An agent-based model of child sugar-sweetened beverage consumption: implications for policies and practices

Abstract

Background: A strong body of evidence links young children's intake of sugar-sweetened beverages (SSBs) with myriad negative outcomes. Objectives: Our research provides insight into whether and to what extent potential intervention strategies can reduce young children's consumption of SSBs. Methods: We built an agent-based model (ABM) of SSB consumption representing participants in the Project Viva longitudinal study between ages 2 and 7 y. In addition to extensive data from Project Viva, our model used nationally representative data as well as recent, high-quality literature. We tested the explanatory power of the model through comparison to consumption patterns observed in the Project Viva cohort. Then, we applied the model to simulate the potential impact of interventions that would reduce SSB availability in 1 or more settings or affect how families receive and respond to pediatrician advice. Results: Our model produced age-stratified trends in beverage consumption that closely match those observed in Project Viva cohort data. Among the potential interventions we simulated, reducing availability in the home - where young children spend the greatest amount of time - resulted in the largest consumption decrease. Removing access to all SSBs in the home resulted in them consuming 1.23 (95% CI: 1.21, 1.24) fewer servings of SSBs per week on average between the ages of 2 and 7 y, a reduction of ∼60%. By comparison, removing all SSB availability outside of the home (i.e., in schools and childcare) had a smaller impact (0.77; CI: 0.75, 0.78), a reduction of ∼40%. Conclusions: These results suggest that interventions reducing SSB availability in the home would have the strongest effects on SSB consumption.