Australian National Children's Nutrition Research Articles

The direct and indirect associations of usual free sugar intake on BMI z-scores of Australian children and adolescents.

This cross-sectional analysis aimed to assess the association between free sugar consumption and the BMI z-score of Australian children and adolescents. Data from the 2007 Australian National Children's Nutrition and Physical Activity Survey were analyzed. Structural equation modeling was used to assess the direct association between usual free sugar intake and age-and-sex-specific BMI z-score, and the indirect association mediated via energy overconsumption. Weak and statistically non-significant associations were found for the direct (BMI z-score β = -0.02 per 10% change in energy intake from free sugar, p = 0.705) and indirect pathways (BMI z-score β = -0.04 per 10% change in energy intake from free sugar, p = 0.705). We concluded that free sugar intake was not associated with BMI z-score in this cohort. Instead of focusing on a single energy source in the diet, improving the quality of the whole diet may be a better approach in tackling childhood obesity.

Intake of total and added sugars and nutrient dilution in Australian children and adolescents.

This analysis aimed to examine the association between intake of sugars (total or added) and nutrient intake with data from a recent Australian national nutrition survey, the 2007 Australian National Children's Nutrition and Physical Activity Survey (2007ANCNPAS). Data from participants (n 4140; 51 % male) who provided 2×plausible 24-h recalls were included in the analysis. The values on added sugars for foods were estimated using a previously published ten-step systematic methodology. Reported intakes of nutrients and foods defined in the 2007ANCNPAS were analysed by age- and sex-specific quintiles of %energy from added sugars (%EAS) or %energy from total sugars (%ETS) using ANCOVA. Linear trends across the quintiles were examined using multiple linear regression. Logistic regression analysis was used to calculate the OR of not meeting a specified nutrient reference values for Australia and New Zealand per unit in %EAS or %ETS. Analyses were adjusted for age, sex, BMI z-score and total energy intake. Small but significant negative associations were seen between %EAS and the intakes of most nutrient intakes (all P<0·001). For %ETS the associations with nutrient intakes were inconsistent; even then they were smaller than that for %EAS. In general, higher intakes of added sugars were associated with lower intakes of most nutrient-rich, 'core' food groups and higher intakes of energy-dense, nutrient-poor 'extra' foods. In conclusion, assessing intakes of added sugars may be a better approach for addressing issues of diet quality compared with intakes of total sugars.

DKA as a presentation of childhood diabetes mellitus

Within 20 years, the number of people in Australia with type 2 diabetes may increase from an estimated 870,000 in 2014 to over 2.5 million. 1 The care for these adults is predominantly provided by general practitioners. It is understandable that when a GP thinks diabetes, they think type 2 diabetes. Results from the 2007–2008 Australian National Children's Nutrition and Physical Activity Survey indicated that one in four children aged 5–17 years are now overweight or obese. 2 Yet the diabetes present in childhood, even in obese children, is overwhelmingly type 1. 3 Most of the care for children with diabetes, type 1 diabetes is provided by paediatric endocrinologists. It is understandable that when a GP thinks childhood diabetes, they think type 2 diabetes. The natural history of type 1 diabetes in childhood is progression from dysglycaemia to polyuria and polydipsia, with development of diabetic ketoacidosis if the diagnosis of diabetes mellitus is not made and appropriate treatment instituted. It is understandable that when a GP sees a child with polyuria and polydipsia, the GP thinks diabetes. The standard practise for diagnosing type 2 diabetes is lab measurement of fasting glucose, glucose tolerance test, or recently, glycated haemoglobin. The polyuria of developing diabetes can be interpreted as urinary frequency. Secondary enuresis is a common presentation in younger children. Both of these prompt consideration of urinary tract infection. Investigation of urine with microscopy, culture and sensitivity is the sensible next step. Laboratory medicine is essential to the diagnosis of diabetes. Its diagnostic criteria are laboratory based. Yet from work in Sydney, children who are given forms for lab-based testing present in DKA at a higher rate than children who have PoC testing done in the GP office, or are sent to hospital with no testing at all. 4 In Parma, across 8 years, the frequency of presentation of childhood diabetes in ketoacidosis dropped from 78% to 12.5%. 5 This was accomplished by focusing on diagnosis of diabetes in childhood before the presentation of ketoacidosis. In Australia today 40% of childhood diabetes presents in DKA. Our pathology services can improve that.

