The global beverage industry has witnessed unprecedented market activity throughout this last century; there is a relentless need for innovation to meet the consumer demand. The term 'beverage', according to the Union of European Beverages Association (2011), is defined as a drink specially prepared for human consumption. These drinks complement the foods we eat and when consumed in the right proportions, are a needed component of a balanced diet as they provide hydration, quench thirst and may also deliver essential vitamins and minerals (ABA, 2011). The European Food Safety Authority (2008) in its advice on nutrient profiles, emphasised on the special role that beverages play in the diet due to their hydration properties.
According to Ashurst (2005) the global beverage market is divided into four primary sectors categorised as 'hot', 'soft', 'milk' and 'alcoholic' drinks. Fermented milk drinks are however not mentioned under the 'milk drinks' category. Zenith International (2011) explains that the carbonated category includes sparkling soft drinks with a flavour, often cola, but there are other variants such as lemon or orange.
Figure 1: Beverage sectors and segments
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According to Zenith International (2011) the U.S. non-alcoholic beverages market is the largest in the world at 110 billion litres in 2009, with carbonated soft drinks having a share of 48% of total consumption. Interestingly, soft drink consumption has been associated with the displacement of healthier food and beverage choices. A number of studies in the U.S. and in Australia have revealed that milk consumption has decreased over time and that this has been related to an increasing soft drink intake (Capps et al., 2005; Hector et al., 2009). A high level of soft drink intake is also associated with lower intakes of a number of vitamins and minerals, and dietary fibre.
The Mauritius Food Regulations (1999) defines soft drinks as 'any liquid suitable or intended for human consumption as a drink, without dilution or after dilution and includes any fruit drink, soda water or artificially carbonated water, Indian or quinine tonic water, ginger beer and any herbal or botanical beverage and barley water.' Moreover Ashurst (2005) explains that 'soft drinks' are 'sweetened water-based beverages, usually with a balancing acidity. They are flavoured, frequently coloured and often contain an amount of fruit juice, fruit pulp or other natural ingredients'. Other ingredients of technological or nutritional value designed to improve the appearance and stability of the product and to ensure its organoleptic properties remain unchanged within the determined shelf life may also be added to soft drinks. Codex Alimentarius Commission (1995) definition of carbonated water-based flavoured drinks includes water-based flavoured drinks with added carbon dioxide with nutritive, non-nutritive and/or intense sweeteners and other permitted food additives. The Mauritius Food Regulations (1999) provides for sweeteners and acids that can be used in the manufacture of soft drinks.
The wide variety of products in today's beverage market reflects a background of intense creativity where the characterisation of drink types is concerned. Although the ingredients in soft drinks may vary among different types and brands of sodas, most contain some variation or combination of the same basic ingredients. The combination of ingredients and especially the different flavour additives are what give each soft drink its own unique taste. The main ingredient used in all soft drinks is water. According to the British Soft Drinks Association (2011), it is always the major ingredient and accounts for almost 86% of the drink. Moreover water also acts as a carrier for other ingredients (Steen and Ashurst, 2006). It is carbon dioxide, a colourless and odourless gas that provides the characteristic effervescence and bubbles of carbonated soft drinks (ABA, 2010).
One of the basic properties of a soft drink is its acidity. Acids are mainly used in soft drinks not only to inhibit the growth of microorganisms such as yeasts, moulds and bacteria but also to improve the taste profile of the drink by balancing the sweetness (BSDA, 2011). Citric, malic and phosphoric acids are the three most commonly used acids. Steen and Ashurst (2006) report that, in the soft drinks industry, phosphoric acid is used mostly for the cola-flavoured carbonated beverages, to provide their typical taste. The Mauritius Food Regulations (1999) permits the use of no other acids than ascorbic, citric, lactic, malic, nicotinic, tartaric acid and benzoic acids. It is also mentioned that a soft drink other than a squash or a comminuted citrus drink may contain acetic acid or phosphoric acid.
