVERA-DOMMARCO J, POPKIN B M, et al. In Mexico, evidence of sustained consumer response two years after implementing a sugar-sweetened beverage tax[J]. Health Aff (Millwood), 2017, 36(3): 564-571. doi: 10.1377/hlthaff.2016.1231

[41]

FALBE J, THOMPSON H R, BECKER C M, et al. Impact of the Berkeley excise tax on sugar-sweetened beverage consumption[J]. Am J Public Health, 2016, 106(10): 1865-1871. doi: 10.2105/AJPH.2016.303362

[42]

TAILLIE L S, REYES M, COLCHERO M A, et al. An evaluation of Chile's Law of Food Labeling and Advertising on sugar-sweetened beverage purchases from 2015 to 2017: A before-and-after study[J]. PLoS Med, 2020, 17(2): e1003015. doi: 10.1371/journal.pmed.1003015

[43]

VOLKOVA E, NI MHURCHU C. The influence of nutrition labeling and point-of-purchase information on food behaviours[J]. Curr Obes Rep, 2015, 4(1): 19-29. doi: 10.1007/s13679-014-0135-6

[44]

VYTH E L, STEENHUIS I H, ROODENBURG A J, et al. Front-of-pack nutrition label stimulates healthier product development: a quantitative analysis[J]. Int J Behav Nutr Phys Act, 2010, 7: 65. doi: 10.1186/1479-5868-7-65

[45]

SEYEDHAMZEH S, NEDJAT S, SHAKIBAZADEH E, et al. Nutrition labels' strengths & weaknesses and strategies for improving their use in Iran: A qualitative study[J]. PLoS One, 2020, 15(10): e0241395. doi: 10.1371/journal.pone.0241395

[46]

SANDOVAL L A, CARPIO C E, SANCHEZ-PLATA M. The effect of 'Traffic-Light' nutritional labelling in carbonated soft drink purchases in Ecuador[J]. PLoS One, 2019, 14(10): e0222866. doi: 10.1371/journal.pone.0222866

[47]

WHO. Set of recommendations on the marketing of foods and non-alcoholic beverages to children[M]. Geneva: World Health Organization, 2010.

[48]

HAWKES C, SMITH T G, JEWELL J, et al. Smart food policies for obesity prevention[J]. Lancet, 2015, 385(9985): 2410-2421. doi: 10.1016/S0140-6736(14)61745-1

[49]

TABER D R, CHRIQUI J F, VUILLAUME R, et al. How state taxes and policies targeting soda consumption modify the association between school vending machines and student dietary behaviors: a cross-sectional analysis[J]. PLoS One, 2014, 9(8): e98249. doi: 10.1371/journal.pone.0098249

[50]

THOW A M, HAWKES C. Global sugar guidelines: an opportunity to strengthen nutrition policy[J]. Public Health Nutr, 2014, 17(10): 2151-2155. doi: 10.1017/S1368980014001840

[51]

WHO. Report of the commission on ending childhood obesity[M]. Geneva: WHO, 2016: 18-20.

[52]

WHO. Fiscal policies for diet and prevention of noncommunicable diseases: technical meeting report, 5 - 6 May 2015, Geneva, Switzerland[R]. Geneva: WHO, 2016.