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Background Results from clinical trials have shown that sugar-sweetened beverages (SSBs) lead to increased BMI and obesity. This relationship has yet to be explored in observational data for non-clinical populations of adults. Objective To compare adults who drank 4+ SSBs daily to those who drank 0 in the population of adults in New York City, and to better understand adult risk factors associated with higher daily SSB consumption and BMI. Design Secondary analysis of cross-sectional data using propensity score matching (PSM). Participants/Setting 2009 NYC Community Health Survey (n=9,934). Main outcome measure BMI Statistical Analyses For each of the participants who consumed 4+ SSBs daily, PSM identified matched comparisons who did not drink any SSBs. T-tests compared BMI in unadjusted and matched pairs. A post hoc analysis compared features of those likely to drink SSBs and those not. Results In unmatched analyses, participants who consumed 4+ SSBs daily (n=475) had higher BMI than those who consumed 0 SSBs (n=3,818; difference=1.4 kg/m2, SE=0.29; t-value=4.81, p<0.001); however, when compared to similar participants using nearest neighbor with replacement matching (n=1,062), the difference between those who consumed 4+ SSBs daily and those who consumed none decreased (difference=0.37 kg/m2, SE=0.36; t-value=1.01, p=0.32). Analyses also indicated that those likely to drink SSBs and those unlikely to drink SSBs differed in several important characteristics, including sex, age, race, ethnicity, SES, education, diet, and exercise. Conclusions The data preclude strong causal conclusions about the role of SSB in obesity. However, our results suggest that there is a subset of participants demographically and behaviorally similar with higher BMI regardless of their self-reported SSB intake. In addition to targeting SSBs, public health policies and programs should identify and address other modifiable aspects of this profile and tailor approaches to the groups identified to be most affected by high BMI.

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