INTRODUCTION:

Soft drink is a non-alcoholic beverage, mostly carbonated, contains natural or artificial sweetening agent, edible acids, natural or artificial flavors, and sometimes juice. Pepsi, Coca cola, Mirinda, and Seven Up are the examples of soft drinks. The term soft drink was originated to differentiate the flavored drinks from hard liquor, or distilled spirits.¹ Joseph Priestly was the first who created carbonated water in 1767. Since then, many researchers began working on carbonated water and in 1835 the first bottled liquid soda was manufactured in the United States. Soft drinks usually composed of carbonated water, sugar syrup, caramel color, caffeine, orthophosphoric acid, citric acid, natural or artificial flavors, carbon dioxide, organic diol, and Brominated oil, in addition to several other ingredients.² Soft drinks are high in calories with no other nutrients. The average can of soft drink and fruit drink provides about 150 calories, majority from the added sugar. If you consume soft drink every day without reducing other calories, you can gain weight up to 5 pounds in one year. Furthermore, these sugary drinks can increase the risk of type-II diabetes, heart diseases, and other chronic diseases.³

Numerous studies have found relationship between soft drink and obesity. A twenty year study on 120,000 people found that those who increased the consumption of soft beverage by one serving everyday gained more weight than those who didn’t change their consumption.⁴ Another study found that for every additional 12-ounce soda children consumed every day, the chances of becoming obese increased by 60% during 1½ years of follow-up.⁵ Other studies also found a link between sugary drink consumption and weight gain in children.⁶ A unique study of 33,097 individuals concluded that among people with a genetic predisposition for obesity, those that drank sugary drinks were more likely to be obese than those who didn’t. It suggests that genetic risk for obesity doesn’t become a reality if healthy habits, like avoiding sugary drinks, are followed. Alternatively, if we replace sugary drinks or fruit juices with water then there is a less chance of long-term weight gain. People who consume 1 or 2 soft drinks everyday have 25% more chances of type-2 diabetes than people who rarely consume drinks.⁷

The Nurses’ Health Study explored the link between soft drinks and diabetes by following the health of about 90,000 women for eight years. The nurses who consumed one or more servings each day of a sugar-sweetened beverage or punch were twice chances to developed type 2 diabetes than those that rarely had these beverages. Another study data was collected from 192,000 male and female of age group 22-26 participating in three long-term studies found that increasing total sugary beverage intake, including both sugar sweetened beverages and 100% fruit crush, by quite 4 ounces per day over a four-year period was related to a 18% higher risk of type 2 diabetes. The study also found that drinking more artificially sweetened beverages instead of sugary beverages didn’t appear to reduce diabetes risk. However, replacing daily serving of a sugary beverage with water, coffee, or tea was linked with a 2–10% lower risk of diabetes.⁸

Consumption of free sugars, including products like sugary drinks, is a major factor in the global increase of people suffering from obesity and diabetes,” says Dr Douglas Bettcher, Director of WHO’s Department for the Prevention of NCDs. “If governments tax products like sugary drinks, they can reduce suffering and save lives. They can also cut healthcare costs and increase revenues to invest in health services” In 2022, India’s carbonated soft drink market had a total revenue of $18.25 billion, which is a 19.8% compound annual growth rate (CAGR) from 2017 to 2022. The consumption volume also increased by 10.2% during that period, reaching 9.29 billion litres in 2022. According to Statista, the consumption volume is expected to increase by 12.97% between 2023 and 2027, reaching 7.82 billion litres in 2027. This would be the seventh year in a row of increasing consumption. The average household consumption of soft drinks in India has also increased from 6.5 litres in 2019 to just over 7 litres annually.⁹