Food and beverage portion sizes in Australian children: a secondary analysis of 1995 and 2007 national data.

BackgroundPortion size of foods is reported to contribute to the rise in obesity prevalence. However, evidence of changes in portion size for commonly consumed foods in Australia is lacking. The aim was to evaluate whether Australian child and adolescent portion sizes of selected foods changed from 1995 to 2007.MethodsTime-series study, comparing dietary data from two national cross-sectional surveys in nationally representative population survey of Australian households. The dietary data was from children aged 2–16 years who participated in the 1995 National Nutrition Survey (n = 2198) and 2007 Australian National Children’s Nutrition and Physical Activity Survey (n = 4799).ResultsDifferences were found across survey years in median portion size of common foods and beverages assessed by 24-hour recalls for age and sex categories. Of the 61 foods items evaluated across the whole population sample, portion size increased in 18 items, decreased in 22, with no change in 20, although the magnitude of change varied by age and sex. Decreases in portion size were detected for most dairy products, breakfast cereal, some packaged snack foods and vegetables, p < 0.0001. Increases were detected for cooked chicken, mixed chicken dishes, bacon and ham (p < 0.0001), cooked meat (p < 0.05), fish (p < 0.01) and pizza (p < 0.0001). No significant changes were detected for many items including white and wholemeal bread, mincemeat, chocolate and soft drink.ConclusionsSmall changes in portion sizes were detected over 12 years in Australian children and adolescents with the degree of change varying by sex, age and food group. Knowledge of usual portion sizes could inform programs targeting appropriate serving sizes selection in children and adolescents.

Misreporting of energy intake in the 2007 Australian Children's Survey: differences in the reporting of food types between plausible, under‐ and over‐reporters of energy intake

Misreporting is common when collecting dietary intake data, although relatively little is known about the types of foods misreported among children. The present study aimed to identify differences in the reporting of food types between plausible and misreporters of energy intake in a national nutrition survey of Australian children. Dietary data were collected using a 24-h recall from 4826 children aged 2-16 years who were participating in the 2007 Australian National Children's Nutrition and Physical Activity Survey. Misreporters of energy intake were classified using the Goldberg criteria. Differences in the reporting of a range of food types were examined between plausible, under- and over-reporters. Compared with plausible reporters, under-reporters reported less frequent consumption and smaller quantities of consumption of both core and noncore foods. Older children (self-report) under-reported a larger selection of noncore foods than younger children (parental report). Over-reporters reported similar percentages of consumption of many core and noncore foods, with some exceptions. The quantities consumed by over-reporters were generally much larger and this was evident in younger and older children. Compared with plausible reporters, under-reporters had significantly higher intakes of protein and starch but lower intakes of sugar and fat, as percentage energy, than plausible reporters, whereas over-reporters had higher fat and lower carbohydrate intakes. Differences in the reporting of food types were common between plausible, under- and over-reporters of energy intake by children (or their parents) and were not restricted to noncore foods.

Processed pork is the most frequently consumed type of pork in a survey of Australian children

Pork represents a core food that provides key nutrients to the diet. Dietary guidelines recommend limiting processed meat intake because of adverse health outcomes. The aims of this study were to describe pork consumption, assess the contribution of pork to nutrient intakes, and compare anthropometric characteristics between pork consumers and nonconsumers in a survey of Australian children. We hypothesized that pork consumption will contribute to intakes of key nutrients and that the weight status of children who consume pork will be similar to nonconsumers. This study involved a secondary analysis of the 2007 Australian National Children's Nutrition and Physical Activity Survey. Pork and pork-containing dishes were identified and classified as fresh or processed pork. The contributions of pork to nutrient intakes were calculated. Weight, waist circumference, and body mass index were compared between pork consumers and nonconsumers. Data from 4487 children were available for use. Of this sample, 2245 reported consuming pork, 14% (n = 310) of whom consumed fresh pork, whereas 93% (n = 2084) consumed processed pork. All types of pork contributed to intakes of protein, niacin, and zinc. In addition, fresh pork contributed to intakes of thiamine, long-chain omega-3, phosphorous, and potassium. Total and processed pork contributed 12.2% and 13.0% of sodium, respectively. There were no significant differences between weight, waist circumference, and body mass index in consumers and nonconsumers of total, fresh, or processed pork. In a survey of Australian children, processed pork was the most frequently consumed form of pork, suggesting a deviation from dietary guidelines.

