Warning Labels Help Reduce Sugary Drink Intake among College Students

New Study from Cindy Leung and Julia Wolfson

December 9, 2020

Placing warning labels on beverage dispensers might be enough to help college students cut back on sugary drinks, according to a new study.

The study by the University of Michigan School of Public Health and University of California, Davis, found that labels helped reduce consumption by nearly 15%.  

"Warning labels may be effective tools for reducing consumption of sugar-sweetened beverages, particularly beverages such as sweetened teas, pink lemonade and chocolate milk for which the sugar content is not immediately obvious or well known," said lead author Cindy Leung, University of Michigan School of Public Health assistant professor of Nutritional Sciences.

Co-author Julia Wolfson, University of Michigan School of Public Health assistant professor of Health Management and Policy and Nutritional Sciences, said that sugar-sweetened beverages remain ubiquitous in retail and cafeteria settings on college campuses.

"As we explore avenues to promote healthy food and beverage choices, warning labels are a potential tool to reduce their consumption that should be tested in other populations and other settings," she said.

The researchers placed warning labels on beverage dispensers at a University of Michigan cafeteria for one semester in 2019. 

The labels, based on previously proposed California legislation, were bright yellow with a large triangle and exclamation mark stating, "Warning: Drinking beverages with added sugar(s) contributes to type 2 diabetes, heart disease, and tooth decay." 

Two other cafeterias on campus—located geographically distant from the cafeteria with the labels—served as control sites and had no warning labels.

Nearly 1,000 students were contacted by email before and after the warning labels were implemented to ask them to participate in surveys with no specific mention of sugar-sweetened beverages. In all, 840 students across were included in the study. 

At the intervention site, consumption of sugary drinks that had the warning label declined by nearly 19%, compared to a decline of about 5% at the control sites. Students exposed to the warning labels also reduced their 100% fruit juice consumption by 21% even though in the experiment they had not been labeled as sugar-sweetened beverages.

Jennifer Falbe, assistant professor of nutrition and human development at UC Davis, designed the warning label used in the study.

"These results provide evidence to inform future institutional strategies ... and legislative efforts to use warning labels as a promising approach to SSB consumption," she said, adding that nine states, including California, have introduced sugar-sweetened beverage warning label legislation. "These laws could ensure that consumers have the necessary information to make informed choices." 

Co-author Keith Soster, director of student engagement for Michigan Dining, agreed.

"College is a great time to educate students on healthy eating and beverage consumption. We hope to aid in building habits that will last a lifetime," he said.

Co-author Steve Manga, director of Michigan Dining, said "the study will help inform future adjustments to our beverage program as we explore  healthier options for our customers." 

The study was published in the Journal of Nutrition. Other authors include Keith Soster, Robert Hsu and Steve Mangan, all of the University of Michigan. 

Funding for the research came from a grant from the University of Michigan Poverty Solutions; the McNerney Award from the University of Michigan Department of Health Management and Policy; the National Institutes of Health: Eunice Kennedy Shriver National Institute of Child Health and Human Development grant 4R00HD084758; and the National Institute of Diabetes and Digestive and Kidney Diseases grants K01DK119166 and K01DK113068. 

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