Global trends in sugar-sweetened beverage consumption among children and adolescents

In a recent study published in BMJ, researchers quantify the consumption of sugar-sweetened beverages (SSBs) and examine these trends among children and adolescents from 185 countries between 1990 and 2018.

Study: Intake of sugar sweetened beverages among children and adolescents in 185 countries between 1990 and 2018: population based study. Image Credit: Ann in the uk / Shutterstock.com 

SSBs and disease risk in children

An unhealthy diet, which often includes the consumption of SSBs, significantly increases the risk of obesity among children and adolescents. Childhood obesity has been shown to persist into adulthood and subsequently increase the risk of developing other health disorders, such as cardiovascular disease and type 2 diabetes (T2D).

There has been a recent surge in the consumption of SSBs due to the rapid globalization of markets and aggressive advertising directed at children and adolescents. Nevertheless, some studies have reported the efficacy of public health policies in reducing the intake of SSBs among children and adolescents. These include restrictions on food marketing, taxation on SSBs, and school restrictions.

To date, there remains a lack of sufficient data on SSB consumption rates in children and adolescents, which limits the ability to effectively evaluate trends over time and determine the potential determinants of over-consumption such as education, sex, age, urbanicity, and other key sociodemographic factors.

About the study

The current study examined SSB consumption rates among children and adolescents between three and 19 years of age. National, regional, and global data between 1990 and 2018 for 185 countries were stratified at the sub-national level by sex, age, area of residence, and level of parental education.

Data on SSB intake were extracted from the Global Dietary Database for 2018. For individual-level dietary surveys, systematic online searches were performed in global and regional databases like PubMed and Embase. SSB intake rates were adjusted according to the daily calorie requirements for various age groups.

Study findings

A standardized serving of SSB was defined as 248 g or eight oz servings each week. In 2018, the mean global intake of SSBs among children and adolescents was estimated to be 3.6 servings.

Significant variation was observed, as the servings ranged from 1.3 servings/week in South Asia to 9.1 in Latin America and Caribbean nations. Moreover, 56 countries, which represent 10.4% of the global population for this age group, reported average SSB consumption rates of seven or more servings every week.

SSB consumption did not differ significantly across males and females at the national, regional, and global levels. At both the global and regional levels, SSB consumption rates increased in a dose-dependent manner with age.

Intakes of SSBs were about one serving/week among young people 10 years and older in South Asia. Comparatively, SSB consumption rates exceeded nine servings/week among children in North Africa, the Middle East, Latin America, and the Caribbean.

As compared to children from rural areas, those residing in urban regions were more likely to consume SSBs. Children of highly educated parents living in urban areas also consumed the most amount of SSBs.

A similar pattern was observed regionally in sub-Saharan Africa, Latin America, South Asia, and the Caribbean. In North Africa and the Middle East, higher consumption rates were observed among younger individuals from rural areas and those with lower parental education.

Among the 185 countries, the consumption of SSBs among children and adolescents increased by 23% or 0.68 servings/week, which resembles the rise in the prevalence of obesity among this population globally.

Between 1990 and 2005, highest-income countries were associated with the largest increase in SSB consumption rates, whereas little to no change was observed in South Asia, eastern Europe, and Central Asia, and SSB consumption rates declined in the Caribbean and Latin America. Between 2005 and 2018, the largest increase in SSB consumption habits was observed in sub-Saharan Africa, whereas SSB intake was reduced high-income countries.

A positive correlation was observed between national intakes of SSBs and the sociodemographic development index. In 1990 and 2005, countries with a higher sociodemographic development index reported greater SSB consumption rates; however, this correlation was not observed in 2018. Obesity and SSB consumption were positively correlated in both 1990 and 2018.

Conclusions

Globally, SSB consumption among younger people increased significantly between 1990 and 2018, which closely resembles the rise obesity rates in this age group. Taken together, the study findings should inform global efforts, like the United Nation’s 2030 Agenda for Sustainable Development, to reduce SSB consumption to ultimately enhance overall health and well-being.