Nearly One in Three Adults Have Sugary Drinks Daily

Ricki Lewis, PhD

February 25, 2016

Sugar-sweetened beverages (SSBs) are a major source of excess sugar intake in the United States, but the extent to which people have at least one such drink a day varies by state and socioeconomic group, according to a study published in the February 25 issue of the Morbidity and Mortality Weekly Report.

The 2015 to 2020 Dietary Guidelines for Americans recommend that daily caloric intake from added sugars not exceed 10% of total calories, and the link between excess sugar intake and compromised health is well-established. For example, a recent literature review found that drinking just one or two SSBs a day increases the risk for type 2 diabetes by as much as 26%, the risk for coronary heart disease by 35%, and the risk for stroke by 16%.

Efforts to limit consumption include guidelines from the Canadian Diabetes Association and proposed legislation in 16 states, but the public loves its sweetened drinks: In 2013, for example, a judge ruled against New York City Mayor Bloomberg's soda-limiting initiative a day before it was to take effect, calling the action "arbitrary and capricious," in response to many complaints from business owners and consumers.

In the current study, Sohyun Park, PhD, from the Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, assessed daily intake of SSBs in people from 23 states and the District of Columbia, using data from the 2013 Behavioral Risk Factor Surveillance System, which is an annual, state-based, random-digit-dialed telephone survey of US adults. Two questions dealt with SSBs: "During the past 30 days, how often did you drink regular soda or pop that contains sugar? Do not include diet soda or diet pop," and "During the past 30 days, how often did you drink sugar-sweetened fruit drinks (such as Kool-Aid and lemonade), sweet tea, and sports or energy drinks (such as Gatorade and Red Bull)? Do not include 100% fruit juice, diet drinks, or artificially sweetened drinks."

Overall, 30.1% of the 157,668 participants reported drinking at least one SSB per day. However, results varied by geographical region and sociodemographic group.

The highest percentage of daily drinkers came from Mississippi (47.5%), followed by Louisiana (45.5%) and West Virginia (45.2%). The lowest reported frequency of daily drinking of SSBs was 18.0% in Vermont.

The highest intake population groups for SSB consumption were among individuals aged 18 to 24 years (43.3%), men (34.1%), non-Hispanic blacks (39.9%), the unemployed (34.4%), and people who did not graduate high school (42.4%).

The authors note that the study had several limitations including self-reporting, that only some states participated, and that the questions did not ask about drink volume (eg, 8 vs 16 oz).

Dr Park and colleagues note that the level reported in this survey was somewhat lower than that found in the 2009 to 2010 National Health and Nutrition Examination Survey, which showed that 50.6% of US adults drink at least one SSB each day. They suggest the difference may reflect differences in methodology between the two studies. Specifically, the National Health and Nutrition Examination Survey involves in-person interviews, with telephone follow-up and 24-hour dietary recalls, whereas the Behavioral Risk Factor Surveillance System is a telephone survey probing dietary intake during the preceding 30 days.

The researchers call for continuing public health efforts to lower SSB intake, including "education and awareness initiatives, increasing access to and promotion of healthier options through nutrition standards including food service guidelines, and increasing the availability and promotion of drinking water in schools and public venues." They also encourage healthcare providers to screen and counsel patients on strategies to reduce SSB consumption.

The researchers have disclosed no relevant financial relationships.

Morb Mortal Wkly Rep. 2016;65:169-174. Full text


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