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

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.


DESIGN
We built an agent-based model (ABM) of SSB consumption representing participants in the Project Viva longitudinal study between ages 2 and 7 years. 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 one 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 two and seven, a reduction of about 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 about 40%.


CONCLUSIONS
These results suggest that interventions reducing SSB availability in the home would have the strongest effects on SSB consumption.