Dietary Intake and Food Sources of EPA, DPA and DHA in Australian Children

Secondary analysis of the 2007 Australian National Children's Nutrition and Physical Activity survey was undertaken to assess the intake and food sources of EPA, DPA and DHA (excluding supplements) in 4,487 children aged 2-16years. An average of two 24-h dietary recalls was analysed for each child and food sources of EPA, DPA and DHA were assessed using the Australian nutrient composition database called AUSNUT 2007. Median (inter quartile range, IQR) for EPA, DPA and DHA intakes (mg/day) for 2-3, 4-8, 9-13, 14-16year were: EPA 5.3 (1.5-14), 6.7 (1.8-18), 8.7 (2.6-23), 9.8 (2.7-28) respectively; DPA 6.2 (2.2-14), 8.2 (3.3-18), 10.8 (4.3-24), 12.2 (5-29) respectively; and DHA 3.9 (0.6-24), 5.1 (0.9-26), 6.8 (1.1-27), 7.8 (1.5-33) respectively. Energy-adjusted intakes of EPA, DPA and DHA in children who ate fish were 7.5, 2 and 16-fold higher, respectively (P<0.001) compared to those who did not eat fish during the 2days of the survey. Intake of total long chain n-3 PUFA was compared to the energy adjusted suggested dietary target (SDT) for Australian children and 20% of children who ate fish during the 2days of the survey met the SDT. Fish and seafood products were the largest contributors to DHA (76%) and EPA (59%) intake, while meat, poultry and game contributed to 56% DPA. Meat consumption was 8.5 times greater than that for fish/seafood. Australian children do not consume the recommended amounts of long chain omega-3 fatty acids, especially DHA, which could be explained by low fish consumption.

Australian children who drink milk (plain or flavored) have higher milk and micronutrient intakes but similar body mass index to those who do not drink milk

In Australia, 60% of children (9-16 years) are not meeting the estimated average requirement (EAR) for calcium, and milk is an important dietary source of calcium. We hypothesized that milk drinking (plain or flavored) would be associated with higher milk and nutrient intake among Australian children. Nutrient intakes reported via 24-hour recalls and anthropometric measurements collected from the 2007 Australian National Children's Nutrition and Physical Activity Survey were analyzed. Children and adolescents (cross sectional, n = 4487, 2-16 years) were classified into 4 categories according to milk intake: (i) exclusively plain milk drinkers, (ii) flavored (flavored and plain) milk drinkers, (iii) nondrinkers of milk (no plain or flavored milk as beverage), and (iv) nonconsumers of milk (total milk intake is 0 g). Total daily milk, energy and nutrient intake, body mass index, and waist circumference were compared between categories of milk drinking by analysis of variance models. Results of this study show that milk drinkers (plain or flavored) had a significantly higher total milk intake than did nondrinkers of milk. Milk drinking was associated with higher intakes of calcium, phosphorus, magnesium, potassium, and iodine in comparison with nondrinkers of milk and nonconsumers of milk (P < .05). Milk drinkers (exclusively plain or flavored) were more likely to meet the EAR for calcium than nondrinkers and nonconsumers of milk, whereas flavored milk drinkers were more likely to meet the EAR for calcium than exclusively plain milk drinkers. In particular, among children aged 9 to 16 years, flavored milk drinkers were 1.7 times more likely to meet the EAR for calcium than plain milk drinkers (P < .001). Although flavored milk drinkers had higher total sugar and energy intakes than did exclusively plain milk drinkers and nonconsumers of milk (P < .05), no between-group differences were observed in body mass index, waist circumference, or physical activity level. In conclusion, drinking milk was associated with higher total milk and micronutrient intake, and drinking both plain and flavored milk may help children meet their calcium requirements without negatively impacting body weight measures.

Sleep duration or bedtime? Exploring the association between sleep timing behaviour, diet and BMI in children and adolescents

