Who is Replacing Sugar-Sweetened Beverages with Plain Water? Analyses of NHANES 2011–16 Data

Abstract

Abstract Objectives In the United States, replacing sugar-sweetened beverages (SSB) with plain drinking water is recommended via by numerous public health agencies and non-governmental organizations. While declines in SSB consumption in the US are well-documented, it is not clear if consumers are replacing SSBs with other beverages, namely plain drinking water. Methods Beverage consumption data for 7453 children (4–18y) and 15,263 adults (≥19y) came from two 24 h dietary recalls in three most recent cycles of the National Health and Nutrition Examination Survey (NHANES 2011–2016). Consumption trends for water intakes (in mL/d) from SSBs and from drinking water were analyzed by gender, age group, family income, and race/ethnicity. Results Mean water intakes from SSBs declined from 322 mL/d to 262 mL/d (p-trend = 0.002) on average, whereas plain drinking water increased from 1011 mL/d to 1144 mL/d (p-trend = 0.0108). Statistically significant reductions in SSBs were observed only among men (-18%), younger participants (-26% in 4–8, -22% in 9–13, -33% in 14–19 and -30% in 20–30), those with lower incomes (family income-to-poverty ratio < 2.0), non-Hispanic whites and non-Hispanic black participants (p-trend < 0.05 for each). Within these population sub-groups, only non-Hispanic white participants, those with a family income to poverty ratio of 1–1.99, but not < 1.0, and children aged < 14y had a corresponding increase in plain water consumption. When examining types of water, non-Hispanic white participants replaced SSBs with tap water as opposed to bottled water, and the lower income group replaced SSBs with bottled water, as opposed to tap water. Conclusions The expected replacement of SSBs with plain drinking water was not uniformly observed across socio-demographic group. Only non-Hispanic Whites and lower income groups replaced SSB with water, whereas teenagers (14–19y) and non-Hispanic black participants did not. Understanding how and if specific population sub-groups are replacing a declining food/beverage category with another category has important population health implications. Funding Sources Analyses of publicly available federal NHANES databases were sponsored by PepsiCo Inc. and conducted by MS-Nutrition. The views expressed in this abstract are those of the authors and do not necessarily reflect the position or policy of PepsiCo, Inc.