Less Sweet Drinks, More Fruitful Research

Walk into any grocery store, convenience store or big box store in the US and you’ll likely be inundated with sugar-sweetened beverages (SSB).

“Sugar sweetened beverages include drinks containing added sugar, whether to make them sweeter or more shelf-stable,” said Christen Cupples Cooper, EdD, RDN, founding director and chair of the Nutrition and Dietetics department in the College of Health Professions. “Soda, Sunny Delight, Yoohoo chocolate milk, sports drinks and Frappucinos are all sugar sweetened beverages. SSB research suggests that SSB can lead to overweight and obesity, diabetes, heart disease, depression, tooth decay and other serious conditions."

Beverage companies figured out long ago that if they appeal to young people through eye-catching marketing, they can ensure profits for years to come. No one needs SSB to live, so why buy them? Despite growing awareness that SSB contribute significantly to poor health, these drinks are sold everywhere—in vending machines, at gas stations, grocery stores, and social events. Parents are frequently persuaded to let kids drink them—something that Cooper and Professor of Nursing Angela Northrup, PhD, attribute to both the "pester power" of marketing as well as various degrees of knowledge across different populations.

“I had noticed in a previous study, and just in general, many parents indiscriminately giving their children, for example, Capri Sun, even when other choices were available, like water and juice,” said Northrup. “We really were concerned with how much this is contributing to the obesity epidemic, because when you look at the numbers, a large proportion of children’s daily calories are drunk as empty calories. We really want to see what people know and where they’re getting the messaging from.”

Thus, Northrup embarked on a research study, in collaboration with Cooper, focused on the prevalence of sugar sweetened beverage consumption amongst young children. They began interviewing with a qualitative study of residents in Peekskill, New York. To give the study a greater breadth, Northrup had been planning on interviewing a Spanish-speaking population of farmworkers in upstate New York. After interviewing several candidates to conduct the interviews in Spanish, Northrup realized that the ideal candidate was someone she already knew—her clinical student, Rachel Mazariegos ’21. Once the semester ended and Rachel was no longer her student, Northrup brought Rachel on in anticipation of conducting several interviews in March 2020.

“Last fall, I had Rachel as a student in my clinical,” She just had this way with the patients, and was just amazing. This light clicked that she would be perfect,” said Northrup.

“I find it really interesting, this population is relatable to me,” said Mazariegos. “I come from a Spanish-speaking household and I’ve seen the knowledge change over time—from what my cousins give my younger cousins, to what my aunts and uncles gave my cousins. The knowledge has increased with generations, but there’s still people who are not as knowledgeable on these topics.”

After receiving funding and approvals, Northrup and Mazariegos were finally set to interview a number of parents in this particular upstate migrant farm-working community, who had children between the ages of 2–5. The world however, had other plans—the first set of interviews had been scheduled a few days before New York State began shutting down due to COVID-19, and Northrup, understanding the risks and what was about to happen across the country, cancelled the interviews.

“I approached Rachel to work with us, and we were going to use some of our funds, and then unfortunately, the pandemic hit and they froze all of our funds.”

The project was thus put on hold, and Rachel’s involvement was uncertain given the lack of funds available. But in summer 2021, Northrup realized an alternative option—the research could instead be conducted by taking advantage of the Office of the Provost’s undergraduate student faculty/research program, which had just put out a call for submissions.

“In the summer, the undergraduate faculty research call came out. I had participated numerous times, and it was the perfect place, the perfect time, and the perfect student,” said Northrup.

Given the intricacies and difficulties of conducting research during the COVID-19 pandemic, Northrup, Cooper, and Mazariegos have spent the past few months obtaining various approvals, submitting necessary forms, and laying the foundation for Rachel to conduct interviews over Zoom. Mazariegos, who has handled all of the unforeseen obstacles wrought by the pandemic admirably, has enjoyed learning about all of the factors that go into conducting impactful research, and has found the experience helpful in terms of preparing her for the future.

“I would like to become a pediatric nurse and I’m hoping to become a nurse practitioner,” said Mazariegos. “This type of research study, especially with migrant farmers—migrant farmers can be hard to reach, bringing more attention and research to a group that’s underserved. I’ve enjoyed it so far, even the IRB, the whole paperwork part of it.”

As the research proceeds, the trio hopes to better some of the underlying causes behind consumption of sugar sweetened beverages amongst young children—whether its confronting the immense marketing pull of certain drinks, or better educating underserved populations about the risks and consequences of sugar sweetened beverages, particularly as they relate to child development.

Northrup notes that ultimately, they would like to use the information to potentially support policy recommendations.

“I think we need to make a normative shift of some type, and a lot those types of shifts don’t really happen until you have policies that support it, such as anti-smoking laws, and even sugar sweetened beverage taxes,” said Northrup. “As contentious as it is, I think that it’s a very effective way of getting the message across at how bad it is.”

“I think the ultimate goal for me is seeing how families are impacted by this, and seeing the shift of knowledge between family members,” said Mazariegos. “There are people who are unaware of the harm that these drinks are doing to their children."

When the research is complete, the trio plans on publishing a paper to demonstrate their findings, and perhaps help galvanize support for that aforementioned normative shift to help better elucidate the harms of sugar sweetened beverages. Cooper notes that their paper is rather distinct, and given its interdisciplinary nature, represents a major accomplishment for interdisciplinary research at Pace.

“We’re bringing Rachel’s patient care and language skills, Angela’s patient care skills and nursing expertise, and I’m a registered dietician and doctor of education—we’re bringing nutrition education, nursing, language skills, and nursing experience to this,” said Cooper. “We have a much broader base of understanding from a number of different angles.”