Daily Sugar-sweetened Beverages Intake Research Articles

Perceptions of Water Safety and Tap Water Taste and Their Associations With Beverage Intake Among U.S. Adults.

Examine differences in perceptions of tap water (TW) and bottled water (BW) safety and TW taste and their associations with plain water (PW) and sugar-sweetened beverage (SSB) intake. Quantitative, cross-sectional study. United States. 4,041 U.S. adults (≥18years) in the 2018 SummerStyles survey data. Outcomes were intake of TW, BW, PW (tap and bottled water), and SSB. Exposures were perceptions of TW and BW safety and TW taste (disagree, neutral, or agree). Covariates included sociodemographics. We used chi-square analysis to examine sociodemographic differences in perceptions and multivariable logistic regressions to estimate adjusted odds ratios (AOR) for consuming TW ≤ 1cup/day, BW > 1cup/day, PW ≤ 3cups/day, and SSB ≥ 1 time/day by water perceptions. One in 7 (15.1%) of adults did not think their home TW was safe to drink, 39.0% thought BW was safer than TW, and 25.9% did not think their local TW tasted good. Adults who did not think local TW was safe to drink had higher odds of drinking TW ≤ 1cup/day (AOR = 3.12) and BW >1 cup/day (AOR = 2.69). Adults who thought BW was safer than TW had higher odds of drinking TW ≤1 cup/day (AOR = 2.38), BW > 1cup/day (AOR = 5.80), and SSB ≥ 1time/day (AOR = 1.39). Adults who did not think TW tasted good had higher odds of drinking TW ≤ 1cup/day (AOR = 4.39) and BW > 1cup/day (AOR = 2.91). Negative perceptions of TW safety and taste and a belief BW is safer than TW were common and associated with low TW intake. Perceiving BW is safer than TW increased the likelihood of daily SSB intake. These findings can guide programs and services to support water quality to improve perceptions of TW safety and taste, which might increase TW intake and decrease SSB intake.

The Frequency of Daily Consumption of Sugar-Sweetened Beverages Is Associated with Reduced Muscle Mass Index in Adolescents.

The consumption of sugar-sweetened beverages (SSBs) has increased in recent years and has become a cause of concern because these beverages pose a risk to human health. Thus, we evaluated the association between SSBs consumption and muscle mass index (MMI) in adolescents. This cross-sectional study evaluated 2393 adolescents (18/19-years-old). Consumption of SSBs was analyzed based on the frequency of daily consumption and energy contribution categorized into tertiles. MMI was examined using the ratio of muscle mass (kilograms) to height (meters squared). The highest tertile of the frequency of daily SSB intake was associated with a reduced MMI in men (β = -0.31; 95%CI: -0.60, -0.01) and women (β = -0.24; 95%CI: -0.45, -0.02). However, these associations were not observed after adjusting for sugar contained in SSBs in men (β = -0.26; 95%CI: -0.69, 0.17) and for carbohydrate, lipid, and protein intake in women (β = -0.19; 95%CI: -0.42, 0.04). The highest energy contribution tertile of SSBs was associated with a reduced MMI in male adolescents (β = -0.34; 95%CI: -0.64, -0.04). This association was not observed after adjusting for intake of sugar in SSBs (β = -0.38; 95%CI: -0.75, 0.01). The frequency of daily consumption of SSBs was considered a risk factor for decreased MMI in both sexes, and the energy contribution of these drinks was a risk factor for MMI reduced only in male adolescents.

Sugar Is the Key Cause of Overweight/Obesity in Sugar-Sweetened Beverages (SSB).

To evaluate association between overweight/obesity and sugar-sweetened beverages (SSB) types, SSB sugar, among children and adolescents. A total of 1,068 children and 751 adolescents were identified from a provincial survey conducted in Shandong, China. χ2 tests, logistic regression, restricted cubic spline (RCS), mediation analysis, pathway analysis, and ordinary least square (OLS) regression were applied to test association among overweight/obesity, SSB sugar, SSB types, and a set of factors. The mean daily SSB intake for children and adolescents was 210.7 and 208 ml, respectively. The threshold of SSB sugar consumption causing overweight/obesity was around 25 g/day and verified by RCS based on logistic regression. Approximately, 44.8% of the study subjects consumed more than 25 g/day of SSB sugar. SSB sugar intake above 25 g/day resulted in higher risk of overweight/obesity (OR = 1.391, 95% CI, 1.115–1.734). The effects of all types of SSBs on overweight/obesity were fully mediated by SSB sugar (p < 0.05), except for milk. Consumption of any types of SSBs had a positive impact on SSB sugar intake in both children and adolescents. Any type of SSB intake was a risk factor in excessive intake of SSB sugar (OR > 1, p < 0.05). In particular, milk powder, tea, and tea-flavored drinks, and carbonated have greater ORs for excessive intake of SSB sugar (OR = 76.08, 8.879, 4.355, p < 0.05, respectively). It was found that the effect of SSB on overweight/obesity was mediated by the intake of SSB sugar, and the effects of various SSBs were different according to multiple linear regression and pathway analysis (p < 0.05, respectively).

