Demographic, socioeconomic and lifestyle factors associated with sugar-sweetened beverage intake: a population-based study

Fontes, Amanda Silva; Pallottini, Ana Carolina; Vieira, Diva Aliete dos Santos; Fontanelli, Mariane de Mello; Marchioni, Dirce Maria; Cesar, Chester Luiz Galvão; Alves, Maria Cecilia Goi Porto; Goldbaum, Moisés; Fisberg, Regina Mara

doi:10.1590/1980-549720200003

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Revista Brasileira de Epidemiologia

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ORIGINAL ARTICLE • Rev. bras. epidemiol. 23 • 2020 • https://doi.org/10.1590/1980-549720200003 copy

Demographic, socioeconomic and lifestyle factors associated with sugar-sweetened beverage intake: a population-based study

Fatores demográficos, socioeconômicos e de estilo de vida associados ao consumo de bebidas açucaradas: um estudo de base populacional

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT:

Introduction:

The intake of sugar-sweetened beverages (SSB) varies according to the characteristics of the population.

Objective:

To investigate the SSB intake and demographic, socioeconomic and lifestyle factors associated with its consumption in adolescents, adults, and older adults in São Paulo.

Methods:

Data were drawn from the Health Survey of São Paulo, a cross-sectional population-based study including 1,662 individuals aged 12 years or more. SSB were classified into six groups: sugar-sweetened sodas, sweetened coffee and tea, sweetened milk and dairy products, sweetened fruit juice, sweetened fruit drink, and total SSB. The association of each group with demographic, socioeconomic and lifestyle variables was assessed using linear regression models.

Results:

The mean SSB intake was 668.4 mL in adolescents, 502.6 mL in adults, and 358.2 mL in elderly adults. Sodas and sweetened coffee and tea represented had the greatest contribution to energy intake. SSB consumption was lower among female sex and higher among overweight adolescents, among sufficiently active adults, and among lower household per capita income older adults. Consumption of SSB was high, particularly among adolescents. Public policies are required in order to decrease the consumption of these beverages.

Conclusion:

Age group, sex, household per capita income, and body mass index status were associated with SSB intake.

Keywords:
Nutrition surveys; Beverages; Life style; Socioeconomic factors

Characteristics	Adolescents		Adults		Older adults		Total
Characteristics	%	95%CI	%	95%CI	%	95%CI	%	95%CI
Sex
Male	50.1	45.3 - 54.9	46.9	43.3 - 50.6	40.5	36.6 - 44.5	46.5	43.9 - 49.2
Female	49.9	45.1 - 54.7	53.1	49.5 - 56.7	59.5	55.5 - 63.4	53.5	50.8 - 56.1
Skin color
White and yellow	56.8	49.3 - 63.9	58.3	52.7 - 63.7	70.9	65.2 - 76.0	59.8	54.7 - 64.8
Black and brown	43.2	36.1 - 50.7	41.7	36.3 - 47.3	29.1	24.0 - 34.8	40.2	35.2 - 45.3
Smoking status
Non-smoker	93.1	90.7 - 94.9	59.5	54.4 - 64.3	56.6	51.8 - 61.3	64.2	60.4 - 67.7
Former smoker	2.6	1.5 - 4.2	15.5	12.3 - 19.5	33.2	29.0 - 37.8	16.0	13.5 - 19.0
Current smoker	4.3	2.9 - 6.4	25.0	20.5 - 30.0	10.2	7.4 - 13.7	19.8	16.6 - 23.4
Alcohol consumption
Non-consumer	66.5	61.3 - 71.4	41.8	38.2 - 45.4	62.7	57.8 - 67.4	48.4	45.3 - 51.5
Consumer	33.5	28.6 - 38.7	58.2	54.6 - 61.8	37.3	32.6 - 42.2	51.6	48.5 - 54.7
Education of the head of the family
≤ 9 years	45.7	39.3 - 52.3	43.4	36.1 - 51.1	65.1	58.7 - 71.0	46.8	41.0 - 52.7
≥ 10 years	54.3	47.7 - 60.7	56.6	48.9 - 63.9	34.9	29.0 - 41.3	53.2	47.3 - 59.0
Household per capita income
≤ 1 minimum wage	60.9	53.6 - 67.7	39.5	33.4 - 46.0	44.7	37.3 - 52.3	43.5	38.3 - 48.8
> 1 minimum wage	39.1	32.3 - 46.4	60.5	54.0 - 66.6	55.3	47.7 - 62.8	56.5	51.3 - 61.7
Body mass index
Without EBW	70.7	65.8 - 75.2	52.6	48.1 - 57.0	63.6	59.7 - 67.4	56.9	53.3 - 60.3
With EBW	29.3	24.8 - 34.2	47.4	43.0 - 51.9	36.4	32.6 - 40.3	43.1	39.7 - 46.7
Physical activity
Insufficiently active	75.1	69.9 - 79.7	87.1	83.4 - 90.0	89.6	86.5 - 92.1	85.6	82.9 - 87.9
Sufficiently active	24.9	20.3 - 30.1	12,9	10.0 - 16.6	10.4	7.9 - 13.5	14.4	12.1 - 17.1

