Frequent Sugar-sweetened Beverage Consumption Research Articles

Patterns and Predictors of Low-Calorie Sweetener Consumption during Pregnancy: Findings from a National Survey.

Recently, the World Health Organization recommended avoiding low-calorie sweeteners (LCS) during pregnancy due to concerns that it may be linked to adverse pregnancy outcomes and offspring wellbeing. This study examined the patterns and predictors of LCS consumption among pregnant women in Australia. A survey was conducted among 422 pregnant women aged 18-50 years. Sociodemographic, lifestyle, dietary intake including LCS consumption, pregnancy-related characteristics, and awareness about the health effects of LCS were assessed. We used latent class analysis and multinomial logistic regression to identify LCS consumption patterns and predictors of consumption patterns, respectively. The mean (SD) age of the women was 30 (4.6) years. Three LCS consumption patterns were identified: infrequent or non-consumers representing 50% of the women, moderate consumers encompassing 40% of the women, and the remaining were habitual consumers. Over two-thirds (71%) of women were not aware of the potential adverse effects of LCS, and only a quarter of them were concerned about the possible adverse effects on their health and their offspring. Increasing age and living with a medical condition decreased the likelihood of moderate consumption by 7% and 55%, respectively. Frequent sugar-sweetened beverage consumption and gestational diabetes predicted habitual LCS consumption. This research suggested widespread LCS consumption among pregnant women in Australia, but lower awareness of its potential adverse health effects. Interventions to increase awareness of potential adverse effects are warranted.

Photo-Enhanced Health Promotion Messages to Target Reduction in Dietary Sugar among Residents of Public Housing.

Interventions intended to reduce the consumption of dietary sugars among those population groups demonstrating disproportionately greater and more frequent consumption of sugar-sweetened beverages and foods (SSBF) would benefit from intervention strategies that are tailored to population-specific barriers and facilitators. The objective of this study was to develop and evaluate the acceptability of photo-enhanced and theory-based health promotion messages that target the reduction in SSBF among adult residents of public housing developments, a population known for their high rates of chronic disease. Using the message development tool as a framework, we developed a series of 15 SSBF reduction messages, using an iterative process with community member input. We then evaluated the acceptability of the messages and compared three delivery mechanisms: print, text, and social media. We recruited participants who were residents of urban public housing developments, and who spoke either English or Spanish. A majority of participants identified as being of Hispanic ethnicity (73%). The message acceptability scoring did not appear to differ according to the assigned delivery mechanism, despite some imbalances in participants' characteristics across delivery mechanisms. The messages that targeted motivation were least likely to be accepted. In conclusion, our findings suggest that engaging members of the community at all phases of the development process was a feasible method to develop SSBF reduction messages with a high perceived acceptability.

Sugar-sweetened beverages exacerbate high-fat diet-induced inflammatory bowel disease by altering the gut microbiome

High-fat diets (HFDs) and frequent consumption of sugar-sweetened beverages (SSBs) are potential contributors to increasing inflammatory bowel disease (IBD) incidences. While HFDs have been implicated in mild intestinal inflammation, the role of sucrose in SSBs remains unclear. Therefore, we studied the role of SSBs in IBD pathogenesis in a mouse model and humans. C57BL6/J mice were given ad libitum access to a sucrose solution or plain water for 10 weeks, with or without an HFD. Interestingly, sucrose solution consumption alone did not induce gut inflammation in mice; however, when combined with an HFD, it dramatically increased the inflammation score, submucosal edema, and CD45+ cell infiltration. 16S ribosomal RNA gene-sequencing revealed that sucrose solution and HFD co-consumption significantly increased the relative abundance of IBD-related pathogenic bacteria when compared with HFD consumption. RNA sequencing and flow cytometry showed that co-consumption promoted pro-inflammatory cytokine and chemokine synthesis, dendritic-cell expansion, and IFN-γ+TNF-α+CD4+ and CD8+ T-cell activation. Fecal microbiota transplantation from HFD- and sucrose water-fed mice into gut-sterilized mice increased the susceptibility to dextran sulfate sodium-induced colitis in the recipient mice. Consistent herewith, high consumption of SSBs and animal fat-rich diets markedly increased systemic inflammation-associated IBD marker expression in humans. In conclusion, SSBs exacerbate HFD-induced colitis by triggering a shift of the gut microbiome into a pathobiome. Our findings provide new insights for the development of strategies aimed at preventing IBD.