Changes in Sugar Sweetened Beverage Intake Are Associated with Changes in Body Composition in Mexican Adolescents: Findings from the ELEMENT Cohort.

Changes in consumption of sugar sweetened beverage (SSBs) have been associated with increased body mass index (BMI), but little work has evaluated the effect on waist circumference (WC) and body fat percentage during adolescence, a period characterized by rapid growth and change in dietary behaviors. We examined the relationship of changes in SSB intake and changes in adiposity over two years in 464 Mexican adolescents. Food frequency questionnaires were used to sum intake of regular soda, coffee with sugar, tea with sugar, sweetened water with fruit, chocolate milk, corn atole, and a sweetened probiotic milk beverage. Linear regression models were used to estimate the associations of changes in SSBs with changes in BMI, body fat percentage, and WC, adjusting for sex, socioeconomic status, screen time, physical activity, age, and change in age. Adolescents who increased their daily SSB intake by >2 serving had a −2.72% higher body fat percentage (95% CI: 0.61, 4.82); a 1–2 serving increase was associated with a 2.49 cm increase (95% CI: 0.21, 4.76) in WC compared with those with no change in intake. Within an adolescent sample, changes in SSB intake were related to concomitant changes in body fat percentage and WC, but not BMI.

Sugar-Sweetened Beverages and Symptom Complaints among School-Aged Children: A National Longitudinal Study.

The association between sugar-sweetened beverages (SSBs) and symptom complaints among school-aged children remains unclear. Children aged 6–17 years (n = 29,028) were recruited on the basis of a national school-based study. Data collection included two waves: the exposure was the amount and frequency of SSB consumption, collected in the 2013 autumn semester, and outcomes were defined as having clinical symptom complaints after two weeks of observation, collected in the 2014 spring semester. Symptom complaints were defined as fever, cough, headache, loose bowels, vomiting, sore throat, rash, conjunctival congestion, and stomachache. The associations between the amount/frequency of SSBs and symptoms complaints were explored by a general linear model, with adjustments made for socio-demographic and other lifestyle information. Among the 12,454 children (10.32 ± 3.15 years, 48.7% male) in the final analysis, the odds ratio for having symptom complaints (1.46, 95% CI: 1.10–1.95) among children whose SSB consumption was >75 mL/day was significantly higher than that among children who had no SSB consumption. Among children with a daily SSB intake of more than 75 mL, there was a higher risk for symptom complaints. We recommend more support for decreasing SSB consumption among children to minimize negative health outcomes.

Sugar-sweetened beverage consumption and breast composition in a longitudinal study of Chilean girls

BackgroundFrequent sugar-sweetened beverage (SSB) intake has been associated with indirect markers of breast cancer risk, such as weight gain in adolescents and early menarche. How SSB intake relates to breast composition in adolescent girls has not been explored.MethodsWe evaluated the association between prospective intake of SSB and breast density in a cohort of 374 adolescent girls participating in the Growth and Obesity Cohort Study in Santiago, Chile. Multivariable linear regression models were used to analyze the association between average daily SSB intake quartiles and breast composition (absolute fibroglandular volume [aFGV], percent fibroglandular volume [%FGV], total breast volume [tBV]). Models were adjusted for potential confounding by BMI Z-score, age, daily energy intake (g/day), maternal education, hours of daily television watching after school, dairy intake (g/day), meat intake (g/day), waist circumference, and menarche. To examine the sensitivity of the association to the number of dietary recalls for each girl, analyses were further stratified by girls with one dietary recall and girls with > one dietary recall.ResultsA total of 881 dietary recalls were available for 374 girls prior to the breast density assessment. More than 60% of the cohort had > one dietary recall available. In multivariable analyses, we found no association between SSB intake quartile and aFGV (Q2 vs Q1 β: − 5.4, 95% CI − 15.1, 4.4; Q3 vs Q1 β: 1.3, 95% CI − 8.6, 11.3; Q4 vs Q1 β: 3.0, 95% CI − 7.1, 13). No associations were noted for %FGV and tBV. Among girls with at least one dietary recall, we found no significant associations between SSB intake quartiles and %FGV, aFGV, or tBV.ConclusionOverall, we observed no evidence that SSB intake was associated with breast density in adolescent Chilean girls.