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The food industry has been formulating products that are marketed on some form of 'better for you' platform for many years. One such product formulation is the removal of sugar from products to create 'diet' and 'sugar-free' versions of soft drinks. Sugar (sucrose) or intense sweeteners are used to impart sweetness in beverages (Paquin, 2009). In the United States, most non-diet soft drinks are sweetened using either sucrose, high fructose corn syrup (HFCS) or a mixture of both (ABA, 2010). The BSDA (2011) explains that since intense sweeteners are many times sweeter than conventional sugar, only a small amount is needed to give a product the desired sweet taste. The Mauritius Food Regulations (1999) provides standards for the amount of sugar as well as a list of intense sweeteners that can be used in soft drinks. The minimum quantity of sugar, saccharin and aspartame added per 100 kilograms of soft drink is 4.5 kg, 80 g and 70 g respectively. There is no provision however on the combination of intense sweeteners.
The Mauritius Food Regulations (1999) defines the addition of a permitted food additive as a technological process whereby the additive directly or indirectly becomes a component of the food or otherwise affects the characteristics of the food. Preservatives, colourings and flavourings are among those preservatives that can be added to soft drinks. The FDA (2009) has stated that only those food and colour additives that have been determined to be safe may be used in the manufacture of soft drinks. Sorbic acid (E200) and benzoic acid (E210) are among those preservatives permitted for use in soft drinks in Mauritius. The European Directive and Mauritius legislation have both set the maximum level of sorbates in soft drinks to 300mg/L. However for benzoic acid, the maximum level has been set to 150 mg/L while the Mauritius legislation has set it to 160mg/L.
1.1.2 Fermented and flavoured milk drinks
Nutrients can be obtained from many different sources, including beverages. Milk, for instance, is an important source of calcium and vitamin D two nutrients that are of current public health concern (Capps et al., 2005). Liquid, fermented milk products are defined by their sour taste, flavoured and unflavoured, with and without sweeteners and other added ingredients. Fermented milk is described by the varying degree of fermentation/sourness, achieved by using different bacteria. Drinking yogurt is described as yogurt that has been thinned by homogenisation and/or dilution; normally flavoured. They may contain colouring, sweeteners and stabilisers (Canadean Liquid Intelligence, 2008). Codex Alimentarius Commission (2003) defines the fermented milk as 'a milk product that has been manufactured by fermentation of milk, which milk may have been manufactured from products obtained from milk with or without compositional modification, by the action of suitable microorganisms and resulting in a decrease in pH with or without coagulation. These starter microorganisms shall be viable, active and abundant in the product to the date of minimum durability. If the product is heat-treated after fermentation the requirement for viable microorganisms does not apply. The Mauritius Food Regulations (1999) however does not make any provisions for fermented milk.
According to the Mauritius Food Regulations (1999) flavoured milk shall be whole milk, processed milk or reconstituted milk to which any permitted flavouring, colouring substance, food conditioner and sugar may be added. Flavoured milk drinks, according to Canadean Liquid Intelligence (2008), are ready to drink products to which flavouring and often sweeteners, colourings and stabilisers have been added. They include white milk mixed with fruit juice where milk remains the majority ingredient. The USDA (2005) reports that flavoured milk drinks provide four of the seven nutrients limiting in adults' diet that is vitamin A, calcium, magnesium and potassium.
1.2 SOFT DRINK AND MILK DRINK CONSUMPTION
Soft drink consumption has risen dramatically in the past decades as shown in Figure 2. USDA food data supply show that availability of regular soft drinks rose from 24.948 gallons (94.62L) per capita in 1975 to 37.703 gallons (142.78L) in 2000. Despite American's concern with losing weight, diet soft drinks grew slowly from 3.193 gallons (12.09L) per capita in 1975 to 11.8 gallons (43.93L) per capita in 2000 (USDA ERS, 2010). According to Euromonitor (2011) the increase in consumption of diet soft drinks up to 2008 could be explained by the association between high sugar content in carbonates and growing child obesity. Trademark Coca-Cola proudly declared having sold an incremental 5.8 billion unit cases from 1989 to 2009 (The Coca-Cola Company, 2009). The largest growth was noticed in Latin America, Europe, and Eurasia and Africa. According to the Britvic Soft Drinks Report 2010, a 25 percent increase in value sales of diet carbonates was noticed in South Africa.
