Trends and patterns in sugar-sweetened beverage consumption among children and adults by race and/or ethnicity, 2003–2018

Abstract

Objective: Sugar-sweetened beverage (SSB) consumption has declined steadily. This study uses the latest national data to examine trends in SSB consumption among children and adults by race and/or ethnicity and to document whether long-standing disparities in intake remain. Design: Trend analyses of demographic and dietary data measured by 24-hour dietary recall from the National Health and Nutrition Examination Survey (NHANES). Setting: Data from the 2003-2004 through 2017-2018 NHANES survey cycles were analyzed in 2020. Participants: The study sample included 21,156 children aged 2-19 years and 32,631 adults aged 20+ years. Results: From 2003-2004 to 2017-2018, the prevalence of drinking any amount of SSBs on a given day declined significantly among all race and/or ethnicity groups for children (non-Hispanic [NH] White: 81.6% to 72.7%; NH Black: 83.2% to 74.8%, Hispanic: 86.9% to 77.2%) and most race and/or ethnicity groups for adults (NH White: 72.3% to 65.3%; Hispanic: 84.6% to 77.8%). Consumption declined at a higher rate among NH Black and Hispanic children aged 12-19 years compared to their NH White peers; among NH Black children aged 6-11 years, the rate of decline was lower. Despite significant declines in per capita SSB calorie consumption from soda and fruit drinks, consumption of sweetened coffee/tea beverages increased among older children and nearly all adults, and consumption of sweetened milk beverages increased among NH White and Hispanic children. Conclusions: SSB consumption has declined steadily for children and adults of all race and/or ethnicity groups, but disparities persist, and overall intake remains high.

Trends in Added Sugars Intake and Sources Among US Children, Adolescents, and Teens Using NHANES 2001–2018

“…Despite the decline in sweetened beverages, our results showed an increase in added sugars from coffee and tea beverages among adolescents and teens from 2001–2018, consistent with analyses of NHANES data by other researchers ( 14 ). Other sources of added sugars that increased over time include sweet bakery products, which remained the second highest source of added sugars; candy among children; and RTE cereals among adolescents and teens in 2009 and onwards.…”

“…Similar observations of decreasing added sugars intakes have been documented among children, adolescents, and teens in other developed countries ( 32–35 ). Our results also demonstrate that added sugars intakes declined across various strata: regardless of age, sex, race and ethnicity, income, food assistance, physical activity level, or body weight status, intakes decreased over time, albeit to varying degrees, consistent with other studies examining various of these factors ( 7 , 8 , 10 , 11 , 13 , 14 , 18 ).…”

“…Among the different race and ethnicities, the greatest decline in added sugars intake was observed among White individuals; for income, those in the high PIR group had the greatest decline in added sugars intake; and those not receiving food assistance had a greater decline than those who received food assistance. Similar variations have been documented in other time-trend analyses of NHANES data ( 7 , 8 , 10 , 11 , 13 , 14 , 18 ). Overall, the different levels of decline resulted in disparities in added sugars intakes by race and ethnicity and by income, such that by 2018, intakes were highest among Black children, adolescents, and teens and among those in the low PIR group, similar to the results of other studies ( 15 , 16 , 38 ).…”

“…Our findings on the sources of added sugars among US children, adolescents, and teens reveal that declines in intakes were mainly due to declines in added sugars from sweetened beverages, which remained the top source of added sugars among children, adolescents, and teens over the entire time span (2001–2018). Other research on trends in beverage consumption using NHANES data has shown that the percentage of those aged 2–18 years drinking sweetened beverages has declined over time ( 10 , 12 , 14 ), including the percentage of heavy drinkers (≥500 kcal/d) ( 13 ), and that the energy contribution (kcal) from sweetened beverages among children, adolescents, and teens has also declined, mainly driven by decreases in soft drink and fruit drink consumption ( 12 , 14 ). Reductions in the sugar content of some sweetened beverages may have contributed to some of our observed declines, as suggested by analyses of household purchasing data showing shifts over time from the purchase of beverages with caloric sweeteners towards the purchase of beverages containing a mixture of both caloric and noncaloric sweeteners ( 36 ).…”

Health Behavior Changes Among Adults in the Supplemental Nutrition Assistance Program Education, Los Angeles County, California

“…In California, other work indicates that over a recent 3-year period, SSB consumption was unchanged for low-income mothers, adolescents, and children ( 11 ). Nationally, intake of SSBs remained high particularly for racial and ethnic minorities ( 25 ). A possible reason that BMI increased in our study is that local SNAP-Ed interventions may have focused primarily on consumption of healthy foods, with less attention on reducing SSBs or energy dense–low nutrient foods, which are known contributors to weight gain ( 26 ).…”