Five-Year Trends in Sugar-Sweetened Beverage Consumption Among Mothers, Teenagers, Children From SNAP-Ed Eligible Households Indicate Increased Intake Among Children

Abstract Objectives Previously we reported improved dietary intake from 2015 to 2017 for fruits and vegetables, water, and Healthy Eating Index-2015 scores for mothers, teenagers, and children from households eligible for Supplemental Nutrition Education Program-Education (SNAP-Ed). Sugar-sweetened beverage (SSBs) consumption was unchanged during this three-year period across age groups. Our objective was to now examine trends in SSB intake with data from 2018 and 2019. Methods Cross-sectional surveys of mothers and their teenager or child were conducted from 2015 to 2019. Respondents were randomly sampled from households with reported incomes ≤185% of the federal poverty level. A study introduction letter in English or Spanish was sent to sampled households. Next, bilingual staff confirmed by phone household eligibility, the youngest mother (or caregiver), and one teenager (12 to 17 years) or child (5 to 11 years). During the subsequent interviews, staff administered the Automated Self-administered 24-Hour Dietary Assessment Tool (ASA24) in English or Spanish. The quantity and size of each reported food or beverage item was determined by asking mothers to reference pictures in a portion-size booklet or measuring cups or spoons previously mailed to each household. The procedures were replicated to obtain 24-hour dietary information from the teenager or child. Daily SSB intake was converted to ounces and regressed on year of survey with the covariates age, education for mothers, and gender for children. Significance of difference between means was adjusted by Bonferroni. Results Participants over the five-year period were 22,827 mothers, 5855 teenagers, and 10,778 children. Most (64.2%, 69.2%, and 67.9%) survey participants were Latinx. The trend for SSB intake for children was significant, with ounces per day increasing from 5.7 in 2017 to 7.3 in 2018 and 7.9 in 2019 (P = 0.0055). Conclusions A previous study found that, despite improvements across dietary behaviors, SSB intake was unchanged among mothers and children from SNAP-Ed eligible households. This follow-up study adds two years of data and findings indicate that children's SSB intake has increased. Findings suggest a need for interventions and policy work addressing children's SSB intake. Funding Sources California Department of Social Services.

Association of sugar-sweetened beverage intake with maternal postpartum weight retention.

During the perinatal period, modifiable behaviours contributing to excess weight gain, including sugar-sweetened beverage (SSB) intake, are understudied. We examined the extent to which perinatal SSB intake affects postpartum weight retention (PPWR). We measured SSB intake frequency in the third trimester and 1-month postpartum using the NHANES Dietary Screener Questionnaire. We assessed the association between SSB intake and PPWR (difference between 6-month postpartum and pregravid weight) using multivariable regression adjusted for socio-demographic and anthropometric variables. Greater Boston area. Three hundred forty-eight mother-infant pairs in the Rise and SHINE prospective birth cohort. Mean age was 32·7 (sd 5·0) years; the sample was 47 % white, 32 % Hispanic, 14 % Asian and 7 % Black. Women reported mean daily SSB intake frequencies of 0·9 (sd 1·2) and 0·7 (sd 1·0) times/d in the third trimester and 1-month postpartum, respectively. At 6-month postpartum, average weight retention was 3·4 (sd 5·7) kg; 108 (sd 31 %) women had substantial PPWR, defined as a ≥ 5 kg increase between pregravid and 6-month postpartum weight. Each 1-time/d increment in SSB intake frequency during the third trimester (β = 0·46 kg (95 % CI, 0·07, 0·86)) and 1-month postpartum (β = 0·52 kg (95 % CI 0·03, 1·00)) was associated with higher weight retention at 6 months. Increased SSB intake frequency in the third trimester (OR: 1·37; 95 % CI 1·10, 1·75) and 1-month postpartum (OR: 1·17; 95 % CI 0·92, 1·52) resulted in higher odds of substantial PPWR. SSB consumption during the perinatal period is associated with higher weight retention at 6-month postpartum. Avoiding SSB may reduce the risk of excess weight retention.

Consumption of Sugar-Sweetened Beverages and Artificially Sweetened Beverages with Mortality: The National Health and Nutrition Examination Survey and a Meta-Analysis

