Study Synopses: Sugar-Sweetened Beverage (SSB) Consumption Trends Citation Funder(s) Conclusions

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1 Study Synopses: Sugar-Sweetened Beverage (SSB) Consumption Trends Citation Funder(s) Conclusions Block, J.P., Gillman, M.W., Linakis, S.K., Goldman, R.E. (2013). "If it tastes good, I'm drinking it": Qualitative study of beverage consumption among college students. J Adolesc Health, in press. Harvard Catalyst/The Harvard Clinical and Translational Science Center; National Heart, Lung and Blood Institute Among college students surveyed, taste and price were the most important factors in choosing beverages, with health and nutritional content of beverages of limited interest. Grimes, C.A., Wright, J.D., Liu, K., Helen MacPherson Smith Trust; Nowson, C.A., Loria, C.M. (2013). Dietary National Heart Foundation, Australia sodium intake is associated with total fluid and sugar-sweetened beverage consumption in US children and adolescents aged 2-8 y: NHANES Am J Clin Nutr, 98, The high dietary sodium intake of US children and adolescents may contribute to a greater consumption of SSBs, identifying a possible link between dietary sodium intake and excess energy intake. Han, E., Powell, L.M. (2013). Consumption patterns of sugarsweetened beverages in the US. J Acad Nutr Diet, 113, National Heart, Lung, and Blood Institute; CDC; Korea National Research Foundation Heavy total SSB consumption (more than 500 calories per day) increased among children between , although it decreased among adolescents and young adults. Soda was the most heavily consumed SSB in all age groups except for children. While soda consumption decreased, heavy sports and energy drink consumption tripled among adolescents. Black children and adolescents were more likely to be heavy fruit drink consumers versus whites. Low-income children and adults were more likely to have higher energy intake from total SSBs and fruit drinks.

2 Kit, B.K., Fakhouri, T.H.I., Park, S., CDC; US Public Health Service Nielsen, S.J., Ogden, C.L. (2013). Trends in sugar-sweetened beverage consumption among youth and adults in the United States: Am J Clin Nutr, 98, SSB consumption among youth and adults in the United States declined between 1999 and 2010; however, on average, American youth and adults consumed 155 and 151 kcal energy/d from SSBs in , which equates to slightly more than one 12-fluid ounce can of cola. Mathias, K.C., Slining, M.M., Popkin, B.M. (2013). Foods and beverages associated with higher intake of sugarsweetened beverages. Am J Prev Med, 44.4, RWJF; NIH Among children and adolescents, sugar-sweetened beverages are primarily responsible for the higher caloric intakes of SSB consumers. Among adolescents, SSB consumption is associated with intake of a select number of food and beverage groups, some of which are often unhealthy (e.g., pizza, burgers, fried potatoes, savory snacks, and grain-based desserts). Park, S., Onufrak, S., Blanck, H.M., Sherry, B. (2013). Characteristics associated with consumpton of sports and energy drinks among US adults: National Health Interview Survey, J Acad Nutr Diet, 113, CDC Piernas, C., Ng, S.W., Popkin, B. (2013). Trends in purchases and intake of foods and beverages containing caloric and lowcalorie sweeteners over the last decade in the United States. Pediatr Obes, 8, Of 25,492 adults surveyed, 21.5% consumed sports and energy drinks one or more times per week and 11.5% three or more times per week. Weekly sports and energy drink consumption was particularly higher among younger adults, males, non-hispanic Blacks and Hispanics, not-married individuals, adults with higher family income, those who lived in the South or West, adults who engaged in leisure-time physical activity, current smokers, individuals whose satisfaction with their social activities and relationships was excellent, and those with higher intake of regular soda, coffee/tea drinks, fruit drinks, milk, 100% fruit juice, and alcohol. From 2000 to 2010, percent of households purchasing products containing caloric sweeteners decreased, while households purchasing products with low-calorie sweeteners, or a combination of high and low calorie sweeteners, increased among all types. African-American, Hispanic, and households with children purchased a higher % of caloric sweetened beverages.

