Stratified analyses of youth sugar-sweetened beverage (SSB) consumption in the United States suggest that Asians consume the least, and non-Hispanic Blacks consume the most. Yet, potential reasons for this disparity and how factors associated with youth SSB consumption differ among racial/ethnic subgroups remain unknown. Understanding differences in SSB consumption has implications for future interventions aimed at decreasing intake.
To identify correlates of SSB intake and determine whether associations differ by race/ethnicity.
Study Design, Settings, Participants
Secondary data analysis was conducted using demographic and dietary data from National Health and Nutrition Examination Survey (NHANES) 2011-2016, as Asian-Americans were oversampled during these years. The sample consisted of children and adolescents aged 6-19 (n = 5,858).
Mean SSB intake (sodas, sweetened fruit juices, nectars, sports and energy drinks) was estimated accounting for sampling strategy and weighting. An alternative SSB definition (including sweetened coffees, teas, and enhanced waters) was used for an informal sensitivity analysis. Multivariable linear regression models developed for each race/ethnicity included SSB intake and selected covariates (water consumption, age, gender, income, birth country, body mass index, parental education and birth country).
Mean youth SSB consumption was the lowest among Asians (M = 0.47 cups/day; SE = 0.04) and highest among non-Hispanic Blacks (M = 1.31 cups/day; SE = 0.06). Consumption remained low (M = 0.62 cups/day; SE = 0.05) in Asians when using the alternative definition. Drinking less than one cup/day of water and older age increased SSB consumption across all races/ethnicities. Female gender and having a parent graduate college decreased intake among a subset of races/ethnicities (Hispanic, non-Hispanic White, non-Hispanic Black).
SSB consumption was disproportionately low among Asians, regardless of how SSB was defined. Current dietary recall methods may not accurately capture culturally relevant beverages in Asians, e.g. boba tea, aloe drinks, beverages which should be considered in future surveys. None of the factors explored explained racial/ethnic differences in SSB consumption. Sociocultural determinants and behaviors not measured in NHANES, e.g. acculturation, dietary norms, should be investigated for their effects on youth SSB consumption.