Sugar-sweetened beverage consumption and vascular function in Hispanic and non-Hispanic males.

Introduction: Hispanic men have one of the highest consumptions of sugar-sweetened beverages in the United States. Frequent sugar-sweetened beverage consumption has been associated with higher incidence of cardiovascular disease through altered vascular function. Cardiovascular disease is the second leading cause of death in the Hispanic population. The purpose of this study is to assess the difference in vascular function between Hispanic men and non-Hispanic men and whether this difference is attributed to ethnic predisposition (i.e. ethnicity) or other risk factors, such as sugar-sweetened beverage consumption. Method: Reactive hyperemia forearm blood flow of 11 Hispanic males and 11 non-Hispanic males was measured via venous occlusion plethysmography. Interview-administered questionnaires gathered anthropometric, medical, dietary, and physical activity data for participants. Results: No significant differences were found in peak or total reactive hyperemia forearm blood flow between matched pairs (p = 0.924). Significant differences were also not observed in dietary factors, sugar-sweetened beverage consumption (p = 0.693), or physical activity (0.720). Conclusion: No statistical differences in body composition, dietary intake, physical activity, and vascular function were observed between Hispanic and non-Hispanic males. Environmental and lifestyle factors may play a larger role than ethnicity in the development of cardiovascular disease. Recruitment based on ethnicity alone yielded a population that was similar regarding SSB consumption and vascular function.

Sugar-Sweetened Beverage Consumption, Perceptions, and Disparities in Children and Adolescents

ObjectiveTo examine the association between sugar-sweetened beverage (SSB) perceptions—knowledge, attitudes, and norms and media literacy—and beverage consumption, and to identify differences in beverage consumption and SSB perceptions by race/ethnicity and socioeconomic status. DesignCross-sectional. SettingDiverse California school district. ParticipantsA total of 992 fifth-grade (elementary), seventh-grade (middle), and ninth–12th-grade (high school) students. Main Outcome MeasuresQuestionnaire-assessed continuous beverage consumption and perceptions. AnalysisLinear regression adjusting for school, grade, gender, race/ethnicity, and free and reduced-price meal (FRPM) eligibility. ResultsKnowledge, attitudes, and norms, and media literacy items were associated with SSB consumption in expected directions (P < 0.05). Among elementary students, FRPM-eligible and Black students had higher SSB consumption (P < 0.01). In middle/high school, non-Hispanic White students consumed fewer SSBs than all other racial/ethnic groups (P < 0.01). There were differences in SSB-related perceptions by race/ethnicity and socioeconomic status (eg, Black students perceived sugary drinks as less unhealthy); Black, Hispanic, and FRPM-eligible students expressed less distrust of food/beverage advertisements; and Black, Hispanic, Asian, multirace, and FRPM-eligible students perceived more frequent SSB consumption among their peers (P < 0.05). Conclusions and ImplicationsSugar-sweetened beverage perceptions were associated with SSB consumption. There were racial/ethnic and socioeconomic disparities in SSB consumption and perceptions. Sugar-sweetened beverage perceptions and related social and commercial determinants like marketing may be useful targets for reducing SSB consumption.

