Abstract

Background: Sugar-sweetened beverages (SSBs), fruit juice, and milk each significantly contribute to health and disease. To-date, assessment of their global distributions and health impacts have been limited by insufficient comparable and reliable data by country, age, and sex. Objective: To quantify global, regional, and national levels of SSB, fruit juice, and milk intake by age and sex in adults over age 20 in 2010. Methods: We identified, obtained, and assessed data on intakes of these beverages in adults, by age and sex, from 193 nationally representative diet surveys worldwide, representing 62% of the world’s population. We developed a multi-level hierarchical Bayesian model to account for differences in national and regional missingness, measurement incomparability, study representativeness, and sampling and modeling uncertainty. Results: In 2010, global average intakes were 0.58 (95%UI: 0.37, 0.89) 8 oz servings/day for SSBs, 0.16 (0.10, 0.26) for fruit juice, and 0.57 (0.39, 0.83) for milk. There was significant heterogeneity in consumption of each beverage by region and age (Figure). SSB intakes were highest in the Caribbean (1.9 servings/day; 1.2, 3.0) fruit juice intakes were highest in Australia and New Zealand (0.66; 0.35, 1.13), and milk intakes were highest in Central Latin America and parts of Europe (1.06; 0.68, 1.59). Consumption levels of all three beverages were lowest in East Asia and Oceania. Globally and within regions, SSB consumption was highest in younger adults; fruit juice consumption showed little relation with age; and milk intakes were highest in older adults. Conclusions: This quantitative assessment of current beverage intakes at global, regional, and national levels, as well as by age and sex, is imperative for informing public health and policy priorities for intervention strategies, as well as for quantifying the impacts of these beverages on health worldwide.

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