Abstract Objectives We aimed to investigate the associations of dietary intakes of sugar-sweetened beverages (SSB) and artificially sweetened beverages (ASB) with mortality. Methods Adults without cancer aged 20 years or older from the National Health and Nutrition Examination Survey 1999–2014 were followed up to December 31, 2015. Beverage intake was assessed by 24-hour dietary recall interviews (a single recall in 5109 participants and an average of two recalls in 19,914 participants). Multivariable Cox proportional hazards models were used to evaluate the associations of SSB and ASB intake with all-cause and cause-specific mortality. Pubmed, Embase, Web of Science, Cochrane, ProQuest, ClinicalTrials.gov, and International Clinical Trials Registry Platform were searched for related cohort studies. Random-effects models were used to pool the estimates, and dose-response analyses were conducted using the 2-stage generalized least-squares trend program. Results After a median follow-up of 6.8 years, 2365 deaths were identified in 25,023 participants. Each additional serving of daily SSB intake was associated with an HR (95% CI) of 1.06 (1.02–1.11), 1.13 (1.03–1.24), and 1.06 (1.00–1.11) for mortality from all-cause, heart diseases, and other causes. Each additional serving of daily ASB intake was associated with an HR (95% CI) of 0.96 (0.92–1.00), 0.90 (0.82–0.98), and 0.97 (0.92–1.02) for mortality from all-cause, heart diseases, and other causes. No significant associations were found with cancer mortality. We identified 23,631 citations and included 12 studies (including 13 cohorts) in meta-analyses. It was shown that each additional serving of daily SSB intake was associated with an HR (95% CI) of 1.08 (1.05–1.11, ten cohorts with 388,548 participants) for all-cause mortality and 1.10 (1.06–1.14, five cohorts with 255,584 participants) for cardiovascular mortality. No significant association was found between ASB intake and mortality in the meta-analysis. Conclusions Higher SSB intake was associated with a higher risk of all-cause mortality and cardiovascular mortality, while the association between ASB intake and mortality needed further investigation. Funding Sources National Key Research and Development Program of China, National Nature Science Foundation of China, and Hubei Province Science Fund for Distinguished Young Scholars.

Abstract P209: Sugar and Artificially-sweetened Beverages and 6-year Weight Change: Results From The Hispanic Community Health Study, Study of Latinos

Background: Sugar sweetened beverages (SSBs) are the largest contributor to added sugars and calories in the U.S. diet with highest intake among US Hispanics. The prevalence of obesity in adults in the US is much higher in Hispanics compared to non-Hispanic whites (47% and 38% respectively). Improving our understanding of the association between SSB and artificially sweetened beverage (ASB) consumption and measures of adiposity can inform interventions targeting overweight and obesity. Aim: Examine the independent associations of daily SSB and ASB consumption with 6-year changes in weight, waist circumference (WC) and body mass index (BMI) in Hispanics in the US. Methods: We examined 7402 adults without diabetes aged 18-74yrs at baseline (2008-11) from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a multi-site community-based cohort in the US. Baseline exposures of daily SSB and ASB consumption were estimated combining two 24-hour dietary recalls and a Food Propensity Questionnaire using the NCI method to correct for measurement error and account for episodically consumed foods. Complex survey linear regression models were used to examine associations of SSBs and ASBs with 6-year change in weight (kg), WC (cm) and BMI. Models were adjusted for age, gender, center, background, education, employment, marital status, cigarette use, physical activity, healthy eating index, depressive symptoms, non-SSB sugar intake, years in the US and years between visits. Interactions of SSB and ASB with gender and years lived in the U.S. (US born, &gt;10yr, ≤10 yr) were assessed. Results: Overall, 3326 [male=49.7%] and 1244 [male=35.7%] reported daily intake of &gt;2 servings of SSBs and ASBs respectively whereas 2203 [male=26.1%] and 4318 [male=41.2%] reported daily intake &lt; 1 servings of SSBs and ASBs respectively. Daily energy intake (kcal) was higher among those with higher daily SSB consumption [means=14768 and 2008 kcals; &lt;1 serving and &gt;2 servings, respectively] and lower with higher ASB consumption (means=1836 and 1773 kcals; &lt;1 serving and &gt;2 servings, respectively). Daily sugar intake independent of SSBs was higher with daily consumption of both SSB and ASB (&lt;1 serving vs. 2 servings). Non-significant associations were found for daily SSB and ASB intake and changes in adiposity for all measures in males and females. Interaction between years in the U.S. and ASB consumption were significant only for change in weight and BMI [p&lt;0.05]. Among those consuming &lt;1 serving per day of ASBs, there was a larger mean change in weight and BMI for those who spent &lt; 10yr in the U.S. compared to U.S. born. Conclusion: In this diverse Hispanic cohort, 6-year changes in measures of adiposity are not associated with daily SSB or ASB consumption. Modification of the association of ASB and measures of adiposity by years in US suggests further exploration is needed to discern its relationship among Hispanics.

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

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.

Daily Adolescent Sugar-Sweetened Beverage Intake Is Associated With Select Adolescent, Not Parent, Attitudes About Limiting Sugary Drink and Junk Food Intake.