In a study conducted on 40,000 men for time span of almost two decades, explored that people who intake averaged one can of a sugary beverage per day had a 20% higher risk of having a congestive-heart-failure or dying from congestive-heart-failure than men who rarely consumed sugary drinks.¹⁰ Similar study in women which tracked the health of nearly 90,000 women over 20 years, found that women who drank quite two servings of sugary beverage every day had a 40 percent higher risk of heart attacks or death from heart condition than women who rarely drank sugary beverages.¹¹ Researchers investigate to find out why and how intake of sweet beverages leads to heart disease. An observational study examined medical data of nearly 6,000 people that were followed for a mean of 12.5 years. Researchers found drinking quite 12 ounces per day of sugary beverages was related to a 53% higher incidence of high triglycerides and a 98% higher incidence of low good cholesterol compared to those that drank but 12 ounces per month.¹² It is concluded that people who consume soft drinks are at high risk of having heart diseases. A study found that ladies who intake quite three 12-ounce servings of cola each day had 2.3 to 5.1 percent lower bone mineral density in the hip compared to women who intake one serving every day.¹³ A high content of orthophosphoric acid in soft drinks has been assumed to be one among the mechanisms linking soft beverages and fracture. Excessive intake of orthophosphoric acid changes calcium/phosphorus ratio and imbalance of not only the calcium and phosphorus ratio but also the acid-base within the body, leading to decreased bone density and even osteoporosis and fractures.^14,15 Consumption of two or more soda drinks daily was related to an increased risk of chronic kidney diseases due to high levels of orthophosphoric acid within the body.¹⁶ A study of over 3,000 women concluded that consuming two servings or more of artificially sweetened soft drinks each day was significantly connected to more rapid renal function decline in older women and doubled the danger of kidney function decline . There is a robust relationship between a high risk of developing gout and drinking sweetened soda and fructose.¹⁷ A 22-year study of 80,000 women found women who drank a soft drink can each day had a 75% higher risk of gout than women who rarely had such drinks.¹⁸ Researchers found a similar high risk in men.¹⁹

There is a high risk of cavity as many soft drinks contain high levels of sucrose, carbohydrates, and fructose sugars. Over consumption of sugary drinks will cause dental problems due to sugar components. Also, phosphoric and citric acid present in soft drinks weakened the enamel with long exposure time, removing the protective layer (enamel) and exposing the soft dentin. These circumstances cause cavity and hypersensitivity.²⁰

MATERIALS AND METHODS:

· Research approach - Quantitative approach

· Research design - Non experimental descriptive design

· Study setting - Snehatheeram Nagar, Pallithottam, Kollam

· Target population - Adolescents belonging to the age group of 13-19 years.

· Sampling technique - Purposive sampling technique was used

· Sample size - 100 adolescents

· Data collection - Demographic variables Self Structured knowledge questionnaire

· Intervention - An informational booklet

· Analysis and interpretation of data by using descriptive and inferential statistics

RESULTS:

Section A: Description of demographic variables

SI. No.	Demographic Variables	Frequency	Percentage
1	Age
	13 Years	5	5%
	14 Years	10	10%
	15 Years	13	13%
	16 Years	14	14%
	17 Years	18	18%
	18 Years	17	17%
	19 Years	23	23%
2	Gender
	Male	43	43%
	Female	57	57%
3	Type of family
	Nuclear family	84	84%
	Joint family	16	16%
4	Economic Status
	APL	19	19%
	BPL	81	81%
5	Frequency of Consumption
	Never	9	9%
	Rarely	51	51%
	Occasionally	33	33%
	Usually	7	7%
6	Prefered Carbonated Drink
	7up	32	32%
	Pepsi	27	27%
	Tilo	26	26%
	Others	15	15%
7	Occasion of Consumption
	Feeling thirsty	30	30%
	Without any occasion	27	27%
	Parties	26	26^
	Others	15	15%
8	Previous Source of Information
	Yes	61	61%
	No	39	39%
9	Money Spent on Drinks
	Less than 50	58	58%
	50- 100	28	28%
	100- 150	11	11%
	More than 150	3	3%

Section B: Assessing the knowledge among adolescent regarding health hazards of carbonated drink.

Level of Knowledge	Score Key	Frequency	%
Poor	0-5	23	23
Moderate	6-10	60	60
Good	11-15	17	17
Excellent	16-20	0	0

Section C: Association between knowledge score among school children regarding sexual abuse and selected demographic variables.

