VA Knowledge on Sugar-Sweetened beverages and alternatives Alice Green, dietetic intern

Outline Background Purpose Methods John Cochran Jefferson Barracks Results- evaluations Discussion

Background: Obesity In 2014, 78 percent of Veterans were overweight or obese. In 2013, more than 165,000 Veterans who received their health care from the department had a BMI of 40 or greater Obesity: complex Obesity is a complex struggle. As well all know, veterans can suffer from many physical, mental, or emotional barriers. It’s important to focus on one aspect Why I chose the topic of SSB- we had materials available, it is a topic that individuals may not think about as much

Sugar-Sweetened Beverages Adults in the United States consume an average of 16% of their calories as added sugars, and 46% of those are from beverages (Edmond, Patterson, Jardack, Arab, p. 603, 2014). (Murgermaster, Bhana, Fullwood, Bazuldua, & Tipton, 2016). Studies show that participants who consume SSBs have a higher BMI on average People are consuming these calories and may not even know it

Purpose Spread awareness of the amounts of sugar in beverages Provide education on low-calorie alternatives, particularly water.

Methods/Materials One booth set up at John Cochran and Jefferson Barracks Empty drinks with bags of sugar with respective amounts Posters of SSBs Handouts from MOVE Water Bottles Evaluations Many of these were already available Show handouts

John Cochran Wednesday 9:15-11:15 Busy, high-traffic area Reached many people who filled out the evaluation and signed up for Move Moving Forward: Ensure that individuals are sincerely signing up for Move Discuss alternatives to SSBs more Help with questions to evaluations The location at JC is great because it is high in traffic. I was able to reach a lot of people. I even had to run up and grab more water bottles

Jefferson Barracks Thursday 1:00-3:00 pm Slower Less people, but more interaction Moving Forward: Set up at JB in the mornings Speak to more people, ask more people to fill out evaluations Could use more motivational interviewing More questions from participants Could discuss flyers and handouts more

Evaluation Questions 36 total responses Pre-questions: Why do you think drinking water is healthy? In addition to water, what beverages do you drink in a day? How many sugary beverages do you drink in a day? Post-questions: Name two benefits to drinking water Please list two ways that you will increase water intake in the future Please list a low-calorie beverage choice (in addition to water) On a scale of 1-5, how confident are you that you can choose water instead of sugary drinks throughout the day? 36 total responses

Evaluations Common benefits to drinking water: Skin Body function For hydration Kidney function Digestion No sugar Keeps you full

Sugary Drinks Reported in a Day Number of responses *reported* Number of drinks

Please list a low-calorie beverage choice… Question answered the least Common answers: Pepsi-cola, Powerade, cranberry juice Other answers: none, N/A Number of people who correctly answered the question: 16 (44.4% of participants) Examples of correct answers: tea with stevia, black coffee, Powerade zero, diet soda Conclusion: more education on what exactly a low calorie beverage is, and what makes it low- calorie People would put coffee or tea, and I counted it… but… (sugar, sweetened…?)

Confidence Level: one (not very), five (extremely) On a scale of 1-5, how confident are you that you can choose water instead of sugary drinks throughout the day? Number of responses Confidence Level: one (not very), five (extremely)

Moving Foward Many individuals surprised about amounts of sugar in beverages Few people (44%) of individuals could correctly name a low-calorie beverage Skewed Results: Individuals not reading full questions Taking survey just to receive a free bottle Overall Conclusion: More education is needed on the consequences of sugar- sweetened beverages as well as low-calorie alternatives.

Discussion What went well? What didn’t? How can we educate more people on the topic of SSBs and alternatives?

References Burgermaster, M., Hiershenee, G., Fullwood, D., Bazaldua, D., & Tipton, E. (2017). Exploring the role of sugar-sweetened beverage consumption in obesity among New Yorkers using propensity score matching. Academy of Nutrition and Dietetics. 117(5), 753-762. Edmond, J., Patterson, R., Jardack, P., & Arab, L. (2014). Using doubly labeled water to validate associations between sugar-sweetened beverage intake and body mass among White and African-American adults. International Journal of Obesity. 38, 603-609. U.S. Department of Veterans Affairs. (2016). VA research on obesity. Retrieved from www.research.va.gov/topics/obesity.cfm