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Carbonated soft drinks availability (volume in gallons)
(Source: USDA ERS, 2010)
Figure 2: U.S. per capita CSDs availability from 1970 to 2002 (available volume in gallons)
A study carried out in Mauritius entitled Dietary Habits of Mauritian School Adolescents in 2007 revealed that sweet fizzy drinks, providing "empty calories" were taken by 29.5 percent of the adolescents at least four times per week (Oogarah-Pratap, 2007). The report also revealed that soft drinks were among the most commonly purchased foods at school canteens with a total of 42.3 percent. Even though soft drinks remain the most widely consumed beverage in the non-alcoholic category, there has been an observed reduction in its intake. In 1988, 56 percent of youths reported drinking these beverages at least three times weekly.
The non-alcoholic industry is very competitive, with hundreds of new products introduced annually. As a direct result of this, consumers are being offered a wider variety of choices among non-alcoholic beverages. The USDA (2005) has disclosed the fact that more households are purchasing soft drinks than milk. According to Hector et al. (2009), soft drink consumption can lead to the displacement of healthier food choices. There is now an established trend toward decreased consumption of milk and increased consumption of soft drinks. The USDA (2005) also reports that a study carried out in 1999 revealed that soft drinks had displaced milk and fruit juice. Yen and Lin found that, on average, for each 1-ounce (0.03L) reduction in milk consumption, a child consumes 4.2 (0.12L) ounces of soft drinks. This results in a net gain of 31 calories, as well as a loss in calcium intake.
According to Mintel (2011) the carbonated soft drinks market in the U.S. continues to exhibit a downtrend in sales and consumption due to the rising demand for bottled water and functional beverages (including energy drinks) amongst others. Despite the fact that carbonated soft drinks consumption is still highest in the non-alcoholic beverage category, its long term profitability is being affected by a number of factors such as the related obesity issues or consumers' increasing doubts about the use of intense sweeteners in diet soft drinks. Consumers have also become more health conscious and are now demanding 'all-natural' products (Just Drinks, 2011).
HEALTH EFFECTS OF SOFT DRINKS AND MILK DRINKS
Soft drinks have been around for a long time now. Over the years soft drink consumption has continuously evolved and in 2005, according to the Datamonitor Report, it was estimated to have a market share of 46.8% within the non-alcoholic drink industry. This increase in consumption is however not without consequences. In fact, soft drink consumption has not only been found to displace healthier food and beverage choices but it has also been associated with a number of health effects. Milk, on the other hand, has come to be known as one of the most complete of all foods. Milk-based beverages have been found to be beneficial to the health and are also related to a healthier weight status (Hector et al., 2009). Paquin (2009) reports that as the demand for healthier products increases, milk manufacturers are developing reduced fat and reduce carbohydrate flavoured milk beverages.
Benefits and adverse health effects of soft drinks
According to Ashurst and Steen (2006), soft drinks have been consumed for many centuries in order to meet the body's fundamental requirement for hydration. As the major component of the beverage water usually accounts for between 85 to 95 % of the product (BSDA, 2011). However the primary function of soft drinks, that is hydration, is often overlooked. Indeed soft drinks as reported by Ashurst (2005) can rapidly satiate thirst as the acidity causes stimulation of saliva in the mouth. Moreover soft drinks are popular among consumers of all ages as the pleasant flavours incorporated coupled with the balance of acidity and sweetness make the product much enjoyable. Further development in the soft drinks industry has led to the use of intense sweeteners in low-calorie drinks which can also be consumed by diabetics. Ashurst (2005) claims that these low-calorie drinks also lack much of the carcinogenic property for which many have criticised sugar-containing beverages. This is also supported by the U.S. National Cancer Institute (2009) which claims that that studies of FDA-approved sweeteners have not demonstrated clear evidence of an association of cancer with humans.