Beverages group	mL/d Mean (standard deviation)				% total daily energy Mean (standard deviation)
Beverages group	Total	Adolescents	Adults	Older adults	Total	Adolescents	Adults	Older adults
Sugar-sweetened sodas	163.6 (172.8)	263.9 (216.3)	157.0 (164.7)	87.3 (92.8)	3.8 (3.7)	5.3 (4.1)	3.7 (3.7)	2.6 (2.6)
Sweetened coffee and tea	164.4 (151.0)	115.6 (133.1)	174.3 (152.4)	166.8 (153.0)	3.6 (3.6)	2.2 (2.7)	3.7 (3.5)	4.5 (4.5)
Sweetened milk and dairy products	56.2 (99.9)	101.0 (129.0)	51.1 (96.0)	32.9 (61.9)	2.6 (4.3)	4.3 (5.4)	2.4 (4.2)	1.9 (3.4)
Sweetened fruit juice	29.8 (69.1)	43.9 (104.6)	28.8 (63.0)	19.4 (43.13)	0.61 (1.3)	0.7 (1.5)	0.6 (1.2)	0.5 (1.2)
Sweetened fruit drinks	87.3 (116.8)	123.4 (138.0)	87.3 (116.2)	47.6 (75.0)	1.1 (1.6)	1.5 (2.0)	1.1 (1.6)	0.7 (1.1)
Total sugar-sweetened beverages	507.7 (262.1)	668.4 (280.2)	502.6 (250.0)	358.2 (198.2)	11.9 (6.3)	14.5 (6.3)	11.7 (6.2)	10.4 (6.4)

Variables	Sugar-sweetened sodas		Sweetened coffee and tea		Sweetened milk and dairy products		Sweetened fruit juice		Sweetened fruit drink		Total sugar-sweetened beverages
Variables	β	p	β	p	β	p	β	p	β	p	β	p
Adolescents
Sex (ref. male)
Female	-75.9	0.001	-21.6	0.100	-11.4	0.436	12.0	0.169	-22.9	0.097	-141.1	0.000
Skin color (ref. white and yellow)
Black and brown	-7.4	0.726	35.1	0.011	-21.9	0.096	5.7	0.534	17.6	0.173	35.8	0.075
Smoking status (ref. non-smoker)
Former smoker	144.3	0.056	-40.5	0.084	57.8	0.201	11.4	0.690	-48.1	0.095	161.1	0.086
Current smoker	6.4	0.878	38.3	0.117	-10.6	0.628	5.62	0.833	-13.7	0.548	16.2	0.717
Alcohol consumption (ref. non-consumer)
Consumer	-13.4	0.468	11.6	0.325	-12.8	0.274	4.4	0.630	8.9	0.480	-12.4	0.640
Household per capita income (US$ per month)	0.4	0.792	-1.3	0.019	-0.0	0.945	3.2	0.027	-1.9	0.000	1.2	0.343
Body Mass Index (ref. without excess body weight)
With excess body weight	62.7	0.006	-11.7	0.461	22.3	0.155	17.8	0.148	-6.9	0.743	103.2	0.001
Physical activity (ref. Insufficiently active)
Sufficiently active	40.8	0.067	-12.0	0.378	21.8	0.161	-14.1	0.072	5.1	0.692	41.5	0.098
Adults
Sex (ref. male)
Female	-33.3	0.031	5.2	0.673	-9.7	0.354	1.8	0.770	-14.7	0.153	-61.2	0.014
Skin color (ref. white and yellow)
Black and brown	29.1	0.086	0.95	0.945	-18.2	0.050	1.4	0.843	15.8	0.130	30.4	0.096
Smoking status (ref. non-smoker)
Former smoker	-12.2	0.507	13.1	0.287	-25.3	0.025	1.5	0.836	-16.8	0.185	-34.3	0.259
Current smoker	15.2	0.412	26.3	0.125	-25.1	0.037	-5.9	0.280	-19.6	0.238	-9.0	0.757
Alcohol consumption (ref. non-consumer)
Consumer	-5.3	0.060	-9.6	0.518	9.4	0.365	-0.8	0.890	9.0	0.428	14.7	0.599
Household per capita income (US$ per month)	-0.6	0.413	-1.6	0.102	0.6	0.265	-0.3	0.092	0.1	0.905	-1.7	0.171
Body Mass Index (ref. without excess body weight)
With excess body weight	33.4	0.060	-19.8	0.227	-10.4	0.283	6.3	0.308	-2.5	0.790	4.0	0.841
Physical activity (ref. Insufficiently active)
Sufficiently active	2.5	0.926	-7.0	0.741	48.4	0.020	5.4	0.586	28.8	0.143	94.1	0.027
Older Adults
Sex (ref. male)
Female	-17.8	0.101	2.6	0.865	-2.3	0.679	6.2	0.025	-12.3	0.052	-27.8	0.160
Skin color (ref. white and yellow)
Black and brown	-6.9	0.469	-8.1	0.518	-2.5	0.733	1.3	0.756	5.8	0.500	-20.4	0.208
Smoking status (ref. non-smoker)
Former smoker	5.6	0.621	-22.8	0.141	-8.2	0.240	0.2	0.949	10.7	0.217	-19.1	0.348
Current smoker	-1.4	0.931	-7.2	0.735	-14.8	0.110	-2.1	0.676	-1.0	0.939	-30.6	0.245
Alcohol consumption (ref. non-consumer)
Consumer	-4.1	0.641	3.3	0.798	-4.1	0.555	8.8	0.044	-8.0	0.337	7.2	0.687
Household per capita income (US$ per month)	-0.3	0.341	-1.0	0.017	-0.2	0.314	-0.4	0.002	-0.4	0.059	-2.4	0.001
Body Mass Index (ref. without excess body weight)
With excess body weight	16.2	0.120	-26.2	0.109	-3.3	0.599	0.9	0.811	17.2	0.036	4.4	0.832
Physical activity (ref. Insufficiently active)
Sufficiently active	-0.54	0.974	8.6	0.747	-2.0	0.826	4.8	0.366	2.2	0.817	7.8	0.810

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[1] Corresponding author: Regina Mara Fisberg. Avenida Dr. Arnaldo, 715, Cerqueira Cesar, CEP: 01246-904, São Paulo, SP, Brazil. E-mail: rfisberg@usp.br