Ambient temperature and intake of sugar-sweetened beverages among women across 16 countries in sub-Saharan Africa: a cross-sectional analysis

Abstract Background While a growing body of evidence associates high ambient temperatures with an increased risk of sugar-sweetened beverage consumption, this relationship remains understudied in sub-Saharan Africa population. Our study aimed to quantify the association between ambient temperature and consumption of sugar-sweetened beverages (SSBs) among women in sub-Saharan Africa. Methods We conducted a secondary analysis of data from 16 countries in sub—Saharan African to assess the association between ambient temperature and the prevalence of SSB consumption among women aged 15—49 years. The study utilized geocoded Demographic and Health Survey (DHS) data on women’s feeding practices; spatially linked to remote sensed maximum daily 2—meter air temperature. We used modified Poisson regression with natural cubic splines, controlling for potential confounders, to estimate the association between ambient temperature and the prevalence of SSB consumption. We also examined whether these relationships differed by age group, number of children, marital status, fridge ownership, place of residence (rural or urban), wealth quintile and education level. Findings Of the 300,314 women, 22.2% (95%CI [21.8—22.6]) reported drinking at least one kind of SSB a day preceding the DHS interview. Overall, mean daily temperature at the 90th percentile was associated with a 24% higher prevalence of consuming SSBs (aPR = 1.24, 95% CI [1.13—1.36], p < 0.001) compared to the minimum prevalence temperature percentile (temperature at which prevalence was lowest). These associations varied substantially across countries, ranging from 12% in Ethiopia (aPR = 1.12, 95% CI [0.94—1.35], p = 0.201) to 44% in Senegal (aPR = 1.44, 95% CI [1.19—1.73], p < 0.001). Associations between heat exposure and SSB intake were more pronounced among women living in urban areas and in higher wealth quintiles, however, there was no evidence of effect modification (interaction effect p-value > 0.05). Interpretation Our analysis demonstrated substantial regional heterogeneity in the association between ambient temperature and intake of SSBs among women in sub—Saharan Africa. This evidence has important implications in planning heat—related nutritional interventions.