Selected Demographic variables	Knowledge				Degree of freedom	Chi square	Table value	Level of significance at 0.05 level
Selected Demographic variables	poor	Below average	average	Above average	Degree of freedom	Chi square	Table value	Level of significance at 0.05 level
1. Age:
13	5	0	0	0	24	34.11	28.87	S
14	5	5	0	0
15	2	10	1	0
16	1	12	1	0
17	3	9	6	0
18	1	12	4	0
19	6	12	5	0
2. Gender:
Male	13	22	8	0	2	2.81	5.99	NS
Female	10	38	9	0	2	2.81	5.99	NS
3. Type of family:
Nuclear family	20	48	16	0	2	2.16	5.99	NS
Joint family	3	12	1	0	2	2.16	5.99	NS
4. Economic status:
APL	7	10	2	0	2	2.74	5.99	NS
BPL	16	50	15	0	2	2.74	5.99	NS
5. Frequency of consumption:
Never	1	7	1	0	6	13.39	12.59	S
Rarely	15	30	6	0
Occasionally	6	18	9	0
Usually	1	5	1	0
6. Prefered carbonated drink:
7up	9	19	4	0	6	2.47	12.59	NS
Pepsi	7	16	4	0
Tilo	5	15	6	0
others	2	10	3	0
7. Occasion of consumption:
feeling thirsty	7	18	5	0	6	3.43	12.59	NS
without any occasion	12	23	6	0
parties	3	16	4	0
others	1	3	2	0
8. Previous source of information:
Yes	9	39	13	0	2	7.17	5.99	S
No	14	21	4	0	2	7.17	5.99	S
9. Money spend on drinks:
less than 50	14	36	8	0	6	5.14	12.59	NS
50-100	5	16	7	0
100-150	4	5	2	0
More than 150	0	3	0	0

DISCUSSION:

The present study was conducted to assess the knowledge regarding health hazards of carbonated drinks among adolescents in selected areas of Pallithotam, with a view to develop informational booklet. In order to achieve the objectives of the study, non-experimental descriptive study design was adopted. The sample was selected by purposive sampling technique. The sample consisted of 100 adolescents belonging to the age group of 13-19years residing in areas of Pallithotam, Kollam. The findings of the study has been discussed in relation to objectives and other similar studies.

OBJECTIVES OF THE STUDY:

To assess the knowledge of adolescents regarding health hazards of carbonated drinks among adolescents.

To find out the association between knowledge regarding health hazards of carbonated drinks among adolescents and selected demographic variables.

To develop an informational booklet on health hazards of carbonated drinks.

To assess the knowledge of adolescents regarding health hazards of carbonated drinks among adolescents:

In the present study, knowledge was assessed by a knowledge questionnaire. The present study findings revealed that 23% had poor knowledge, 60% had moderate knowledge, 17% had good knowledge and 0% had excellent knowledge regarding health hazards of carbonated drinks.

The above findings are supported by a non-experimental descriptive study conducted in a selected school of Alappuzha district to assess the knowledge regarding ill effects of carbonated drinks among adolescent. The study was conducted among 60 adolescents in between the age group of variables 13-18 years studying in 8th 9th and 10 standards using purposive sampling technique. The data was collected by using structured questionnaire. The results revealed that 85% of them had average knowledge, minor proportion (10%) of them had good knowledge and only 5% of them had poor knowledge regarding ill effects of carbonated drink.

To find out the association between knowledge regarding health hazards of carbonated drinks among adolescents and selected demographic:

The association was found out by using Chi-square test. It was inferred that the present study showed significant association between knowledge score and demographic variables like age, frequency of consumption of carbonated drinks and previous source of information. (Calculated values were greater than table value at 0.05 level of significance). There was no association between knowledge and the demographic variables like gender, type of family, economic status, preferred carbonated drinks, occasion of consumption of carbonated drinks and money spend to buy carbonated drinks. (Calculated values were less than table value at 0.05 level of significance).

The study was supported by a study to assess the knowledge regarding health hazards of soft drinks among nursing students in Chaitanya College of nursing, Ongole, Andhra pradesh. Study was conducted among 100 samples and selected by using non- probability purposive sampling technique, students who fulfilled the inclusion criteria were selected. Data was collected using a structured questionnaire. The study shows that there is no significant association between level of knowledge on health hazards of soft drinks and socio demographic variables such as Age, types of soft drink, amount of consumption, duration of consumption of soft drink, types of dietary habits, source of information, and previous knowledge regarding health hazards of soft drinks.

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Received on 26.10.2024 Revised on 19.02.2025

Accepted on 07.04.2025 Published on 22.05.2025

Available online from May 24, 2025

A and V Pub J. of Nursing and Medical Res. 2025;4(2):51-55.

DOI: 10.52711/jnmr.2025.13

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