Inj Prev 18:259-263 doi:10.1136/injuryprev-2011-040117
  • Original article

The ‘Twinkie Defense’: the relationship between carbonated non-diet soft drinks and violence perpetration among Boston high school students

Press Release
  1. David Hemenway2
  1. 1Department of Economics, University of Vermont, University Place, Burlington, Vermont, USA
  2. 2Health Policy and Management, Harvard School of Public Health, Boston, Massachusetts, USA
  1. Correspondence to Sara J Solnick, Department of Economics, University of Vermont, 237 Old Mill, 94 University Place, Burlington, VT 05405, USA; sara.solnick{at}
  1. Contributors DH was largely responsible for conception and design and acquisition of data. SS was not involved in that phase of the project. SS conducted the statistical analyses. Both authors participated in analysis and interpretation of data, drafting and revising the article for important intellectual content and both shared final approval of the version to be published.

  • Accepted 15 September 2011
  • Published Online First 24 October 2011


Objectives To investigate the association of carbonated non-diet soft drink consumption and violence perpetration in a sample of Boston adolescents.

Methods In a survey of Boston public high schools, respondents were asked how often they drank non-diet soft drinks and whether they had carried a weapon or engaged in physical violence with a peer. Regression analysis was used to determine the role of soft drink consumption in these behaviours.

Results Adolescents who drank more than five cans of soft drinks per week (nearly 30% of the sample) were significantly more likely to have carried a weapon and to have been violent with peers, family members and dates (p<0.01 for carrying a weapon and p<0.001 for the three violence measures). Frequent soft drink consumption was associated with a 9–15% point increase in the probability of engaging in aggressive actions, even after controlling for gender, age, race, body mass index, typical sleep patterns, tobacco use, alcohol use and having family dinners.

Conclusions There was a significant and strong association between soft drinks and violence. There may be a direct cause-and-effect relationship, perhaps due to the sugar or caffeine content of soft drinks, or there may be other factors, unaccounted for in our analyses, that cause both high soft drink consumption and aggression.


  • Funding This work was supported by the Centers for Disease Control and Prevention, grant number 5U49 CE00-740. CDC supplied the funds to create, conduct and analyse the survey.

  • Competing interests None.

  • Ethics approval Harvard School of Public Health Office of Human Research Administration.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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