Consumption of sugar‐sweetened beverages and metabolic markers in children – a narrative review of the evidence

AbstractA healthy hydration habit is an important aspect of a healthy diet, but recommendations on beverage choices are still less detailed than food‐based recommendations. It is our working hypothesis that frequent consumption of sugar‐sweetened beverages (SSBs) may cause insulin resistance by inducing rapid increases in insulin concentration. Insulin resistance is central to the risk of developing type 2 diabetes and may also be linked to development of obesity. This narrative review aims to review the literature on SSB consumption in relation to adverse markers of glucose metabolism in children. Literature searches were conducted in Medline and Embase via Ovid® on June 21st and June 22nd, 2020. From 8892 titles, abstracts were screened from 76 publications. This screening resulted in the inclusion of 13 publications, while reference screening of the 13 publications resulted in inclusion of an additional six publications. A total of 11 cross‐sectional studies, two prospective studies, five experimental studies and one randomised controlled trial were reviewed. The majority of the reviewed studies reported significant, positive associations between SSB consumption and a broad range of adverse markers of glucose metabolism. Results suggested that the adverse effects of SSB consumption on metabolic health may not be limited to individuals with overweight. The results suggest that more frequent consumption of SSBs may be associated with adverse markers of glucose metabolic health among children. However, the evidence is limited by a paucity of prospective studies and randomised controlled trials, as well as by profound heterogeneity in definitions of exposures and outcomes.

Children's Sugar-Sweetened Beverage Consumption: Striking Parallels With Substance Use Disorder Symptoms.

Sugar-sweetened beverage (SSB) intake contributes to obesity and cardiometabolic disease (1). Children's SSB consumption considerably exceeds public health recommendations (2), and efforts to reduce intake have had limited success (3). In addition to high sugar content, many SSBs also contain caffeine, and caffeinated SSBs are the predominant source of caffeine intakes among youth (4). Sugar activates central reward pathways, and similar to drugs of abuse, stimulates dopamine release (5), and meets several criteria for addiction (6). Chronic caffeine intake causes tolerance and withdrawal in children (7), which are core behavioral indicators of substance use disorders (SUDs) (6). Compelling evidence for addictive-like responses to excess sugar intake is emerging, with accumulating support in rodent models (5). Synergistic biopsychological effects of caffeine and sugar may reinforce unfavorable beverage consumption patterns (7). SSBs are a novel stimulus from an evolutionarily standpoint, yet products containing sugar and caffeine (e.g., energy drinks) are increasingly available (8) and heavily advertised to children (7). Children have developing brains and less inhibitory control compared to adults, and thus, are particularly vulnerable to addictive substances (9). Added caffeine in already highly palatable SSBs increases their hedonic and reinforcing properties (10) and may further promote excess added sugar intakes (11). Emerging evidence indicates that children's consumption of highly processed foods, typically high in added sugar and/or saturated fat, can lead to an addictive process reflected by core behavioral indicators of SUDs (12). These include craving, loss of control, tolerance, and withdrawal (12). Children who demonstrate more signs of addiction in their highly processed food consumption are more likely to have higher reward drive for food and higher body mass index (12). Signs of addiction have also been reported among children in response to frequent SSB consumption (13, 14). In our qualitative study (14), parents of children 8–17 years old reported that children experienced physical and affective withdrawal symptoms when caffeinated SSB intake was restricted. Similarly, Falbe et al. (13) reported that adolescents, who reported habitual SSB consumption, regardless of whether SSBs were caffeinated or caffeine-free indicated increased SSB cravings and headaches, and decreased motivation, contentment, concentration, and well-being during 72 h of SSB cessation. It is likely that other aspects of addiction (e.g., tolerance, craving, repeated unsuccessful efforts to reduce) represent important and overlooked obstacles to sustained SSB reduction. Herein, we propose that children's SSB consumption may reflect SUD symptomology and focus specifically on caffeinated SSBs, which are manufactured to contain a highly rewarding mixture of added sugar and caffeine, two ingredients that do not naturally occur in combination.

The impact of a sugar-sweetened beverages tax on oral health and costs of dental care in Australia.