On the other hand soft drinks have been identified as one of the factors independently associated with increased risk of obesity (Joint WHO/FAO Expert Consultation, 2003). A study carried out to identify the popular snacks upper primary school children in Mauritius buy at school stated that obesity among Mauritian children is a growing problem (Oogarah-Pratap, 2005). Hector et al. (2009) also reported about a possible link between soft drink consumption (diet and non-diet) and weight status such that it is strongly recommended to decrease intake at the population level to prevent weight gain and reduce the prevalence of obesity.
Soft drinks have been associated to enamel erosion and dental caries due to their high sugar content and high acidity (WHO, 2003). The Ministry of Health and Quality of Life in Mauritius has identified dental caries as a common problem affecting 19.5 per cent of primary schoolchildren (Oogarah-Pratap, 2005). It has also been reported that the low pH of soft drinks may cause erosion of the enamel surface and that the sugars are metabolised by plaque micro-organisms to produce organic acids that bring about demineralisation leading to dental caries.
A study carried out by Bray, Despres, Hu, Malik, Popkin and Willett (2010) on the consumption of sugar-sweetened beverages (including soft drinks) and associated weight gain and risk of overweight and obesity has revealed that a high consumption of such beverages is significantly associated with the occurrence of type 2 diabetes. The high sugar content of carbonated soft drinks as well as the large volumes consumed has also been shown to increase the likelihood of developing type 2 diabetes. Obesity and increasing dietary glycemic index have also been identified to cause insulin resistance (Hector et al., 2009)
Benefits and adverse health effects of milk drinks
Milk has been identified as one of the most complete of all foods since it contains most of the constituents of nutritional importance to humans. Paquin (2009) explains that the addition of flavour, colour and sucrose to milk has increased the popularity of milk as a beverage to consume with a meal, as a hydration product or as a snack. Milk-based beverages are an important source of calcium which is essential for bone metabolism and also to prevent osteoporosis. According to Hector et al. (2009) a number of studies have revealed that calcium intake or dairy intake overall contributes to improved weight status and weight loss. The U.S. National Dairy Council (2009) explains that flavoured milks, which are available in a variety of flavours, are of same nutritional value as unflavoured milk. The essential nutrients include calcium, potassium, phosphorus, proteins, vitamins A, D and B12, riboflavin and niacin. A USDA continuing survey of food intakes by individuals revealed that children who drank flavoured milk increased their milk intake and consumed fewer soft drinks compared to those who did not drink flavoured milk (US National Dairy Council, 2009).
Despite the important nutrient contributions flavoured milk makes to the diet, concerns about the potential effects of the added sugar and flavourings have raised questions regarding its role in a healthy diet. Even if flavoured milk does contain some added calories from sugar, no evidence has been found about whether flavoured milk adversely affects body mass index (BMI) in youth. In addition, experts have classified flavoured milk as a good choice for healthy teeth since milk components such as calcium, phosphorus, protein, and cocoa may protect the teeth from decay (U.S. NDC, 2009).
Modern consumers are increasingly focused on their personal health and well-being, and increasingly demanding that the foods they consume be beneficial to the health. Fermented milk drinks are one such type of foods. Indeed, the reported health effects of fermented milk are classified into two groups: nutritional and physiological functions. According to Chandan (2006) bacteria in such drinks cause fermentation thereby reducing the amount of lactose and increasing the level of lactic acid. Such products, in which the lactose has been effectively 'removed', can be consumed by lactose-intolerant consumers. Thus the dairy industry gains new milk consumers, who would otherwise avoid milk and dairy products all together (Paquin, 2009).
Other benefits of consuming fermented milk drinks would be that it enhances intestinal health by encouraging peristaltic movement thus improving overall digestion and absorption of food. An example would be the prevention of diarrhoea which occurs as a result of an infection by pathogenic bacteria (Chandan, 2006). Fermented products have also been reported to have potential anticarcinogenic properties. Conjugated linoleic acids (CLAs) are a class of fatty acid that has been found to exhibit potent physiological properties. Paquin (2009) reports that CLAs used in minute amounts in animal studies, have blocked all three stages of cancer and have slowed the growth of various tumours. CLAs, according to Chandan (2006), are also reported to increase bone density and regulate blood glucose levels by increasing insulin sensitivity.
