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The role of water insecurity in influencing water and sugar-sweetened beverage choices: A scoping review

  • Laina Ewoldt
  • , Ana Clara Duran
  • , Checkna Diawara
  • , Carolina Batis
  • , Deshira D. Wallace
  • , Paul Taillie
  • , Joshua D. Miller
  • , Shu Wen Ng
  • , Ryan Cronk
  • , Lindsey Smith Taillie
  • University of North Carolina at Chapel Hill
  • Universidade Estadual de Campinas
  • Universidade de São Paulo
  • Instituto Nacional de Salud Publica

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Water is a critical nutrient for human health, however more than 4 billion people globally lack access to safe drinking water and climate change is expected to worsen water insecurity. Simultaneously, consumption of packaged water and sugar-sweetened beverages (SSBs) is increasing globally. Despite many plausible linkages, little is known about the relationship between water insecurity and sugar-sweetened or packaged beverage selection. The current study aimed to characterize the relationship between water insecurity and beverage selection by conducting a scoping review to identify trends in available research on beverage selection among individuals experiencing water insecurity, and creating a conceptual model explaining this relationship. The Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guided the systematic search of 4 databases, which resulted in the inclusion of 82 studies from 7 geographical regions, representing both middle- and high- income countries. Key emergent themes included perceptions of non-packaged water characteristics, adaptive behaviors, and how each alter consumer selection of packaged water and SSBs. Frequently mentioned non-packaged water characteristics included perceived safety (n=49; 60%), taste (n=31; 38%), convenience/accessibility (n=29; 35%), cost (n=18; 22%), appearance/turbidity (n=12; 15%), smell (n=10; 12%), temperature (n=9; 11%), and hardness (n=5; 6%). Reported adaptive strategies included water treatment/filtering (n = 25; 30%) and water testing (n = 5; 6%). Associations between water insecurity and non-packaged water, packaged water, and SSB selection varied by country income classification and demographic characteristics. These can inform potential areas for future interventional trials aiming to increase trust in and selection of plain water as well as reduce reliance on packaged or sugar-sweetened beverages.

Original languageEnglish
Article numbere0000174
JournalPLOS Sustainability and Transformation
Volume4
Issue number5
DOIs
StatePublished - May 2025

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