Sugar-Sweetened Beverage Intake Among Adults, by Residence in Metropolitan and Nonmetropolitan Counties in 12 States and the District of Columbia, 2017.

Omoye Imoisili,Terry O’Toole,Heidi M. Blanck,Karen R. Siegel,Liping Pan,Elizabeth A. Lundeen,Sohyun Park

doi:10.5888/pcd17.190108

Abstract

The objective of this study was to describe the prevalence of sugar-sweetened beverage (SSB) intake among US adults (n = 68,896) residing in metropolitan and nonmetropolitan counties, by state, using data from the Behavioral Risk Factor Surveillance System. We used multinomial logistic regression to calculate adjusted prevalence ratios for daily (≥1 time per day) SSB intake. Overall, 26.0% of respondents reported daily SSB intake, with significantly higher prevalence in nonmetropolitan counties (30.9%) than in metropolitan counties (24.8%) (adjusted prevalence ratio = 1.32, 95% confidence interval, 1.26–1.39). This same pattern was significant in 5 of 11 states with metropolitan and nonmetropolitan counties. These findings could inform efforts to reduce frequent SSB intake in nonmetropolitan areas.

Highlights

A higher percentage of adults in nonmetropolitan counties (30.9%) than in metropolitan counties (24.8%) reported daily sugar-sweetened beverage (SSB) intake (APR = 1.32; 95% confidence intervals (CIs), 1.26–1.39; P < .001) (Table 2)
The largest adjusted prevalence ratios (APRs) for daily SSB intake between adults in nonmetropolitan counties and adults in metropolitan counties, by sociodemographic characteristic, were the following: by age, among adults aged 25 to 34 (APR = 1.45; 95% CI, 1.27–1.65); by sex, among men (APR = 1.33; 95% CI, 1.25–1.43); by race/ethnicity, among non-Hispanic others (APR = 2.01; 95% CI, 1.69–2.39); by education, among college graduates (APR = 1.51; 95% CI, 1.33–1.70); and by employment status, among employed persons (APR = 1.39; 95% CI, 1.30–1.49)
Daily SSB intake in nonmetropolitan counties ranged from 17.0% in Vermont to 44.1% in Arkansas (Table 2), and in metropolitan counties SSB intake ranged from 17.1% in Vermont to 37.6% in West Virginia

Summary

Methods

The Behavioral Risk Factor Surveillance System (BRFSS) is a state-based, random-digit–dialed, annual landline and cellular telephone survey of US adults aged 18 years or older conducted by state health departments with assistance from the Centers for Disease Control and Prevention (CDC) to monitor chronic health conditions and associated risk factors (4). VOLUME 17, E07 JANUARY 2020 landline and cell phone data, 43.0% [range, 32.9%–54.0%] [5]) included an optional module with 2 questions on SSB intake: 1) “During the past 30 days, how often did you drink regular soda or pop that contains sugar? Of 80,662 adult respondents, we excluded 11,766 (14.6%; range, 10.4%–26.1%) who had missing responses to either SSB question. Our analysis included 68,896 adults who responded to both questions in the SSB module. We used χ2 tests to determine whether SSB intake differed by covariates (significant at P < .05)

Results

Discussion

Conclusion