Abstract P217: Neighborhood and Individual Characteristics Associated With Sugar-sweetened Beverage Consumption Among Overweight and Obese Adults in the Portal Obesity Cohort

Abstract

A diet high in sugar sweetened beverages (SSB), which includes soda and beverages with added sugar, has been shown to be associated with adverse health outcomes. National data indicate that one-half of adults and two-thirds of youth consume at least one SSB per day. Studies have suggested that proximity to SSB vendors and neighborhood food environment are not associated with consumption; however higher intake has been shown in adults with lower individual level education and income. Less is known about how neighborhood socioeconomic status may be associated with SSB intake. We examined SSB consumption by individual demographic and neighborhood characteristics in a large racial/ethnically and regionally diverse cohort of overweight and obese insured adults in the U.S. Data were from adults in the Patient Outcomes Research to Advance Learning (PORTAL) network-Overweight and Obese Cohort randomly selected to complete a survey in 2015 including questions of health-promoting behavior. A total of 2,683 out of 2,811 participants answered the question, “Over the past 7 days, on average, how many servings of regular soda and other sugar-sweetened drinks did you drink each day? A serving = 8 oz or ¾ can” and were included in the analysis. Responses ranged from 0 to 56 servings with median (IQR) of 0 (0,1). The study outcome was divided into 4 categories: 0, 1, 2, and 3 or more servings per day. Of the 2,683 respondents, most were non-Hispanic white (50.2%, n=1,348) with 20% non-Hispanic black (n=537), 14.8% Hispanic (n=396), and 5.5% Asian (n=148). The median (IQR) age was 54 (42, 64). The majority reported attending some college or holding a 2-year degree (35.5%, n=942) and lived in a neighborhood where > 48% of residents had a high school or lower education (28.3%, n=677) and <5% of residents living at poverty income level (33.5%, n=797). We calculated multivariable ordinal logistic regression models to determine the association of SSB with study variables. In fully adjusted models, older participants consumed fewer servings of SSB (OR (95% CI) .98 (.97, .99)), while black survey respondents drank more SSB than white participants (OR (95% CI) 2.46 (1.91, 3.18)). Additionally, males consumed more SSB than females (OR (95% CI) 1.40 (1.18, 1.66) and participants with class 4 obesity drank more SSB than those who were overweight (OR (95% CI) 1.70 (1.18, 2.44). Participants who self-reported some college/2-year degree and high school graduate or lower drank more SSB than those who had more than a college degree (OR (95% CI) 1.55 (1.20, 2.01), 1.99 (1.51,2.61)). Neighborhood education, poverty level, and study site were not significant. In conclusion, individual level characteristics are associated with higher SSB consumption more so than neighborhood variables. This highlights the importance of tailored individual intervention strategies to mitigate the adverse health outcomes associated with consumption of SSB.