In response to "The ‘Twinkie Defense': the relationship between carbonated non-diet soft drinks and violence perpetration among Boston high school students," a survey analysis published in the British journal Injury Prevention, the American Beverage Association issued the following:

American Beverage Association Statement:

"The authors of this study failed to factor out other important considerations and, importantly, did not prove cause and effect. The fact remains that there is no scientific evidence to support that young adults who consume sugar-sweetened beverages are more likely to carry a weapon or perpetrate violence. The conclusions of the authors, who surveyed less than 1,900 Boston public high school students, are not representative of the broader teen population. In a world where eight teens ages 16 to 19 die every day from motor vehicle injuries according to CDC, this study may result in false misperceptions about sugar-sweetened beverage consumption with no scientific evidence."

Additional Background:

The conclusions of this study cannot be extrapolated to the broader U.S. teen population. In fact, the authors survey only 1,878 students from 22 public high schools in Boston only. Furthermore, the respondents were largely black and Hispanic. Thus, the sample is far from nationally representative. The authors themselves note that the conclusions "may not be generalisable to other populations" and that they "do not know the reason for the association between soft drinks and the perpetration of violence." Their analysis has considerable limitations: it was self-reported, there was "limited information" about the type of soft drinks consumed by respondents and no other information about the respondents' overall diet. In addition, there are potential confounders for which the authors did not control, all of which were acknowledged in the analysis. The authors also did not control for school attendance, school performance, engaging in sports or other school activities, and coffee consumption. Importantly, alcohol and tobacco use also were higher among those who responded that they had been violent or carried a weapon. Soft drinks are comprised primarily of sweetener, carbonated water, natural flavors and, in some cases, caffeine. Yet, when assessing caffeine and sugar, the authors state that "a recent, thorough review of the effects of caffeine on young people does not even mention aggression," and that "the evidence of a direct impact of sugar on behavior may be weaker than popularly believed. The Boston Public Health Commission's Health of Boston 2010 report itself noted "additional need for improvement in the areas of teen risk behaviors, nonfatal assault-related gunshot, and stabbing injuries, and homicides." The report also showed that, when 2007 and 2009 are combined, "almost one in four male public high school students reported carrying a weapon during the past month." That report, which includes no mention of soft drinks related to teen violence, was accessed on October 22, 2011, at:

Of note, the authors of this analysis found "no support for a connection between soft drink consumption and BMI" and noted that "BMI for the frequent soft drink consumers was not significantly higher than for those who consumed less." The above is especially of interest as the survey population resides in a city where the Mayor and Public Health Commission have launched campaigns to reduce soft drink consumption alleging they are major contributors to obesity. The Mayor's Office and the Boston Public Health Commission are listed in the acknowledgments of this analysis, as is the Centers for Disease Control and Prevention (CDC) for providing funding. CDC also funded Boston's anti-soda campaign through the use of stimulus dollars.

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The American Beverage Association is the trade association representing the broad spectrum of companies that manufacture and distribute non-alcoholic beverages in the United States.