Despite a clear causal link between frequent consumption of sugar-sweetened beverages (SSBs) and dental disease, little is known about the implications of a tax on SSBs in the context of oral health. The aim of our study was to estimate the impacts of a SSB tax on the Australian population in the context of oral health outcomes, dental care utilisation and associated costs. We designed a cohort model that accounted for the consequences of the tax through the mechanisms of consumer response to price increase, the effect on oral health due to change in sugar intake, and the implications for dental care use. Our results indicate that in the adult population an ad valorem tax of 20% would lead to a reduction in decayed, missing and filled teeth (DMFT) by 3.9 million units over 10 years, resulting in cost savings of A$666 million. Scenario analyses show that the outcomes are sensitive to the choice of the time horizon, tax rate, price elasticity of demand for SSBs, and the definition of target population. We found that the total and per-person consequences of SSB tax were considerable, both in terms of dental caries (tooth decay) averted and dental care avoided. These results have to be compounded with the implications of SSB tax for other aspects of health and health care, especially in the context of chronic diseases. On the other hand, the improved outcomes have to be weighted against a welfare loss associated with introducing a tax.

Controlled cohort evaluation of the LiveLighter mass media campaign’s impact on adults’ reported consumption of sugar-sweetened beverages

ObjectiveTo evaluate the LiveLighter ‘Sugary Drinks’ campaign impact on awareness, knowledge and sugar-sweetened beverage (SSB) consumption.DesignCohort study with population surveys undertaken in intervention and comparison states at baseline (n=900 each),...

Frequent Sugar-Sweetened Beverage Consumption and the Onset of Cardiometabolic Diseases: Cause for Concern?

The incidence of noncommunicable diseases is on the rise and poses a major threat to global public health. This is in parallel to a steady increase in worldwide intake of sugar-sweetened beverages (SSBs) among all age groups. As several studies demonstrated a controversial relationship between SSB consumption and the metabolic syndrome (MetS), this mini-review focuses on links between its intake and (1) MetS, (2) prediabetes/type 2 diabetes mellitus (T2DM), and (3) hypertension. A detailed search for clinical and observational studies published during the past 10 years was conducted using key terms that link SSBs to the MetS, T2DM, and hypertension. Here we excluded all meta-analyses and also literature that solely focused on obesity. The analysis revealed that most epidemiological studies strongly show that frequent SSB intake contributes to the onset of the MetS in the longer term. Some of the findings also show that regular SSB intake can alter glucose handling and insulin sensitivity, thereby contributing to the development of the MetS and T2DM. There is also evidence that frequent SSB intake (and particularly fructose) is linked to hypertension and well-known cardiovascular disease risk factors. However, some studies report on the lack of negative effects as a result of SSB consumption. Because of this discrepancy, we propose that well-designed long-term clinical studies should further enhance our understanding regarding the links between SSB consumption and the onset of cardiometabolic diseases.

Frequent consumption of sugar-sweetened beverages and sweets starts at early age

Objectives: We aimed to investigate the habitual consumption of sugar-sweetened beverages (SSBs) and sweets in relation to mothers’ behaviours and practices with their infants.Methods: We targeted mothers with children 1–24 months (N = 200) visiting Public Child Health clinics in Finland. During routine visits mothers (N = 179) volunteered to complete a self-administered anonymous questionnaire about their child’s health-related behaviours (consumption of sweets and SSBs, tooth brushing frequency). The questionnaires also included questions about the mothers’ background (age, education) and health-related behaviours (consumption of sweets, tooth brushing frequency and smoking habits). The children were categorised by age, and Chi-squared tests, Fischer’s exact test, ANOVA and correlation coefficient served for the statistical analyses.Results: Of those under 6 months, almost half (44%) received SSBs, and 45% of them more than once a week. Their use gradually increased by age such that by 19–24 months, all received SSBs at least sometimes, and 56%, frequently. Fewer than half of the mothers (33–43%) gave sweets to their children between the ages of 10–15 months, but 92% by the age of 2 years. Children’s twice-a-day tooth brushing increased from 14% to 33%. The child’s age and tooth brushing frequency correlated with the consumption of sugar-sweetened products (r = 0.458).Conclusions: Infants frequent consumption of sugar-sweetened products begins early in childhood. Thus, tackling these common risk factors in the first years of life is essential and calls for health-promoting actions in multiple areas that target primarily the parents of infants.