To examine associations of adolescent sugar-sweetened beverage (SSB) intake with parent SSB intake and parent and adolescent attitudes about limiting SSB and junk food (SSB/JF) intake. Quantitative, cross-sectional study. The 2014 Family Life, Activity, Sun, Health, and Eating study. Parent-adolescent dyads (N = 1555). The outcome was adolescent SSB intake. Exposure variables were parent SSB intake, sociodemographics, and parent and adolescent attitudes about SSB/JF intake (responses: agree, neither, or disagree). Multinomial logistic regressions estimated adjusted odds ratios (aOR) and 95% confidence intervals (CIs). Half (49.5%) of adolescents and 33.7% of parents consumed SSB ≥1 time/day. Parent daily SSB intake was associated with adolescent daily SSB intake (aOR = 8.9; CI = 4.6-17.3) [referent: no consumption]. Adolescents who disagreed on having confidence to limit SSB/JF intake had higher odds of daily SSB intake (aOR = 3.5; CI = 1.8-6.8), as did those who disagreed they felt bad about themselves if they did not limit SSB/JF intake (aOR = 1.9; CI=1.1-3.3), compared to adolescents who agreed with these attitudes. No parental attitudes were significant. Higher odds of daily SSB intake among adolescents was associated with parent SSB intake and adolescent attitudes about confidence in, and feeling bad about, limiting SSB/JF intake. Parent attitudes were not associated with daily adolescent SSB intake. Efforts to reduce adolescent SSB intake could consider strategies geared toward improving adolescent attitudes and dietary behaviors and parental SSB intake.

P48 Sugar-Sweetened Beverage Intake Among a Convenience Sample of Hispanic Adults Who Report Trying to Eat a Healthy Diet

Background Frequent intake of sugar-sweetened beverages (SSB) decreases diet quality and is associated with adverse health outcomes. Objective We examined associations between status of actively trying to eat a healthy diet and SSB intake among a convenience sample of Hispanic adults. Study Design, Settings, Participants This cross-sectional study used 2015 Estilos data including a convenience sample of 1,000 Hispanic adults (≥ 18 years) from an online panel survey (conducted in Spanish and English). Measurable Outcome/Analysis The outcome variable was SSB intake (regular soda, sweetened coffee/tea drink, sports/energy drink, and fruit drink). The exposure variable was agreement on actively trying to eat a healthy diet (disagree, neither, or agree). Covariates included sociodemographic and acculturation variables, and weight status. We used chi-square tests and logistic regression analyses to examine the associations between actively trying to eat a healthy diet and SSB intake. Results Overall, 71.3% of Hispanics agreed that they were actively trying to eat a healthy diet and 17.4% neither disagreed nor agreed. The prevalence of SSB intake ≥ one time/day was the highest among those who neither disagreed nor agreed (94.3%), followed by agreed (89.9%) and disagreed (89.4%). In the crude models, the odds of consuming sweetened coffee/tea drink ≥ one time/day was greater among those who agreed (OR = 1.65) than those who disagreed, and the odds of consuming sports/energy drink ≥ one time/day was lower among who neither disagreed nor agreed (OR = 0.51) than those who disagreed. However, after controlling for covariates, these associations were no longer significant. Conclusion Daily SSB intake among a convenience sample of Hispanics was high regardless whether or not they are actively trying to eat a healthy diet. Intention alone may not be adequate for Hispanic adults to change their behaviors. Beverage may be a topic for additional consideration when seeking to promote healthful dietary behaviors among Hispanics. Funding CDC.

Prevalence of and Factors Associated with Sugar-sweetened Beverage Intake Among Women of Reproductive Age—12 States and District of Columbia, 2017 (P16-022-19)