To determine whether sleep timing behaviour is associated with energy intake and diet quality in children and adolescents. Cross-sectional analysis of nationally representative survey data. A total of 2200 participants of the 2007 Australian National Children's Nutrition and Physical Activity Survey aged 9-16 years with 2 days of food intake data, 4 days of use of time data and complete anthropometry. Participants were grouped into one of four sleep-wake behaviour categories: early bed-early rise (EE); early bed-late rise (EL); late bed-early rise (LE) and late bed-late rise (LL). The four categories were compared for body mass index (BMI) z-score, energy intake and diet quality assessed using the Dietary Guideline Index for Children and Adolescents. Analyses were adjusted for survey design, sociodemographic characteristics, sleep duration and physical activity level (PAL). In adjusted multivariate regression models with sleep timing behaviour group as the independent variable, the 'LL' category compared with the 'EE' category had a higher BMI z-score (β=0.20, 95% confidence interval (CI) 0.06 to 0.34, P=0.007), and lower diet quality (β=-4.0, 95% CI -5.7 to -2.3, P<0.001). Children and adolescents who went to bed late also had a higher intake of extra foods (that is, energy-dense, nutrient-poor foods) while those whom went to bed early consumed more fruit and vegetables. Energy intake was associated with sleep duration (β=-4.5 kJ, 95% CI -6.7 to -2.4, P<0.001), but not sleep timing behaviour. Late bedtimes and late wake up times are associated with poorer diet quality, independent of sleep duration, PAL and child and sociodemographic characteristics.

Is socioeconomic status associated with dietary sodium intake in Australian children? A cross-sectional study

ObjectiveTo assess the association between socioeconomic status (SES) and dietary sodium intake, and to identify if the major dietary sources of sodium differ by socioeconomic group in a nationally representative...

Consumption of beef/veal/lamb in Australian children: Intake, nutrient contribution and comparison with other meat, poultry and fish categories

AbstractAimTo describe reported consumption of meat for children using the 2007 Australian National Children's Nutrition and Physical Activity Survey.MethodsOne‐day, weighted data are described for consumption of meat, poultry and fish consumed as ‘cuts’ and from mixed dishes. Data are presented for all children by age groups (2–3 years, 4–8 years, 9–13years, 14–16 years) and gender. Trimming practices, time and place of consumption, and nutrient contributions are described.ResultsNinety per cent of children reported consuming meat, poultry or fish on the day surveyed. Reported mean consumption of all beef/veal/lamb, pork/ham/bacon, poultry and fish ranged from 52 g in 2 to 3‐year‐old boys to 161 g in 14 to 16‐year‐old boys; and was lower in 9 to 16‐year‐olds girls; 98 g.Mean reported consumption of beef/veal/lamb was 21–64 g for boys and 23–36 g for girls, depending on age group.For meals where the meat, poultry or fish were identified individually, meals with beef/veal/lamb contained more vegetables (159 g) than pork/ham/bacon (50 g) and poultry (110 g). The beef/veal/lamb was fully (20%) or semi‐trimmed (58%), and 49% of minced beef/veal/lamb was lean. Sixty‐eight per cent of respondents reported eating poultry with the skin removed.Across all age groups, beef/veal/lamb in cuts and mixed dishes contributed 4% of total energy, 6% of total fat, 5% of saturated fat, 46% of haem iron, 18% of zinc and 21% of long‐chain omega‐3 fatty acid intake.ConclusionsThese findings help to inform evidence‐based individual or population‐level recommendations.

Misreporting by BMI category in the 2007 Australian National Children's Nutrition and Physical Activity Survey

Misreporting by BMI category in the 2007 Australian National Children's Nutrition and Physical Activity Survey

Where do Australian children get their dietary fibre? A focus on breakfast food choices

AbstractAims: There is little data in Australian children assessing dietary fibre intakes or ready‐to‐eat cereal consumption. The aims were to: (i) assess the dietary fibre intake of 2‐ to 16‐year‐old children from the 2007 Australian National Children's Nutrition and Physical Activity Survey; (ii) determine the percentage of children meeting adequate fibre intake; and (iii) determine the contribution of breakfast and ready‐to‐eat cereal fibre intake.Methods: Secondary analysis of the 2007 Australian National Children's Nutrition and Physical Activity Survey.Results: On the day of the survey, the mean (SE) dietary fibre intake among all children at breakfast was 4.5 (0.1) g and total daily fibre intake was 20.7 (0.2) g. Fibre adequacy was achieved by 50% of Australian children. Forty‐nine percent of all children consumed ready‐to‐eat cereal, providing 2/3 of fibre intake at breakfast and 1/10 of total daily fibre intake. Consuming ready‐to‐eat cereal was a significant predictor of total daily fibre intake (β= 0.028). Over 60% of all children consumed ready‐to‐eat cereal in which at least a ‘source’ of fibre (1.5–3.0 g) was available; however, &lt;10% of children consumed ready‐to‐eat cereal containing a ‘very high source’ of fibre (≥6.0 g).Conclusions: While ready‐to‐eat cereal was only consumed by close to half of all children, it was a significant contributor of fibre at both the breakfast meal occasion and over the whole day. Randomised controlled trials are necessary to identify whether increasing consumption of fibre from ready‐to‐eat cereal alters health outcomes such as anthropometric and biochemical end points.