Consumption of sugar-sweetened beverages and type 2 diabetes incidence in Thai adults: results from an 8-year prospective study

Background:The global prevalence of type 2 diabetes mellitus (T2DM) is high and is increasing in countries undergoing rapid socio-economic development, including Thailand. Sugar-sweetened beverage (SSB) intake may contribute to the risk of developing T2DM. However, few studies have assessed this association in Asian populations, and the results have been inconsistent. We aimed to assess that association in a prospective study of Thai adults.Methods:Data were from Thai Cohort Study participants surveyed in 2005, 2009 and 2013. The nation-wide sample included adult cohort members who were free of diabetes in 2005 and who were followed-up in 2013 (n=39 175). We used multivariable logistic regression to assess associations between SSB intake and eight-year T2DM incidence. We used a counterfactual mediation analysis to explore potential mediation of the SSB intake and T2DM-risk relationship.Results:In women (but not men) consuming SSBs once or more per day (versus rarely) was associated with increased T2DM incidence at the 8-year follow-up (odds ratio (OR)=2.4, 95% confidence interval (CI) 1.5–3.9). Obesity in 2009 was found to mediate ~23% of the total association between SSB intake in 2005 and T2DM risk in 2013 (natural indirect effect 1.15, 95% CI (1.02, 1.31).Conclusions:Frequent SSB consumption associated with higher T2DM incidence in women but not men. We found that a moderate proportion of the SSB-T2DM relationship was mediated through body mass index (BMI). Our findings suggest that targeting SSB consumption can help prevent a national rise in the incidence of T2DM.

Associations between children's diet quality and watching television during meal or snack consumption: A systematic review

Studies have identified an association between watching television (TV) and childhood obesity. This review adds context to existing research by examining the associations between TV viewing, whilst eating, and children's diet quality. Web of Science and PubMed databases were searched from January 2000 to June 2014. Cross-sectional trials of case control or cohort studies, which included baseline data, measuring the associations between eating whilst watching TV and children's food and drink intake. Quality of selected papers was assessed. Thirteen studies, representing 61,674 children aged 1-18yrs, met inclusion criteria. Of six studies reporting overall food habits, all found a positive association between TV viewing and consumption of pizza, fried foods, sweets, and snacks. Of eight studies looking at fruit and vegetable consumption, seven identified a negative association with eating whilst watching TV (p<.0001). Four out of five studies identified a positive association between watching TV whilst eating and servings of sugar-sweetened beverages (p<.0001). Four studies identified an association between low socioeconomic status and increased likelihood of eating whilst watching TV (p≤.01). Family meals did not overcome the adverse impact on diet quality of having the TV on at mealtimes. Eating whilst watching television is associated with poorer diet quality among children, including more frequent consumption of sugar-sweetened beverages and high-fat, high-sugar foods and fewer fruits and vegetables. Although these differences in consumption are small, the cumulative effect may contribute to the positive association between eating whilst watching TV and childhood obesity.

Early sugar-sweetened beverage consumption frequency is associated with poor quality of later food and nutrient intake patterns among Japanese young children: the Osaka Maternal and Child Health Study

Evidence from Western countries shows that higher consumption of sugar-sweetened beverages (SSBs) is associated with lower quality of young children’s diets, but little is known about these relations in non-Western countries with relatively low consumption levels of SSBs. We hypothesized that SSB consumption in infancy would be associated with poor quality of later food and nutrient intake patterns among Japanese young children. The study subjects were 493 Japanese mother-child pairs from a prospective birth cohort study. Dietary data on children were collected from the mothers using self-administered questionnaires when the children were aged 16-24 months and 41-49 months. Multiple linear regression analyses were used to examine the relationships between SSB consumption frequency in infancy and later intake of foods and nutrients. At 16-24 months of age, more than half of the children (56.4%) consumed SSBs less than once a week, whereas 11.6% consumed SSBs at least once daily. More frequent consumption of SSBs in infancy was associated with higher intake of confectionaries and SSBs and lower intake of fruits and vegetables at 41-49 months of age. These associations were still evident after adjustment for maternal SSB consumption and socioeconomic status. At the nutrient level, SSB consumption frequency was positively associated with energy intake and inversely associated with intake of many nutrients, such as protein, dietary fiber, and most of the micronutrients examined. In conclusion, higher consumption frequency of SSBs at an early age is associated with poor quality of overall dietary intake among young Japanese children 1.5-2.5 years later.