Abstract Objectives Frequent sugar-sweetened beverage (SSB) intake is associated with weight gain and type 2 diabetes. There are limited data describing SSB intake among women of reproductive age (WRA). We described SSB intake patterns among pregnant and non-pregnant WRA, and identified characteristics associated with daily SSB intake. Methods Using 2017 Behavioral Risk Factor Surveillance System data, we analyzed self-reported SSB intake for 392 pregnant and 11,321 non-pregnant WRA (18–49 years). SSB intake (regular soda, fruit drinks, sweet tea, and sports/energy drinks) was measured in an optional module used by the District of Columbia and 12 states (AK, AZ, AR, DE, HI, IA, NY, NC, OH, VT, WV, WI). Multivariable logistic regression models were used to estimate adjusted odds ratios (aOR) for daily (≥1 time/day) SSB intake (ref: &lt;1 time/day) by sociodemographic and behavioral characteristics. Results Compared to non-pregnant women, a higher proportion of pregnant women were 18–29 years (51.1% vs 36.2%), married (58.3% vs 44.8%), nonsmokers (72.0% vs 67.8%), and had ≤ high school education (49.7% vs 36.3%). Overall, 27.3% of non-pregnant and 21.9% of pregnant women consumed SSB ≥1 time/day; 12.6% and 9.7%, respectively, consumed SSB ≥2 times/day. Among non-pregnant women, odds of SSB intake ≥1 time/day were higher for women who were non-Hispanic (NH) Black (aOR = 2.04, 95% CI = 1.55–2.69) compared to NH white; had ≤ high school education (aOR = 2.79, CI = 2.26–3.44) or some college (aOR = 1.85, CI = 1.50–2.27) vs college graduates; lived in nonmetropolitan counties (aOR = 1.35, CI = 1.11–1.63) vs metropolitan; had no leisure-time physical activity (aOR = 1.72, CI = 1.43–2.07) vs some; were former (aOR = 1.51, CI = 1.17–1.94) or current (aOR = 3.48, CI = 2.82–4.28] smokers vs nonsmokers. For pregnant women, only marital status was significant: those not married had higher odds (aOR = 2.81, CI = 1.05–7.51) for daily SSB intake than married women. Conclusions Reducing SSB intake is a strategy to maintain a healthy weight, particularly in pregnancy when added calories should be nutrient rich. Information from monitoring SSB intake among WRA can be used to promote healthy pre-pregnancy weight and pregnancy weight gain, which can reduce the risk of adverse maternal and infant health outcomes. Funding Sources CDC.

Association between adolescents’ consumption of total and different types of sugar‐sweetened beverages with oral health impacts and weight status

Objective:To examine the associations between adolescents’ intake of sugar‐sweetened beverages (SSBs) with oral health impacts (OHI) and weight status. Methods:Cross‐sectional health survey with anthropometry and self‐report OHI (toothache and avoiding some foods because of oral problems) and SSB intake (fruit juice, flavoured water, soft, diet, sports and energy drinks) collected in 2015. Results:A total of 3,671 adolescents participated (50% girls; mean age 13.2 years ±1.7). Drinking ≥1cup/day of SSBs was consistently associated with higher odds of OHI compared with drinking <1cup/day: diet soft drinks (AOR, 5.21 95%CI 2.67, 10.18); sports drinks (AOR 3.60 95%CI 1.93, 6.73); flavoured water (AOR 3.07 95%CI 1.55, 6.06); and energy drinks (AOR 2.14 95%CI 1.44, 3.19). Daily SSB intake was not consistently associated with weight status. The odds of overweight/obesity (AOR 1.27 95%CI 1.01, 1.59) and obesity (AOR 1.61 95%CI 1.01, 2.57) were higher for energy drink consumption, compared with not drinking energy drinks; and the odds of abdominal obesity were twice as high among adolescents who drank ≥1cup/day of sports drinks, compared with <1cup/day intake. Conclusions:Daily consumption of SSBs is prevalent among adolescents and is consistently associated with higher odds of OHI. The most popular SSBs among adolescents were energy drinks. Different types of SSB were differentially associated with OHI and weight status. Implications for public health:Different types of SSBs were differentially associated with OHI and weight status in adolescents. Diet soft drinks and new generation SSBs such as energy and sport drinks and flavoured water had a greater impact on adolescents’ OHI compared with soft drinks and fruit juice.

Factors Associated With Frequency of Sugar-Sweetened Beverage Consumption Among US Adults With Diabetes or Prediabetes.

This study assessed the associations between sociodemographic and behavioral characteristics and sugar-sweetened beverage (SSB) intake among US adults with diabetes or prediabetes. Quantitative, cross-sectional study. The 2013 Behavioral Risk Factor Surveillance System. A total of 13 268 adults with diabetes and 9330 adults with prediabetes (median response rate: 46.8%). The outcome measure was SSB intake (0, >0 to <1, and ≥1 time/day). The exposure measures were sociodemographic and behavioral characteristics. Both crude and age-adjusted prevalences were calculated. Multinomial logistic regressions were used to estimate the adjusted prevalence ratio (PR) for SSB intake by participants' characteristics. In 2013, 22.0% adults with diabetes and 38.2% adults with prediabetes consumed SSBs ≥1 time/day. Among adults with diabetes, adjusted PR for consuming SSBs ≥1 time/day was significantly greater for those who had shorter duration of diabetes (≤5 years: PR = 1.47; 6-10 years: PR = 1.33 vs ≥11 years), less frequently self-checking blood sugar (≥0 to <1 time/day: PR = 1.69; ≥1 to <3 times/day: PR = 1.43 vs ≥3 times/day), and no self-management of diabetes course taken (PR = 1.25 vs yes). Among adults with prediabetes, testing blood sugar ≤3 years was not associated with consuming SSBs ≥1 time/day. Daily SSB intake was associated with various characteristics among adults with diabetes or prediabetes. The findings can inform efforts to decrease SSB intake among high-risk populations.

