Abstract
Adolescence is a time in life when lifestyle behaviours are acquired. One indicator of poor diet quality is the intake of foods and beverages with a relatively low nutritional value. Using the Australian classification of such foods, termed “discretionary”, we classified the intakes of Swedish adolescents who participated in the Riksmaten Adolescent 2016–17 national dietary survey. From selected schools, 3099 adolescents in age groups 11–12, 14–15 and 17–18 years provided two 24-h recalls. Intakes and healthy dietary scores were calculated. Plasma ferritin, folate and 25(OH)D were available for a third. Almost 40% of total energy came from discretionary foods/beverages. Adolescents with higher intakes were more likely to be female, older, from a low socioeconomic position-household and born in Sweden. Most discretionary foods/beverages were consumed on weekend days and during in-between meals, outside of the home and at school. Percent energy from discretionary intake was associated with healthy dietary scores but not nutritional status. A substantial amount of energy was obtained from discretionary foods/beverages, and we found that consumption is pervasive across sociodemographic factors, time and place. Addressing this pattern will require a comprehensive approach to food environments and behaviours to reach all adolescents in an equitable manner.
Highlights
Poor dietary habits are associated with increased risk of diseases such as type 2 diabetes, cardiovascular diseases, certain cancers and overweight/obesity [1]
The energy from discretionary foods and beverages increased by age and was highest in 17–18year-old boys, the contribution of discretionary foods to total energy intake was fairly similar across the age groups with the exception of 11–12-year-old boys (34%) and 17–18-year-old girls (39%)
Results were very similar to a previous study of Swedish children and adolescents from 1998–9, where sugar sweetened beverages (SSBs), sweets and chocolate, chips and crisps, cakes and biscuits and other sweet foods together accounted for almost one-fifth of energy and saturated fat and two-thirds of sucrose intakes [34]
Summary
Poor dietary habits are associated with increased risk of diseases such as type 2 diabetes, cardiovascular diseases, certain cancers and overweight/obesity [1]. Adolescence is a vulnerable time in life, and dependence on the family environment is still strong, peers and the environment outside the home become more important [3]. One important indicator of poor diet quality is the intake of foods and beverages with a relatively low nutritional value, i.e., foods high in energy and nutrients that the general population consume more than the recommended amounts of. These are foods typically high in sugar, salt and/or saturated fat such as confectionary, cakes, biscuits, desserts, ice cream, salty snacks and sugar sweetened beverages (SSBs), but may include foods such as hamburgers, fries, pizza and highly processed foods. Occurring terms in the literature can refer to their nutritional composition (e.g., “SoFAS”, “energy dense”, “low nutritional value”), their level of processing (e.g., “ultra-processed foods”) or their presumed place—or lack of—in the diet (e.g., “unhealthy”, “junk foods”)
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