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Persistent disparities over time in the distribution of sugar-sweetened beverage intake among children in the United States.
Am J Clin Nutr. 2019 01 01; 109(1):79-89.AJ

Abstract

Background

Recent research suggests that sugar-sweetened beverage (SSB) consumption has been declining among US children aged 2-18 y. However, most studies focused on changes in mean intake, ignore high SSB consumers and do not examine intake among vulnerable groups and, including adolescents, low-income households, and several racial/ethnic minorities.

Objective

The aim was to estimate usual SSB intake from NHANES surveys from 2003-2004 to 2013-2014 to examine shifts at both the median and 90th percentile among US children, evaluating the extent to which intake disparities in total SSBs and subtypes have persisted.

Design

Children 2-18 y from NHANES 2003, 2005, 2007, 2009, 2011 and 2013. SSBs were all non-diet beverages sweetened with sugars including revising all beverages to as consumed status and excluding soy and dairy based beverages. The NCI usual intake method was used to estimate usual intake from two 24-hour recalls. A 2-part correlated model accounted for nonconsumers. Quantile regression was then used to examine differences in SSB usual intakes at the 50th and 90th percentiles by race-ethnicity, and examine interactions indicating whether racial-ethnic disparities in intake were modified by income.

Results

Despite considerable declines, children's SSB intake remains high, particularly among heavy consumers. Among adolescents, median SSB intake in 2013-2014 was on the order of 150-200 kcal/d, and heavy intake at the 90th percentile was on the order of 250-300 kcal/d. There were important disparities in intake that persisted over time. Although high household income was associated with lower SSB intake in non-Hispanic white (NHW) children, intakes of non-Hispanic black (NHB) and Mexican-American (MA) children from these households were similar to or higher than those from poor households. There were also large racial/ethnic differences in the types of SSBs consumed. The consumption of regular sodas by NHB children was somewhat lower than among MA and NHW children, whereas fruit drink intake was markedly higher.

Conclusions

Overall, these findings suggest that, despite recent declines, strategies are needed to further reduce SSB consumption, and particularly heavy intake, especially among NHB children where fruit drinks also are key source of SSBs.

Authors+Show Affiliations

Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC. Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC. Lineberger Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC.Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC.Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC. Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC.Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC.Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC. Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC. Lineberger Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30535176

Citation

Mendez, Michelle A., et al. "Persistent Disparities Over Time in the Distribution of Sugar-sweetened Beverage Intake Among Children in the United States." The American Journal of Clinical Nutrition, vol. 109, no. 1, 2019, pp. 79-89.
Mendez MA, Miles DR, Poti JM, et al. Persistent disparities over time in the distribution of sugar-sweetened beverage intake among children in the United States. Am J Clin Nutr. 2019;109(1):79-89.
Mendez, M. A., Miles, D. R., Poti, J. M., Sotres-Alvarez, D., & Popkin, B. M. (2019). Persistent disparities over time in the distribution of sugar-sweetened beverage intake among children in the United States. The American Journal of Clinical Nutrition, 109(1), 79-89. https://doi.org/10.1093/ajcn/nqy123
Mendez MA, et al. Persistent Disparities Over Time in the Distribution of Sugar-sweetened Beverage Intake Among Children in the United States. Am J Clin Nutr. 2019 01 1;109(1):79-89. PubMed PMID: 30535176.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Persistent disparities over time in the distribution of sugar-sweetened beverage intake among children in the United States. AU - Mendez,Michelle A, AU - Miles,Donna R, AU - Poti,Jennifer M, AU - Sotres-Alvarez,Daniela, AU - Popkin,Barry M, PY - 2017/12/05/received PY - 2018/05/15/accepted PY - 2018/12/12/pubmed PY - 2019/10/18/medline PY - 2018/12/12/entrez SP - 79 EP - 89 JF - The American journal of clinical nutrition JO - Am J Clin Nutr VL - 109 IS - 1 N2 - Background: Recent research suggests that sugar-sweetened beverage (SSB) consumption has been declining among US children aged 2-18 y. However, most studies focused on changes in mean intake, ignore high SSB consumers and do not examine intake among vulnerable groups and, including adolescents, low-income households, and several racial/ethnic minorities. Objective: The aim was to estimate usual SSB intake from NHANES surveys from 2003-2004 to 2013-2014 to examine shifts at both the median and 90th percentile among US children, evaluating the extent to which intake disparities in total SSBs and subtypes have persisted. Design: Children 2-18 y from NHANES 2003, 2005, 2007, 2009, 2011 and 2013. SSBs were all non-diet beverages sweetened with sugars including revising all beverages to as consumed status and excluding soy and dairy based beverages. The NCI usual intake method was used to estimate usual intake from two 24-hour recalls. A 2-part correlated model accounted for nonconsumers. Quantile regression was then used to examine differences in SSB usual intakes at the 50th and 90th percentiles by race-ethnicity, and examine interactions indicating whether racial-ethnic disparities in intake were modified by income. Results: Despite considerable declines, children's SSB intake remains high, particularly among heavy consumers. Among adolescents, median SSB intake in 2013-2014 was on the order of 150-200 kcal/d, and heavy intake at the 90th percentile was on the order of 250-300 kcal/d. There were important disparities in intake that persisted over time. Although high household income was associated with lower SSB intake in non-Hispanic white (NHW) children, intakes of non-Hispanic black (NHB) and Mexican-American (MA) children from these households were similar to or higher than those from poor households. There were also large racial/ethnic differences in the types of SSBs consumed. The consumption of regular sodas by NHB children was somewhat lower than among MA and NHW children, whereas fruit drink intake was markedly higher. Conclusions: Overall, these findings suggest that, despite recent declines, strategies are needed to further reduce SSB consumption, and particularly heavy intake, especially among NHB children where fruit drinks also are key source of SSBs. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/30535176/Persistent_disparities_over_time_in_the_distribution_of_sugar_sweetened_beverage_intake_among_children_in_the_United_States_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.1093/ajcn/nqy123 DB - PRIME DP - Unbound Medicine ER -