3 Simon, P.A., Lightstone, A.S., Baldwin, S., Kuo, T., Shih, M., Fielding, J.E. (2013). Declines in sugar-sweetened beverage consumption among children in Los Angeles County, Prev Chron Dis, 10, CDC In Los Angeles County, the percentage of children who consumed 1 or more SSB per day decreased from 43.3% in 2007 to 38.3% in This decrease was seen across most sociodemographic subgroups. Vericker, T.C. (2013). Limited evidence The Urban Institute that competitive food and beverage practices affect adolescent consumption behaviors. Health Educ Behav, 40.1, The availability of SSBs in schools did not affect consumption overall. However, males, minority youth, and youth in households below the poverty line were adversely affected. Males who gained access to SSBs in school increased their consumption by 20.7% per week compared with males in schools with no access to them. Minority youth consumed SSBs 61.4% and youths in households below the poverty line 68.6% more times per week than their counterparts in schools that did not offer SSBs. Park, S., Blanck, H.M., Sherry, B., Brener, N., O'Toole, T. (2012). Factors associated with sugar-sweetened beverage intake among United States high school students. J Nutr, 142, Brener, N.D., Merlo, C., Eaton, D., Kann, L., Park, S., Blanck, H.M. (2011). Beverage consumption among high school students -- United States, JAMA, 306.4, CDC Factors associated with a greater likelihood of high consumption of SSBs include being male, being non-hispanic black, eating at fast food restaurants at least once a week or more, and watching television. Although water, milk, and 100% juice were the beverages consumed most commonly, 24.3% of high school students drank a serving or regular soda, 16.1% drank a serving of a sports drink, and 16.9% drank a serving of another SSB one or more times per day in a given week.

4 Craddock, A.L., McHugh, A., Mont- Ferguson, H., Grant, L., Barrett, J.L., Wang, Y.C., Gortmaker, S.L. (2011). Effect of school district policy change on consumption of sugar-sweetened beverages among high school students, Boston, Massachusetts, Prev Chronic Dis, 8.4, A74. CDC, RWJF Average consumption of SSBs decreased among Boston public high school students from 2004 to 2006, coinciding with a policy that restricted the sale of SSBs in schools. This decrease was not true for same-aged youth nationwide, indicating that the policy may be a successful means to curb drinking of SSBs among school-aged children and adolescents. Lasater, G., Piernas, C., Popkin, B.M. (2011). Beverage patterns and trends among school-aged children in the US, Nutr J, 10, 103. Dunlevie Honors Undergraduate Research Award; RWJF Increased caloric contribution from SSBs, especially high-fat, highsugar milk, soft drinks and sports drinks, mirrors the current trends of childhood obesity. Ogden, C.L., Kit, B.K., Carroll, M.D., Park, S. (2011). Consumption of sugar drinks in the United States, NCHS Data Brief, 71, 1-8. CDC, National Center for Health Statistics Examination of NHANES data reveals an increase in consumption of SSBs. In addition, data showed that males consume more SSBs than females, teenagers and young adults drink more SSBs than other age groups, approximately 1/2 of the US population drink an SSB on any given day, non-hispanic black and Mexican-American adults consume more SSBs than non-hispanic white adults, lowincome persons consume more SSBs in relation to their overall diet than those with higher income, and most SSBs consumed away from home are obtained from stores and not restaurants or schools. Piernas, C., Popkin, B.M. (2011). Food portion patterns and trends among children and the relationship to total food occasion size. J Nutr, 141, University of North Carolina; NIH; RWJF Energy from eating occasions including soft drinks increased, as did the proportion of energy from soft drinks in an eating occasion. Portion sizes increased across all food sources (stores, restaurants, and fast foods) for soft drinks.

5 Welsh, J.A., Sharma, A.J., Grellinger, L., Vos, M.B. (2011). Consumption of added sugars is decreasing in the United States. AJCN, 94, Examination of NHANES data reveals a decrease in absolute intake of added sugars with two-thirds of this decrease resulting from a reduction in soda consumption. Energy drinks were the only source of added sugars to increase over the study period. Although there was an overal decrease in added sugars, the mean intakes continue to exceed recommended limits. Fiorito, L.M., Marini, M., Mitchell, D.C., Smiciklas-Wright, H., Birch, L.L. (2010). Girls' early sweetened carbonated beverage intake predicts different patterns of beverage and nutrient intake across childhood and adolescence. J Am Diet Asso, 110.4, Popkin, B. (2010). Patterns of beverage use across the lifecycle. Physiol Behav, 100.1, 4-9. NIH, National Dairy Council* Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC Girls who drank soda at age 5 years had higher soda intake, lower milk intake, higher added sugars intake, and lower protein, fiber, vitamin D, calcium, magnesium, phosphorus, and potassium intake from ages 5 to 15 years, than girls who did not consume soda at age 5. Over time there has been a decrease in milk consumption and a marked increase in SSB and bottled water consumption. The biggest shifts among children aged 2 to 18 were an increase in SSB consumption from 87 to 154 calories per day; a smaller increase in juices +21 calories per day; and a decrease in milk consumption -91 calories per day. SSB intake has more than doubled among adults aged 19 and over. Reedy, J., Krebs-Smith, S.M. (2010). Dietary sources of energy, solid fats, and added sugars among children and adolescents in the United States. JADA, 110, National Cancer Institute Data from the National Health and Nutrition Examination Survey show that sugar-sweetened beverages (soda and fruit drinks combined) provided the largest source of daily calories for 2- to 18- year olds. Soda on its own was the third largest contributor. Bleich, S.N., Wang, Y.C., Wang, Y., Gortmaker, S.L. (2009). Increasing consumption of sugar-sweetened beverages among US adults: to Am J Clin Nutr, 89.1, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health; RWJF Data from the National Health and Nutrition Examination Survey show that sugar-sweetened beverage consumption increased over the decade studied, that SSBs comprised a considerable source of total daily intake, and that SSB consumption was highest among people also at risk of obesity and type 2 diabetes.