Where Should We Eat? Lunch Source and Dietary Measures Among Youth During the School Week.

To examine lunch sources during the school week among students and the associations with fruits and vegetable (F&V) and sugar-sweetened beverage (SSB) consumption. Students (n = 23 680) from 43 Ontario, Canada, secondary schools completed a health behaviour survey in the Year 1 COMPASS study. Analysis used generalized linear mixed effects models. The most frequently reported lunch source was home (2.9 days per school week), then the school cafeteria (1.1) and fast-food places or restaurants (FFRs) (0.9). Eating a home lunch was associated with having less spending money, white ethnicity, and females; whereas cafeteria lunch was associated with more spending money, lower school grade, and females. A FFR lunch was associated with males, more spending money, and higher physical activity. Greater frequency of a home lunch was associated with greater F&V consumption. Greater frequency of a FFR lunch was associated with more frequent SSB consumption. Cafeteria lunches were associated with increases in both SSB and F&V. Eating a lunch obtained from outside of the home is a regular behaviour among students. Sources of school-week lunches may have an important influence on dietary intake among youth. These findings reinforce the need for strategies to promote healthier lunch sources and healthier food options.

Sugar-sweetened beverage consumption and age at menarche in a prospective study of US girls

Is sugar-sweetened beverage (SSB) consumption associated with age at menarche? More frequent SSB consumption was associated with earlier menarche in a population of US girls. SSB consumption is associated with metabolic changes that could potentially impact menarcheal timing, but direct associations with age at menarche have yet to be investigated. The Growing up Today Study, a prospective cohort study of 16 875 children of Nurses' Health Study II participants residing in all 50 US states. This analysis followed 5583 girls, aged 9-14 years and premenarcheal at baseline, between 1996 and 2001. During 10 555 person-years of follow-up, 94% (n = 5227) of girls reported their age at menarche, and 3% (n = 159) remained premenarcheal in 2001; 4% (n = 197) of eligible girls were censored, primarily for missing age at menarche. Cumulative updated SSB consumption (composed of non-carbonated fruit drinks, sugar-sweetened soda and iced tea) was calculated using annual Youth/Adolescent Food Frequency Questionnaires from 1996 to 1998. Age at menarche was self-reported annually. The association between SSB consumption and age at menarche was assessed using Cox proportional hazards regression. More frequent SSB consumption predicted earlier menarche. At any given age between 9 and 18.5 years, premenarcheal girls who reported consuming >1.5 servings of SSBs per day were, on average, 24% more likely [95% confidence interval (CI): 13, 36%; P-trend: <0.001] to attain menarche in the next month relative to girls consuming ≤2 servings of SSBs weekly, adjusting for potential confounders including height, but not BMI (considered an intermediate). Correspondingly, girls consuming >1.5 SSBs daily had an estimated 2.7-month earlier menarche (95% CI: -4.1, -1.3 months) relative to those consuming ≤2 SSBs weekly. The frequency of non-carbonated fruit drink (P-trend: 0.03) and sugar-sweetened soda (P-trend: 0.001), but not iced tea (P-trend: 0.49), consumption also predicted earlier menarche. The effect of SSB consumption on age at menarche was observed in every tertile of baseline BMI. Diet soda and fruit juice consumption were not associated with age at menarche. Although we adjusted for a variety of suspected confounders, residual confounding is possible. We did not measure SSB consumption during early childhood, which may be an important window of exposure. More frequent SSB consumption may predict earlier menarche through mechanisms other than increased BMI. Our findings provide further support for public health efforts to reduce SSB consumption. The Growing up Today Study is supported by grant R03 CA 106238. J.L.C. was supported by the Breast Cancer Research Foundation; Training Grant T32ES007069 in Environmental Epidemiology from the National Institute of Environmental Health Sciences, National Institutes of Health; and Training Grant T32HD060454 in Reproductive, Perinatal and Pediatric Epidemiology from the National Institute of Child Health and Human Development, National Institutes of Health. A.L.F. is supported by the American Cancer Society, Research Scholar Grant in Cancer Control. K.B.M. was supported in part by the National Cancer Institute at the National Institutes of Health (Public Health Service grants R01CA158313 and R03CA170952). There are no conflicts of interest to declare.

