Effectiveness of school-based approaches for reduction of sugar and sugar-sweetened beverages in children: a systematic review and meta-analysis.

OBJECTIVE

To verify the effectiveness of school-based interventions (SBI) aimed at reducing sugar-sweetened beverage (SSB) consumption among children to create or enhance public health initiatives.

BACKGROUND

An important source of sugar consumption is SSBs, which are defined as any consumable non-alcoholic water-based beverage containing considerable amounts of free sugars. A growing number of people are using SSBs as their main source of sugar. Obesity and overweight in children and adolescents is a serious public health concern. The frequent consumption of excess amounts of SSBs is a risk factor for obesity, type 2 diabetes, cardiovascular disease and dental caries. The majority of earlier studies have concentrated on the association between SSB intake and obesity, regulatory and policy initiatives on SSB purchase and consumption. Numerous behavioural interventions have been reported to target the reduction of sugary drink consumption among children; however, there is a lack of conclusive evidence regarding their effectiveness. We aimed to evaluate the effectiveness of SBI on the factors that influence the reduction of sugary beverage consumption in a school setting.

MATERIAL AND METHODS

Systematic review of school-based interventions involving children.

SETTING

The following databases were investigated: MEDLINE/PubMed, PsycINFO, CINAHL and EMBASE.

RESULTS

A total of forty-seven studies were included in the review. Most of the studies were found to be of moderate quality. All of the interventions, irrespective of whether they targeted individuals, their environment or both, were effective in decreasing SSB consumption.

CONCLUSIONS

School-based interventions have demonstrated encouraging outcomes in decreasing sugary soft drink intake among teenagers. Several recommendations are made to improve future studies. The included trials demonstrated a moderate quality of evidence, suggesting that educational and behavioural interventions yielded only a modest effect in reducing sugar-sweetened beverage (SSB) consumption.

© 2025. The Author(s), under exclusive licence to British Dental Association.