Prevalence, Trends and Disparities in Beverage Consumption Among Young Children aged 0-24 months from NHANES

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Prevalence, Trends and Disparities in Beverage Consumption Among Young Children aged 0-24 months from NHANES Anna Maria Siega-Riz, PhD Professor of Public Health Sciences and Obstetrics and Gynecology University of Virginia School of Medicine

Methods 24-hr dietary recall data from 2005-2012 NHANES Respondents <24 months old Grimes et al. papers (n=2740) Uses data across all years to estimate prevalence by age groups, race/ethnicity and income One 24hr recall Miles & Siega-Riz paper (n=2,359) Assessed any consumption on at least 1 intake day Compare food group consumption in 2005-2008 and 2009-2012 Calculated prevalence of consumption adjusted for mother s age at birth and income to poverty ratio

Food sources of total energy among 0-23.9 month olds (% of daily intake) 0-5.9 months (99.3%) Infant formula 65.4% Human Milk 30.1% Baby foods 3.7% Grimes et al., Nutrients 2015 7:6797-6836 6-11.9 months (88.3%) Infant formula 47.1% Baby foods 16.5% Human Milk 9.9% Milk 3.1% Fruits 2.3 Mixed dishes-grain based 2.3 Sweet bakery products 1.8 Baby beverages 1.5% 100% Fruit juice 1.5% Breads, rolls, tortillas 1.1% Mixed dishes-soups 1.0% 12-23 months (64% ) Milk 22.4% 100% fruit juice 5.9% Mixed dishes-grain based 5.5% Fruits 4.8% Sweet bakery products 4.6% Breads, rolls, tortillas 3.8% Poultry 3.6% Sugar-Sweetened Beverages 3.1% Baby foods 2.6% Cheese 2.6% Cured meats/poultry 2.5% Crackers 2.4

Food sources of total sugars among 0-23.9 month olds 0-5.9 month olds 6-11.9 month olds 12-23.9 month olds Infant formula Baby foods Human Milk Infant formulas Human Milk Baby foods Fruits Milk 100% Fruit juice 100% fruit juice Baby beverages Fruits SSB Milk Yogurt Sweet bakery products Yogurt Sweet bakery products SSB Infant Fomulas Candy Flavored Milk Baby foods Grimes et al., Nutrients 2015 7:6797-6836 Other desserts Human Milk Sugars Ready-eat-cereals Mixed dishes-grain based Baby beverages

Proportion of children consuming each type of beverage by age group, n=2740 Grimes et al., Nutrients 2017 9:264

Per capita daily intake of water from beverages and food sources Grimes et al., Nutrients 2017 9:264

Trends All from Miles and Siega-Riz. Trends in Food and Beverage Consumption among Infants and Toddlers. Pediatrics 2017;139:e20163290.

Trend for Breast Milk, Formula and Cow s Milk among 0-23.9 month olds Adjusted Prevalence of Consumption (%) 100 90 80 70 60 50 40 30 20 10 0 2005-08 2009-12 2005-08 2009-12 2005-08 2009-12 Breast milk Formula Cow's milk 0-5 mo 6-11mo 12-23 mo

Trend for 100% Fruit Juice Consumption among 0-23.9 month olds Adjusted Prevalence of Consumption (%) 80.0 70.0 60.0 50.0 40.0 30.0 20.0 10.0 0.0 * * 2005-2008 2009-2012 0-5 mo 6-11mo 12-23 mo

Trend for Type of Sweetened Beverage Consumption among 6-23.9 month olds 100 90 80 70 60 50 40 30 20 10 0 Carbonated soda Fruit-flavored drinks Sport drinks Presweetened tea or coffee Unstable estimate Adjusted Prevalence of Consumption 2005-2008 2009-2012 Other sweetened beverages

Trend for all Sweetened Beverage Consumption among 6-23 month olds by Race/ethnicity Adjusted Prevalence of Sweetened Beverage Consumption 100 90 80 70 60 50 40 30 20 10 0 2005-2008 2009-2012 Overall Non-Hispanic white Non-Hispanic black Mexican American

Trend for Soda Consumption by Race/ethnicity among 6-23.9 month olds Adjusted Prevalence of Carbonated Soda Consumption 100 90 80 70 60 50 40 30 20 10 0 2005-2008 2009-2012 Overall Non-Hispanic white Non-Hispanic black Mexican American **

Trend for Fruit-flavored Drink Consumption by Race/ethnicity among 6-23.9 month olds Adjusted Prevalence of Fruit-favored Drink Consumption 100 90 80 70 60 50 40 30 20 10 0 2005-2008 2009-2012 Overall Non-Hispanic white Non-Hispanic black Mexican American

Overall Summary-Fruit juices Fruit juices comprise 1.5% of total energy for 6-11.9 month olds and triples its contribution to the diet of young children by 24 months of age. Fruit juices contributes more to total sugar intake than SSB. Consumption of fruit juices increases with age from 6% of kids at age 0-5.9 months consuming to 57% consuming by age 12-23.9 months. Lower intake of 100% fruit juices in 2009-2012 among 0-5.9 and 6-11.9 month olds.

Overall Summary-SSB SSB comprises 3.1% of total energy for 12-23.9 month olds. SSB makes a small contribution of total sugar intake for 6-11.9 month olds but increases to the 4 th highest contributor of total sugar intake for 12-23.9 month olds. SSB consumption begins early with 1% of 0-5.9 month olds to 6% and 32% for 6-12 and 13-23 month olds respectively. No significant differences in type of SSB consumption across the survey time periods. However, Mexican Americans are consuming less overall SSB and in particular, soda consumption has decreased. While non-hispanic black and Mexican American young children have higher consumption of fruit-flavored drinks compared to non-hispanic whites, consumption across all groups appears to be declining.