Knowledge, Attitude and Consumption Pattern of Alcoholic and Sugar Sweetened Beverages among Undergraduates in a Nigerian Institution

High consumption of alcoholic and sugar sweetened beverages (SSBs) remains a public health problem among the young adults. This study assessed the knowledge, attitude and consumption pattern of alcohol and SSBs among the undergraduate students. A pretested, self-administered questionnaire was used to obtain information on the socio-demographic characteristic, knowledge, attitude and consumption pattern of the students regarding the negative social and health implications of excessive consumption of alcohol and SSBs from 376 undergraduate students from the University of Ibadan. Data was analyzed using descriptive statistics and chi square at P<0.05 was considered significant. The mean age of the students was 22.5±2.3 years. Large proportion (83.0% and 86.7%) had adequate knowledge of the health implications of excessive consumption of alcohol and SSBs respectively. Majority (85.4%) had positive attitude towards intake of alcoholic drinks while 83.5% had negative attitude towards the intake of SSBs. Majority (83.0%) of the respondents considered high intake of alcoholic drinks as dangerous to health while only 32.5% considered regular consumption of SSBs as dangerous to health. Majority (75.0%, 63.3% and 79.3%) of the respondents abstained from intake of beers, alcoholic wines and spirits respectively. Significant relationship was observed between the knowledge of social and health implication of excessive consumption of alcohol and the abstinence of the participants (p<0.05). A significant relationship was also observed between frequent consumption of SSBs by the respondents and being overweight (P<0.05). Knowledge of the undergraduate students on the social and health implication of excessive consumption of alcohol and sugar sweetened beverages was adequate. Majority had negative attitude towards alcohol intake but positive attitude towards the intake of sugar sweetened beverages. Frequent consumption of sugar sweetened beverages could contribute to being overweight. Nutrition education to encourage healthful dietary practices regarding the intake of sugar sweetened beverages should be intensified. Key words : Knowledge, Attitude, Consumption pattern, Sugar Sweetened Beverages, Alcoholic drink

Less-healthy eating behaviors have a greater association with a high level of sugar-sweetened beverage consumption among rural adults than among urban adults

Background: Sugar-sweetened beverage (SSB) consumption is associated with the increasing prevalence of overweight and obesity in the United States; however, little is known about how less-healthy eating behaviors influence high levels of SSB consumption among rural adults.Objective: We assessed the frequency of SSB consumption among rural and urban adults, examined the correlates of frequent SSB consumption, and determined difference in correlates between rural and urban adults in a large region of Texas.Design: A cross-sectional study using data on 1,878 adult participants (urban = 734 and rural = 1,144), who were recruited by random digit dialing to participate in the seven-county 2006 Brazos Valley Community Health Assessment. Data included demographic characteristics, eating behaviors (SSB consumption, frequency of fast-food meals, frequency of breakfast meals, and daily fruit and vegetable intake), and household food insecurity.Results: The prevalence of any consumption of SSB and the prevalence of high consumption of SSB were significantly higher among rural adults compared with urban counterparts. The multivariable logistic regression models indicated that a high level of SSB consumption (≥3 cans or glasses SSB/day) was associated with demographic characteristics (poverty-level income and children in the home), frequent consumption of fast-food meals, infrequent breakfast meals, low fruit and vegetable intake, and household food insecurity especially among rural adults.Conclusions: This study provides impetus for understanding associations among multiple eating behaviors, especially among economically and geographically disadvantaged adults. New strategies are needed for educating consumers, not only about how to moderate their SSB intake, but also how to simultaneously disrupt the co-occurrence of undesirable eating and promote healthful eating.