Beverage Intake among Children: Associations with Parent and Home-Related Factors.

Beverage intake can influence child diet quality in a positive or negative manner depending on the beverage type and amounts consumed. Parenting practices such as role modeling and control of home beverage availability have been associated with child beverage intake, whereas examination of the influence of parental beverage nutrition knowledge has been more limited. The purpose of this study was to examine the relationships between sugar-sweetened and dairy beverage intake among children (9–12 years) and home and parental factors. A questionnaire was administered among a convenience sample of parents (n = 194) to assess beverage nutrition knowledge, beverage intake and home availability of beverages. Children completed a questionnaire to estimate usual beverage intake. Daily sugar-sweetened beverage intake by children ranged from 0.4 to 48 oz. Logistic regression analysis was used to examine relationships. Parents were mostly female, white, well educated, and employed. Home availability of sugar-sweetened and dairy beverages was positively associated with child sugar-sweetened (OR = 1.48, p = 0.03) and dairy beverage intake (OR = 1.34, p = 0.03), respectively. Parent dairy beverage intake was associated with child dairy beverage intake (OR = 1.06, p = 0.01). Parent knowledge about sugar in beverages was related to child dairy beverage intake (OR = 1.46, p = 0.02), whereas calcium/dairy knowledge and general beverage nutrition knowledge were not related to child beverage intake. Parenting practices and knowledge may play a role in determining child beverage intake.

Changes in prices, sales, consumer spending, and beverage consumption one year after a tax on sugar-sweetened beverages in Berkeley, California, US: A before-and-after study.

BackgroundTaxes on sugar-sweetened beverages (SSBs) meant to improve health and raise revenue are being adopted, yet evaluation is scarce. This study examines the association of the first penny per ounce SSB excise tax in the United States, in Berkeley, California, with beverage prices, sales, store revenue/consumer spending, and usual beverage intake.Methods and findingsMethods included comparison of pre-taxation (before 1 January 2015) and first-year post-taxation (1 March 2015–29 February 2016) measures of (1) beverage prices at 26 Berkeley stores; (2) point-of-sale scanner data on 15.5 million checkouts for beverage prices, sales, and store revenue for two supermarket chains covering three Berkeley and six control non-Berkeley large supermarkets in adjacent cities; and (3) a representative telephone survey (17.4% cooperation rate) of 957 adult Berkeley residents.Key hypotheses were that (1) the tax would be passed through to the prices of taxed beverages among the chain stores in which Berkeley implemented the tax in 2015; (2) sales of taxed beverages would decline, and sales of untaxed beverages would rise, in Berkeley stores more than in comparison non-Berkeley stores; (3) consumer spending per transaction (checkout episode) would not increase in Berkeley stores; and (4) self-reported consumption of taxed beverages would decline.Main outcomes and measures included changes in inflation-adjusted prices (cents/ounce), beverage sales (ounces), consumers’ spending measured as store revenue (inflation-adjusted dollars per transaction) in two large chains, and usual beverage intake (grams/day and kilocalories/day).Tax pass-through (changes in the price after imposition of the tax) for SSBs varied in degree and timing by store type and beverage type. Pass-through was complete in large chain supermarkets (+1.07¢/oz, p = 0.001) and small chain supermarkets and chain gas stations (1.31¢/oz, p = 0.004), partial in pharmacies (+0.45¢/oz, p = 0.03), and negative in independent corner stores and independent gas stations (−0.64¢/oz, p = 0.004). Sales-unweighted mean price change from scanner data was +0.67¢/oz (p = 0.00) (sales-weighted, +0.65¢/oz, p = 0.003), with +1.09¢/oz (p < 0.001) for sodas and energy drinks, but a lower change in other categories. Post-tax year 1 scanner data SSB sales (ounces/transaction) in Berkeley stores declined 9.6% (p < 0.001) compared to estimates if the tax were not in place, but rose 6.9% (p < 0.001) for non-Berkeley stores. Sales of untaxed beverages in Berkeley stores rose by 3.5% versus 0.5% (both p < 0.001) for non-Berkeley stores. Overall beverage sales also rose across stores. In Berkeley, sales of water rose by 15.6% (p < 0.001) (exceeding the decline in SSB sales in ounces); untaxed fruit, vegetable, and tea drinks, by 4.37% (p < 0.001); and plain milk, by 0.63% (p = 0.01). Scanner data mean store revenue/consumer spending (dollars per transaction) fell 18¢ less in Berkeley (−$0.36, p < 0.001) than in comparison stores (−$0.54, p < 0.001). Baseline and post-tax Berkeley SSB sales and usual dietary intake were markedly low compared to national levels (at baseline, National Health and Nutrition Examination Survey SSB intake nationally was 131 kcal/d and in Berkeley was 45 kcal/d). Reductions in self-reported mean daily SSB intake in grams (−19.8%, p = 0.49) and in mean per capita SSB caloric intake (−13.3%, p = 0.56) from baseline to post-tax were not statistically significant.Limitations of the study include inability to establish causal links due to observational design, and the absence of health outcomes. Analysis of consumption was limited by the small effect size in relation to high standard error and Berkeley’s low baseline consumption.ConclusionsOne year following implementation of the nation’s first large SSB tax, prices of SSBs increased in many, but not all, settings, SSB sales declined, and sales of untaxed beverages (especially water) and overall study beverages rose in Berkeley; overall consumer spending per transaction in the stores studied did not rise. Price increases for SSBs in two distinct data sources, their timing, and the patterns of change in taxed and untaxed beverage sales suggest that the observed changes may be attributable to the tax. Post-tax self-reported SSB intake did not change significantly compared to baseline. Significant declines in SSB sales, even in this relatively affluent community, accompanied by revenue used for prevention suggest promise for this policy. Evaluation of taxation in jurisdictions with more typical SSB consumption, with controls, is needed to assess broader dietary and potential health impacts.

