Residents of Howard County, Maryland bought fewer sugary drinks compared to residents in a control community after extensive community engagement, a media campaign, and policy changes — according to a study by the Rudd Center for Food Policy and Health at the University of Connecticut.
The study, published Wednesday in AJPM Focus, tracked supermarket sales data to measure the effectiveness of the community-led campaign which was designed to reduce consumption of sugary drinks, the largest source of calories and sugar in our diets. The researchers compared sales data in 2012, before the campaign began, to sales data for each successive year and found notable declines in purchases over the six-year period.
Over the first six years of the campaign, there was a:
- 7% decrease in soda sales;
- 5% drop in fruit drink sales; and
- 5% drop in 100% fruit juice sales.
In addition, to see if residents were making a change from sugar-sweetened beverages to water, the team also examined sales of plain water from 2016 to 2018. Overall, the amount of plain water sold in Howard County significantly increased by 81.4 ounces per week.
“This is one of the most sustained and comprehensive community led efforts to decrease sugary drink consumption in the country,” says Marlene Schwartz, Director of the UConn Rudd Center for Food Policy and Health, professor in the Department of Human Development and Family Sciences, and the study’s lead author. “Howard County has a foundation that is exclusively focused on the health of its residents and the foundation decided to invest in addressing sugary drink consumption back in 2012. They knew from the research and consulting with the experts that it was a concrete target. They knew if you could make a change there, it can really have a lot of positive effects on diet quality, risk of obesity, and Type 2 diabetes.”
The Horizon Foundation—an organization focused on improving the health of people living in Howard County—and several community partners launched the Howard County Unsweetened campaign in 2012 to encourage local residents to reduce their consumption of sugary drinks including sodas, sports drinks, energy drinks, fruit drinks, flavored waters, and sweetened teas. Daily consumption of at least one sugary drink is associated with significantly increased risks for chronic diseases like heart disease, some cancers, stroke, diabetes, and obesity.
“Sugary drink sales are down and water consumption is up. These are early indicators of a healthier nutrition environment in Howard County, though more work needs to be done,” says Nikki Highsmith Vernick, president and CEO of the Horizon Foundation. “We are grateful to our partners in this campaign and look forward to continuing our joint work to improve the health of county residents.”
Howard County Unsweetened partners successfully pursued policy changes including strengthening the school system’s wellness policy to eliminate sugary drinks in student-accessible vending machines and increasing access to water; enacting a 2014 state law prohibiting licensed childcare centers from serving sugary drinks to children in their care and encouraging breastfeeding; enacting a 2015 local law making healthier food and drinks more widely available on local government property; and engaging nearly 50 community organizations in the effort to improve the food and beverage choices they offer at meetings and in vending machines. These organizations included faith communities, health groups, businesses, and nonprofits.
Community-wide public health outreach efforts included:
- Marketing such as TV ads, social media messages, and online ads.
- Directly educating parents and kids about the risks associated with daily sugary drink intake at community and athletic events, local swimming pools, and health fairs.
- Training of healthcare professionals to improve patient counseling on the dangers of sugary drink consumption and the diagnosis and treatment of children with obesity.
In determining the campaign’s impact, researchers compared weekly beverage sales of top-selling brands in 15 Howard County supermarkets with a matched group of 17 supermarkets in southeastern Pennsylvania. The study did not include sales data from non-supermarket vendors such as convenience stores or restaurants, but other research shows most sugary drinks are most commonly purchased from supermarkets. The Horizon Foundation funded the study.
“These local health foundations exists all over the country and there is a lot of work that can be done by local health departments and other non-profits,” says Schwartz. “This really shows it can make a difference. I think sometimes it feels like you are fighting this uphill battle against the food industry because they have so much money and do so much marketing. The approach they used in Howard County shows that you can fight against it, but it takes a lot of work.”
Co-authors of the study include Glenn Schneider and Nikki Highsmith Vernick of the Horizon Foundation; Marlene B. Schwartz, Yoon-Young Choi, Ran Xu, Abiodun T. Atoloye, and Brooke L. Bennett of the UConn Rudd Center, and Lawrence J. Appel of the Horizon Foundation Board of Trustees and Johns Hopkins University School of Medicine.