6 Nelson, M.C., Neumark-Sztainer, D., Hannan, P.J., Story, M. (2009). Five-year longitudinal and secular shifts in adolescent beverage intake: Findings from Project EAT (Eating Among Teens)- II. JADA, 109.2, Maternal and Child Health Bureau, Department of Health and Human Services, University of Minnesota From , SSB intake increased significantly among younger males, from 33% to 45%. Milk consumption decreased significantly among older adolescents. Roberts Jr, W.A. (2009). Beverages in flux. Prep Foods, 178.6, Sturm, R. (2008). Stemming the global obesity epidemic: What can we learn from data about social and economic trends? Pub Health, 122.8, Wang, Y.C., Bleich, S.N., Gortmaker, S.L. (2008). Increasing caloric contribution from sugar-sweetened beverages and 100% fruit juices among US children and adolescents, Pediatrics, 121.6, e e1614. O'Connor, T.M., Yang, S.J., Nicklas, T.A. (2006). Beverage intake among preschool children and its effect on weight status. Pediatrics, 118.4, e Robert Wood Johnson Foundation; CDC The number of people buying regular soda decreased by 16.5 million from 2003 to However, sports drinks and energy drinks consumption grew during the same period. An emphasis on reducing discretionary calorie consumption, particularly sugar-sweetened beverages and salted snacks, may be a promising lever to reduce overweight and obesity and should receive more attention. Per capita daily caloric contribution from SSB intake increased from 204 to 224 calories a day. The largest increase (20%) was among children ages There were significant increases among black and Mexican-American adolescents, but not whites. Soda contributed approximately 67% of all SSB calories among adolescents. Glaser Pediatric Research Network Of the sample of chidren aged 2-5 years, 83% drank milk, 48% drank 100% fruit juice, 44% drank fruit drink, and 39% drank soda. Preschool children consumed a mean total beverage volume of oz/day (12.32 oz milk, 4.7 oz 100% fruit juice, 4.98 oz fruit drinks, and 3.25 oz soda). Weight status of the child had no association with the amount of total beverages consumed. Striegel-Moore, R.H., Thompson, D., Affenito, S.G., Franko, D.L., Obarzanek, E., Barton, B.A., Schreiber, G.B., Daniels, S.R., Schmidt, M., Crawford, P.B. (2006). Correlates of beverage intake in adolescent girls: The National Heart, Lung and Blood Institute Growth and Health Study. J Pediatr, 148.2, National Heart, Lung, and Blood Institute Adolescent girls showed a decreased consumption of milk and increase in soda consumption over time, with soda increasing almost 3-fold over a 10-year period. Increasing soda consumption predicted the greatest increase in calories, and of BMI, and the lowest increase in calcium intake.

7 Nielsen, S.J. and Popkin, B.M. (2004). National Dairy Council*; NIH Changes in beverage intake between 1977 and Am J Prev Med, 27, Ludwig, D.S., Peterson, K.E., Gortmaker, S.L. (2001). Relation between consumption of sugar-sweetened drinks and childhood obesity: a prospective, observational analysis. Lancet, 357, National Institute of Diabetes and Digestive and Kidney Diseases; National Institutes of Child Health and Human Development; CDC; Charles H. Hood Foundation For all age groups (2 years to over 60) between , SSB consumption increased by 135% with a 278 total calorie increase. Milk consumption decreased by 38% in the same time period. Every additional serving of sugar-sweetened beverages consumed by children increases the risk of obesity by 60%. *Funding from food/beverage industry or organizations representing industry For more information, visit Updated 12/11/13

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