Research articleFoods and Beverages Associated with Higher Intake of Sugar-Sweetened Beverages
Introduction
Increased consumption of sugar-sweetened beverages (SSBs) among children and adolescents is associated with higher caloric intake.1, 2, 3, 4 Given the increase in SSB consumption over the past 20 years,5, 6 the relationship between SSB intake and total energy intake is concerning. To date, the primary focus of SSB-related research has been on SSB intake itself or total energy intake; research is lacking on how overall diet is affected by SSB intake. The present study examines whether increased SSB intake is associated with food (“food” is used to indicate solid food throughout the paper) and non-SSB beverage intake.
One small study with children aged 6–13 years showed that consumption of any amount of sweetened beverages did not affect food intake, indicating that the sweetened beverages were responsible for increases in total daily energy intake.2 Additionally, intake of milk was lower on days when >12 oz. of sweetened drinks were consumed. Consumption of SSBs has also been associated with lower intake of fruit7 and with fast-food intake.8 Associations between SSB consumption, particular food groups, dietary quality, and micro/macronutrients have previously been investigated4, 7, 8, 9, 10; however, a comprehensive assessment of foods and beverages associated with SSB consumption has yet to be undertaken. The primary aims of the current study were to determine the extent to which SSBs contribute to higher caloric intake of SSB consumers and to identify food and beverage groups from the overall diet that are associated with increased SSB consumption.
Section snippets
Study Population
The 2003–2004, 2005–2006, 2007–2008, and 2009–2010 What We Eat in America, National Health and Nutrition Examination Surveys (NHANES)11, 12 were combined for this analysis; analyses were conducted in December 2012. All surveys were self-weighting, multistage, stratified area probability samples of the non-institutionalized U.S. population. The study population included non-Hispanic whites, non-Hispanic blacks, and Mexican Americans. Non-Mexican-American Hispanics and other races were excluded
Results
The socioeconomic, demographic, and per capita intakes (kilocalories) of food, SSBs, and non-SSB beverages for the three age categories are presented in Table 1. For the three age groups, SSB consumers had higher (p<0.0001) total caloric intakes than nonconsumers; +147±33, +221±38, and +342±51 kcal for children aged 2–5 years, 6–11 years, and 12–18 years, respectively (data not shown). In order to determine the contribution of SSB to higher caloric intake, total non-SSB intakes were examined.
Discussion
Higher consumption of SSBs was associated with higher food intake among SSB consumers, offset partially by reductions in non-SSB beverage intake. Among children aged 2–5 years and 6–11 years, intake of total non-SSB calories did not differ across levels of SSB consumption, indicating that SSB intake was primarily responsible for the higher caloric intakes of SSB consumers as compared to nonconsumers. Of particular interest are those aged 12–18 years who consumed 500 or more kilocalories from
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