Consumption of Sugar-Sweetened Beverages in Mississippi: Is There A Disparity? Behavioral Risk Factor Surveillance System, 2012.

Although consumption of sugar-sweetened beverages (SSBs) is a key contributor to epidemic obesity and has dramatically increased over the past decade in the United States, little is known about its prevalence and associated factors. Data from the 2012 Behavior Risk Factor Surveillance System (BRFSS) were used to estimate the prevalence of SSB consumption and to explore the associations between socio-demographic characteristics, behavioral factors and SSB intake in Mississippi (n = 7220). Descriptive statistics, Chi-square tests and logistic regressions were conducted using SAS Proc Survey procedures, to account for the BRFSS′s multistage complex survey design and sample weights. Overall prevalence of self-reported daily SSB intake was 41.1%. Our findings showed that males (aOR = 1.4, 95% CI: 1.2–1.7, ref = female), blacks (aOR = 1.7, 95% CI: 1.4–2.1, ref = whites), adults aged 18–24 years (aOR = 5.0, 95% CI: 3.4–7.5, ref = 65 years or older), those with less than high school education (aOR = 1.9, 95% CI: 1.4–2.6, ref = college graduate), annual income <$25,000 (aOR = 1.3, 95% CI: 1.1–1.7, ref ≥ $50,000) and $25,000–49,999 (aOR = 1.3, 95% CI: 1.1–1.6, ref ≥ $50,000), those with no physical activity (OR = 1.3, 95% CI: 1.1–1.6, ref = physically active), daily smokers (aOR = 2.2, 95% CI: 1.7–2.7, ref = non-smokers), and those who reported eating at fast food or chain restaurants (aOR = 1.8, 95% CI: 1.2–2.5, ref = do not eat at fast food or chain restaurants) were more likely to consume SSBs, raising concerns about overweight and obesity in Mississippi.

Total Sugar-Sweetened Beverage Intake Among US Adults Underreported When Using One Question Instead of Four Questions to Assess Intake

Although surveys commonly use one question to assess total sugar-sweetened beverage (SSB) intake for brevity, the performance of a single question is unknown. We compared the performance of one question measuring total SSB intake to four questions measuring SSB types separately. We used the 2014 SummerStyles online survey with 4,167 U.S. adults (≥18 years). We compared frequency of SSB intake using one question measuring total SSB consumption to frequency using a composite of four questions (regular soda, fruit drinks, sports/energy drinks, sweetened coffee/tea). We calculated mean difference between the two and used multiple linear regression to examine demographic predictors of differences. SSB intake categories were: 0, >0–<1, and ≥1 time/day. We evaluated agreement using Kappa, ranging from 0 (no agreement) to +1 (perfect agreement), and sensitivity of 1 question to identify SSB consumption ≥1 time/day compared to 4 questions. Mean (median) SSB intake was 0.6 (0.1) times/day using 1 question and 1.7 (1.0) times/day using 4 questions. Intake frequency based on 1 vs. 4 questions, respectively, was 38.5% vs. 16.0% for no intake, 42.5% vs. 15.6% for >0–<1 time/day, and 18.9% vs. 68.4% for ≥1 time/day (p<0.0001). sensitivity of 1 question was 26.3%. Kappa was 0.20 (p<0.0001). mean difference in SSB consumption using 1 vs. 4 questions was -1.1 times/day. Sex, age, education, and race/ethnicity were significant predictors of this difference. Estimates of daily SSB intake were lower when one question was used compared to four. Researchers should consider assessing SSB types separately when measuring total SSB intake.