CONTROL OF SOFT DRINK AND MILK DRINK CONSUMPTION
1.4.1 Regulatory control for soft drinks and milk drinks
The labelling requirements for soft drinks, as per the Mauritius Food Regulations (1999), vary according to the product type. No soft drink shall be imported, manufactured, processed, packed, stocked, offered for sale or sold unless the container bear a label describing the product type. The use of artificial sweeteners, the acid content and amount of sugar permissible in the product are also regulated.
Standards in the United Kingdom specify the minimum contents of carbohydrate sweetener and maximum contents of artificial sweetener for all soft drinks, the amount varying according to the type of drink, and the minimum fruit juice or potable fruit contents for the various soft drinks in which the consumer would expect some such content. The acids that may be added as well as preservatives and colourings to be used in the product are also controlled in the U.K. In addition, artificial sweeteners, where used, should be clearly indicated on the label (FAO, 1964).
According to the FDA (2009), The Nutrition Facts Panel on carbonated soft drinks typically includes the serving size and the nutrients provided in a serving: calories, total fat, sodium, total carbohydrate, sugars (if present), and protein. If a nutrient content claim, such as "Very Low Sodium," appears on the label, the manufacturer must also add the statement "Not a significant source of ________," with the blank filled in by the names of nutrients that are present only at insignificant levels.
The Mauritius Food Regulations specifies that flavoured milk shall not contain less than 3 per cent milk fat and 8.5 percent of non-fat milk solids. However there are no specific provisions for fermented milk. On the other side, Codex Alimentarius Commission (2003) characterise fermented milks by the specified starter culture(s) used for fermentation. Flavoured fermented milks are defined as composite milk products which contain a maximum of 50% (mass/mass) of non-dairy ingredients (for example nutritive and non-nutritive sweeteners, fruits and vegetables) and/or flavours. In addition Codex specifies that the name of the food, declaration of the food content, labelling of non-retail container (the name of product, lot identification, and the name of the manufacturer or packer) should be detailed in the case of fermented milks.
1.4.2 Soft drink ban in Mauritian schools
As a category, beverages vary widely in their calorie content and nutrient composition. Therefore beverage choice is most likely to affect the dietary quality of an individual. Among the wide range of available beverages, soft drinks have been identified as one of the factors likely to increase the incidence of ill-health consequences such as type 2 diabetes and obesity amongst others (Hector et al., 2009). In fact, the NCD survey carried out in Mauritius in 2004 revealed that nearly one out of every five persons above the age of 30 years suffered from diabetes. Moreover the prevalence of diabetes in the island increased from 14.3 % in 1987 to 19.3% in 2004 while that of obesity increased from 6.3% in 1987 to 10.3% in 2004 (Ministry of Health and Quality of Life, 2007). Type 2 diabetes formerly associated mainly with adults, is now seen with increasing frequency in children and adolescents. Furthermore, according to the Ministry of Health (2004), 8.5% of the schoolchildren population were considered overweight giving rise to much concern. The high obesity rate among Mauritian school children motivated government officials such that as from January 2007 sale of soft drinks was officially banned in primary and secondary schools (Government of Mauritius, 2006).
CONSUMER RESEARCH ON SOFT DRINKS AND MILK DRINKS
Consumer research and findings
Soft drink and milk drink consumption have been a cause of concern for many years now. Certainly, a number of research studies have been carried out in the United States in order to determine the relationship between soft drink and milk drink consumption (USDA ERS 2004; 2005; 2006). Information was collected using questionnaires or by conducting focus groups. Interestingly, researchers have found that soft drinks have gained much popularity among children and adolescents such that soft drink consumption has been linked to the displacement of healthier food and beverage choices (Hector et al., 2009). Moreover Hector et al. (2009) have also reported that a high level of soft drink intake is not only associated with lower intakes of a number of vitamins and minerals, and dietary fibre but it has also been found to negatively affect milk consumption. Since the limited research carried out has involved mostly children and adolescents, there is a lack of information concerning other subgroups of the population. In Mauritius also, no research has yet been done in this area of study.