Dairy food intake of Australian children and adolescents 2–16 years of age: 2007 Australian National Children's Nutrition and Physical Activity Survey – Corrigendum

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Socioeconomic variation in diet and activity‐related behaviours of Australian children and adolescents aged 2–16 years

Evidence for age-related variation in the relationship between obesity-related behaviours and socioeconomic position may assist in the targeting of dietary and physical activity interventions among children. To investigate the relationship between different indicators of socioeconomic position and obesity-related behaviours across childhood and adolescence. Data were from 4487 children aged 2 to 16 years participating in the cross-sectional 2007 Australian National Children's Nutrition and Physical Activity Survey. Socioeconomic position was defined by the highest education of the primary or secondary carer and parental income. Activity was assessed using recall methods with physical activity also assessed using pedometers. Intake of energy-dense drinks and snack foods, fruits and vegetables was assessed using 2 × 24-h dietary recalls. A socioeconomic gradient was evident for each dietary measure (although in age-specific analyses, not for energy-dense snacks in older children), as well as television viewing, but not physical activity. Whether each behaviour was most strongly related to parental income or education of the primary or secondary carer was age and sex dependent. The socioeconomic gradient was strongest for television viewing time and consumption of fruit and energy-dense drinks. A strong socioeconomic gradient in eating behaviours and television viewing time was observed. Relationships for particular behaviours differed by age, sex and how socioeconomic position was defined. Socioeconomic indicators define different population groups and represent different components of socioeconomic position. These findings may provide insights into who should be targeted in preventive health efforts at different life stages.

Dairy food intake of Australian children and adolescents 2-16 years of age: 2007 Australian National Children's Nutrition and Physical Activity Survey.

Dairy food consumption is important for Australian children as it contributes key nutrients such as protein and Ca. The aim of the present paper is to describe dietary intake from dairy foods for Australian children aged 2-16 years in 2007. Secondary analysis of a quota-sampled survey using population-weighted, 1 d (24 h) dietary recall data. Australian national survey conducted from February to August 2007. Children (n 4487) aged 2-16 years. Most Australian children consumed dairy foods (84-98 %), with the proportion consuming tending to decrease with age and males consuming significantly more than females from the age of 4 years. Milk was the most commonly consumed dairy food (58-88 %) and consumed in the greatest amount (243-384 g/d). Most children consumed regular-fat dairy products. The contribution of dairy foods to total energy intake decreased with age; from 22 % of total energy at age 2-3 years to 11 % at age 14-16 years. This trend was similar for all nutrients analysed. Dairy food intake peaked between 06.00 and 10.00 hours (typical breakfast hours) corresponding with the peak in dairy Ca intake. Australian children (older than 4 years) did not reach recommendations for dairy food intake, consuming ≤2 servings/d. The under-consumption of dairy foods by Australian children has important implications for intake of key nutrients and should be addressed by multiple strategies.

The relationship between breastfeeding and weight status in a national sample of Australian children and adolescents

BackgroundBreastfeeding has been shown consistently in observational studies to be protective of overweight and obesity in later life. This study aimed to investigate the association between breastfeeding duration and weight status in a national sample of Australian children and adolescents.MethodsA secondary analysis of the 2007 Australian National Children's Nutrition and Physical Activity Survey data involving 2066, males and females aged 9 to 16 years from all Australian states and territories. The effect of breastfeeding duration on weight status was estimated using multivariate logistic regression analysis.ResultsCompared to those who were never breastfed, children breastfed for ≥6 months were significantly less likely to be overweight (adjusted odds ratio: 0.64, 95%CI: 0.45, 0.91) or obese (adjusted odds ratio: 0.51, 95%CI: 0.29, 0.90) in later childhood, after adjustment for maternal characteristics (age, education and ethnicity) and children's age, gender, mean energy intake, level of moderate and vigorous physical activity, screen time and sleep duration.ConclusionsBreastfeeding for 6 or more months appears to be protective against later overweight and obesity in this population of Australian children. The beneficial short-term health outcomes of breastfeeding for the infant are well recognised and this study provides further observational evidence of a potential long-term health outcome and additional justification for the continued support and promotion of breastfeeding to six months and beyond.

