Abstract
Consumption of added sugars, especially from sugar-sweetened beverages (SSBs), has been associated with several negative health outcomes during adolescence. This study aimed to identify dietary intake and food sources of added sugars in the home, school, and neighborhood environments of Costa Rican adolescents. Dietary intake of added sugars was determined using 3-day food records in a cross-sectional study of 818 adolescents aged 12 to 19 and enrolled in rural and urban schools in the province of San José. On average, 90% of adolescents consumed more than 10% of their total energy intake from added sugars. Furthermore, 74.0% of added sugars were provided at home, 17.4% at school, and 8.6% in the neighborhood. Added sugars were primarily provided by frescos (29.4%), fruit-flavored still drinks (22.9%), and sugar-sweetened carbonated beverages (12.3%), for a total contribution of 64.6%. Our findings suggest that Costa Rican adolescents have a plethora of added sugar sources in all food environments where they socialize. However, it is relevant for public health to consider the home and school environments as fundamental units of interventions aimed at reducing added sugars in the adolescent diet. Frescos prepared at home and school and fruit-flavored still drinks must be the focus of these interventions.
Highlights
Added sugars are defined as any caloric sweeteners, including honey and syrups, added to food during processing/manufacturing or at the table [1]
It has been documented that adolescents with more frequent availability of sugar-sweetened beverages (SSBs) at home have a higher consumption of these drinks [29,30,31,32], regardless of SSB availability in other environments
This study aimed to (1) identify dietary intake and food sources of added sugars in the home, school, and neighborhood environments of Costa Rican adolescents, and (2) determine if added sugar consumption varied according to mealtimes and between weekdays and weekends in this population
Summary
Added sugars are defined as any caloric sweeteners, including honey and syrups, added to food during processing/manufacturing or at the table [1]. The universal availability of SSBs in the neighborhood environment contributes to impulse purchasing and consumption among adolescents [33]. Since most adolescents in Costa Rica cannot drive independently, they may be restricted to purchasing or consuming SSBs in areas near their home and school to which they can walk or bike. Hearts et al [34] found that youth purchases of SSBs in community settings are more frequent when food retail stores are available within a 10 min walk from home. Laska et al [33] found that intake of SSBs in adolescents was associated with residential proximity to restaurants (including fast food), convenience stores, grocery stores, and other retail facilities within the 800 m and 1600 m residential buffer
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