Check the traffic lights!

In many supermarkets, banks of shelves are laden with sugary soft drinks. Indeed soft drinks dominate the beverage market worldwide. Rising consumption of soft drinks is regarded as one of the major factors that are driving the global obesity epidemic, and has been linked to increased risk of diabetes, cardiovascular disease and dental caries. These developments have prompted the World Health Organization to call on politicians, business leaders and society as a whole to design and implement effective ways to wean consumers off their predilection for soft drinks and to support healthier beverage choices.

But what measures are most likely to reduce soft-drink consumption? In collaboration with the Cochrane Network, researchers based at LMU and the Technical University of Munich (TUM) set out to answer this question. They have combed through the published research literature with the aim of identifying those measures that have been empirically shown to be effective in reducing consumption of soft drinks. In doing so, the team focused on measures that target the physical and social environment in which people make beverage choices.

The authors of the review surveyed more than 10,000 published research reports, and identified 58 studies that conformed to their predefined criteria of quality. These investigations were based on work carried out in 14 different countries and involved more than a million participants – children, adolescents and adults.

The review resulted in the identification of a number of measures for which the selected set of studies provides evidence of effectiveness. These include the following:• Use of labels that are easy to understand, such as color coding based on the traffic-light system• Price increases on soft drinks purchased in restaurants, shops and leisure complexes• Restrictions on the availability of soft drinks in schools• Introduction of children’s menus that include healthier beverages as default instead of the soft drinks conventionally offered by many restaurant chains• More favorable placement and better marketing of healthier beverages in supermarkets• Local health campaigns focusing on the deleterious effects of soft drinks• Provision of alternative drinking options at home

“The results of this review are of immediate relevance to politicians in Germany,” says Peter von Philipsborn, lead author of the study and staff scientist at the Institute for Medical Informatics, Biometry and Epidemiology (IBE) and the Pettenkofer School of Public Health at LMU. “The Federal Government in Germany is currently working on a front-of-pack nutrition labelling system. Our review shows that systems using traffic-light color-coding are particularly effective. Moreover, leading medical associations have long argued that soft drinks should not be available in schools. Unfortunately, in Germany we are still a long way from achieving this goal.”

The review highlights measures that should serve as the essential components of a comprehensive strategy that would enable soft-drink consumption to be effectively reduced, says co-author Professor Eva Rehfuess, who holds the Chair of Public Health and Health Services Research at the IBE. “Rates of obesity and diabetes are rising globally”, adds Professor Hans Hauner, Chair of Nutritional Medicine at the TUM. “And this trend will not be reversed without broad and effective action. Governments and industry in particular must do their part to make the healthy choice the easy choice for consumers.”Cochrane Database of Systematic Reviews 2019