Consumption Patterns of Sugar-Sweetened Carbonated Beverages Among Children and Adolescents

Sugar-sweetened beverages (SSBs) have been strongly implicated in the development of obesity and cardiovascular risk in children and adolescents. Among SSBs, carbonated beverages (regular soda) have been the focus of education and public policy efforts to limit consumption. The purpose of this paper is to provide detailed information about regular soda consumption patterns among children and adolescents, which can be used to inform current public policy and educational strategies. A systematic review of papers published between 2004 and 2014 was completed. Two authors independently reviewed all selected papers and abstracted key findings. All measures of consumption of regular soda were considered (i.e., frequency, volume, proportion of consumers, calories from regular soda). In addition, data from The NPD Group's National Eating Trends (R) survey for the years 2006–2011 were analyzed. The primary outcome was consumption of regular soda over a 2-week period. Covariates included demographic, health (BMI, chronic illness), and lifestyle (dieting and exercise). Descriptive and univariate comparative statistics were used to summarize consumption patterns. Multiavariate analysis was used to identify characteristics associated with lower and higher consumption frequency. Several findings were consistent between the systematic review and our analysis of NET data. Regular soda consumption increases with age into adolescence. Consumption is higher among children and adolescents in families of lower income and education levels. Lower levels of exercise are associated with higher consumption of regular soda. Our systematic review did not support an association between regular soda consumption and overall weight status across all age groups. From the review, positive associations between regular soda consumption and a number of unhealthy child and family habits emerged, including high levels of TV viewing, high fast-food consumption, low vegetable intake, adolescent cigarette smoking, and daily consumption by parents of regular soda. For our NET analysis, data was available for 8982 children ages 2–18, 19.8 % of whom were obese. Roughly 71.2 % consumed at least one regular soda in the 2-week survey period. Obesity, Hispanic ethnicity, lower household income, household size ≤4, female head of household with ≤high school education, and exercising <3 days/week were associated with higher consumption frequency. Food allergy and lactose intolerance were associated with lower consumption frequency. The relationship between obesity and higher consumption frequency emerged between ages 6 and 8 and persisted through ages 9–12. Regular soda consumption among children and adolescents is associated with a number of household factors, including lower income and lower levels of education. Regular soda consumption is part of a larger cluster of unhealthy behaviors. Efforts to curb consumption should target economically disadvantaged families with a focus on children under 6.