Objective To assess the impact of a sugar-sweetened beverage (SSB) reduction initiative on customer purchasing patterns, including volume sales of healthy and unhealthy packaged drinks and sales value of all packaged drinks, in a major Australian aquatic and recreation provider, YMCA Victoria.
Setting 16 aquatic and recreation centres in Victoria, Australia.
Interventions The SSB-reduction initiative aimed to remove all SSBs (excluding sports drinks) and increase healthier drink availability over a 1-year period.
Primary and secondary outcome measures Itemised monthly drink sales data were collected for 16 centres, over 4 years (2 years preimplementation, 1 year implementation and 1 year postimplementation). Drinks were classified as ‘green’ (best choice), ‘amber’ (choose carefully) or ‘red’ (limit). Interrupted time series analysis was conducted for each centre to determine the impact on volume sales of ‘red’ and ‘green’ drinks, and overall sales value. A novel meta-analysis approach was conducted to estimate the mean changes across centres.
Results Following implementation, volume sales of ‘red’ drinks reduced by 46.2% across centres (95% CI: −53.2% to −39.2%), ‘green’ drink volume did not change (0.0%, 95% CI: −13.3% to 13.2%) and total drink sales value decreased by 24.3% (95% CI: −32.0% to −16.6%).
Conclusions The reduction of SSBs in health-promoting settings such as recreation centres is a feasible, effective public health policy that is likely to be transferable to other high-income countries with similarly unhealthy beverage offerings. However, complementary strategies should be considered to encourage customers to switch to healthier alternatives, particularly when translating policies to organisations with less flexible income streams.
- nutrition and dietetics
- sugar sweetened beverage
- policy analysis
- interrupted time series analysis
- recreation centres
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Contributors AP, LO, TBR, KB and AC designed the study. AK, AJ and TBR coordinated data collection. AC and BG conducted data coding and data organisation. TBR, LO and KB conducted data analysis. TBR, AP, KB and LO interpreted the data. All authors contributed to the writing of the manuscript.
Funding This study was funded in part by VicHealth. TBR is supported by an Australian Government Research Training Program Scholarship, a National Health and Medical Research Council Centre for Research Excellence grant (APP1152968) and a grant from The Australian Prevention Partnership Centre. LO is supported by Deakin University. KB is supported by a National Heart Foundation Future Leader Fellowship (102047). AK is supported by YMCA Victoria. AJ is supported by YMCA Victoria. BG is supported by research funding from the Victorian Health Promotion Foundation (VicHealth). AC is supported by an Australian Government Research Training Program Scholarship. AP is supported by a National Health and Medical Research Council fellowship (GNT1045456) and Deakin University.
Competing interests Professor Peeters has received funding from Melton and Wyndham city councils to conduct evaluations of healthy food policies. Ms Kurzeme and Ms Jerebine are employed by YMCA Victoria. Dr Boelsen-Robinson, Associate Professor Orellana, Dr Backholer, Ms Gilham and Mrs Chung declare no competing financial interests.
Patient consent for publication Not required.
Ethics approval This study has been approved by the Monash University Human Research Ethics Committee (CF16/691–2016000340) and conforms to principles embodied in the Declaration of Helsinki.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement No data are available. Data are commercially sensitive and therefore cannot be provided.