Comparison of dietary intakes according to breakfast choice in Australian boys

There is little information on how breakfast choices are associated with dietary intakes in Australian boys. (i) To determine the proportion of breakfast skippers, ready-to-eat cereal (RTEC) consumers and non-RTEC consumers at breakfast; (ii) to compare breakfast, and daily nutrient intakes and nutrient density, between the three groups; and (iii) to compare daily nutrient intakes against nutrient recommendations. Cross-sectional analysis of 12 to 16-year-old boys (n = 781) from the 2007 Australian National Children's Nutrition and Physical Activity Survey. Forty-two percent of boys consumed RTEC at breakfast; 38% did not consume RTECs; and 20% skipped breakfast. Breakfast skippers had a higher body mass index and waist circumference compared with RTEC consumers (P ≤ 0.05). At breakfast, RTEC consumers had a higher intake of total sugars and a lower intake of fat and sodium versus non-RTEC consumers. Total daily nutrient density for calcium, iron, thiamin, riboflavin, zinc, dietary folate equivalents, magnesium and iodine was higher for RTEC consumers versus non-RTEC consumers and breakfast skippers (all P ≤ 0.05). Fifty-nine percent of 14 to 16-year-old RTEC consumers reached the fibre adequate intake versus 34% and 24% of non-RTEC consumers and breakfast skippers, respectively (all P ≤ 0.01). More RTEC consumers met the calcium estimated average requirements versus non-RTEC consumers and breakfast skippers (P ≤ 0.01). Breakfast choice, specifically RTECs and the foods consumed with them, provide valuable nutrients that may assist boys in meeting nutrient requirements. Consumption of RTECs may be one way in which intakes of key nutrients, relevant for growth and development, could be increased in older boys.

The impact of complex survey design on prevalence estimates of intakes of food groups in the Australian National Children's Nutrition and Physical Activity Survey

To assess the impact of the complex survey design used in the 2007 Australian National Children's Nutrition and Physical Activity Survey (ANCNPAS07) on prevalence estimates for intakes of groups of foods in the population of children. The impacts on prevalence estimates were determined by calculating design effects for values for food group consumption. The implications of ignoring elements of the sample design including stratification, clustering and weighting are discussed. The ANCNPAS07 used a complex sample design involving stratification, a high degree of clustering and estimation weights. Australian children aged 2-16 years. Design effects ranging from <1 to 5 were found for the values of mean consumption and proportion of the population consuming the food groups. When survey weights were ignored, prevalence estimates were also biased. Ignoring the complex survey design used in the ANCNPAS07 could result in underestimating the width of confidence intervals, higher mean square errors and biased estimators. The magnitude of these effects depends on both the parameter under consideration and the chosen estimator.

Sugar sweetened beverage consumption by Australian children: Implications for public health strategy

BackgroundHigh consumption of sugar sweetened beverages (SSBs) has been linked to unhealthy weight gain and nutrition related chronic disease. Intake of SSB among children remains high in spite of public health efforts to reduce consumption, including restrictions on marketing to children and limitations on the sale of these products in many schools. Much extant literature on Australian SSB consumption is out-dated and lacks information on several key issues. We sought to address this using a contemporary Australian dataset to examine purchase source, consumption pattern, dietary factors, and demographic profile of SSB consumption in children.MethodsData were from the 2007 Australian National Children's Nutrition and Physical Activity Survey, a representative random sample of 4,834 Australian children aged 2-16 years. Mean SSB intake by type, location and source was calculated and logistic regression models were fitted to determine factors associated with different levels of consumption.ResultsSSB consumption was high and age-associated differences in patterns of consumption were evident. Over 77% of SSB consumed was purchased via supermarkets and 60% of all SSB was consumed in the home environment. Less than 17% of SSB was sourced from school canteens and fast food establishments. Children whose parents had lower levels of education consumed more SSB on average, while children whose parents had higher education levels were more likely to favour sweetened juices and flavoured milks.ConclusionsSSB intake by Australian children remains high and warrants continued public health attention. Evidence based and age-targeted interventions, which also recognise supermarkets as the primary source of SSB, are recommended to reduce SSB consumption among children. Additionally, education of parents and children regarding the health consequences of high consumption of both carbonated and non-carbonated SSBs is required.