Intake of sugar sweetened beverages among children and adolescents in 185 countries between 1990 and 2018: population based study

Laura Lara-Castor; Renata Micha; Frederick Cudhea; Victoria Miller; Peilin Shi; Jianyi Zhang; Julia R Sharib; Josh Erndt-Marino; Sean B Cash; Simon Barquera; Dariush Mozaffarian; Global Dietary Database

doi:10.1136/bmj-2024-079234

Intake of sugar sweetened beverages among children and adolescents in 185 countries between 1990 and 2018: population based study

BMJ. 2024 Aug 7:386:e079234. doi: 10.1136/bmj-2024-079234.

Authors

Laura Lara-Castor^{1

2}, Renata Micha^{3

4}, Frederick Cudhea³, Victoria Miller^{3

5

6}, Peilin Shi³, Jianyi Zhang⁷, Julia R Sharib³, Josh Erndt-Marino³, Sean B Cash⁸, Simon Barquera⁹, Dariush Mozaffarian^{3

10

11}; Global Dietary Database

Collaborators

Global Dietary Database:
Antonia Trichopoulou, Murat Bas, Jemal Haidar Ali, Tatyana El-Kour, Anand Krishnan, Puneet Misra, Nahla Hwalla, Chandrashekar Janakiram, Nur Indrawaty Lipoeto, Abdulrahman Musaiger, Farhad Pourfarzi, Iftikhar Alam, Celine Termote, Anjum Memon, Marieke Vossenaar, Paramita Mazumdar, Ingrid Rached, Alicia Rovirosa, María Elisa Zapata, Roya Kelishadi, Tamene Taye Asayehu, Francis Oduor, Julia Boedecker, Lilian Aluso, Emanuele Marconi, Laura D'Addezio, Raffaela Piccinelli, Stefania Sette, Johana Ortiz-Ulloa, J V Meenakshi, Giuseppe Grosso, Anna Waskiewicz, Umber S Khan, Kenneth Brown, Lene Frost Andersen, Anastasia Thanopoulou, Reza Malekzadeh, Neville Calleja, Anca Ioana Nicolau, Cornelia Tudorie, Marga Ocke, Zohreh Etemad, Mohannad Al Nsour, Lydiah M Waswa, Maryam Hashemian, Eha Nurk, Joanne Arsenault, Patricio Lopez-Jaramillo, Abla Mehio Sibai, Albertino Damasceno, Pulani Lanerolle, Carukshi Arambepola, Carla Lopes, Milton Severo, Nuno Lunet, Duarte Torres, Heli Tapanainen, Jaana Lindstrom, Suvi Virtanen, Cristina Palacios, Noel Barengo, Eva Roos, Irmgard Jordan, Charmaine Duante, Corazon Cerdena, Imelda Angeles-Agdeppa, Josie Desnacido, Mario Capanzana, Anoop Misra, Ilse Khouw, Swee Ai Ng, Edna Gamboa Delgado, Mauricio T Caballero, Johanna Otero, Hae-Jeung Lee, Eda Koksal, Idris Guessous, Carl Lachat, Stefaan De Henauw, Ali Reza Rahbar, Alison Tedstone, Annie Ling, Beth Hopping, Catherine Leclercq, Christian Haerpfer, Christine Hotz, Christos Pitsavos, Coline van Oosterhout, Debbie Bradshaw, Dimitrios Trichopoulos, Dorothy Gauci, Dulitha Fernando, Elzbieta Sygnowska, Erkki Vartiainen, Farshad Farzadfar, Gabor Zajkas, Gillian Swan, Guansheng Ma, Hajah Masni Ibrahim, Harri Sinkko, Isabelle Sioen, Jean-Michel Gaspoz, Jillian Odenkirk, Kanitta Bundhamcharoen, Keiu Nelis, Khairul Zarina, Lajos Biro, Lars Johansson, Leanne Riley, Mabel Yap, Manami Inoue, Maria Szabo, Marja-Leena Ovaskainen, Meei-Shyuan Lee, Mei Fen Chan, Melanie Cowan, Mirnalini Kandiah, Ola Kally, Olof Jonsdottir, Pam Palmer, Philippos Orfanos, Renzo Asciak, Robert Templeton, Rokiah Don, Roseyati Yaakub, Rusidah Selamat, Safiah Yusof, Sameer Al-Zenki, Shu-Yi Hung, Sigrid Beer-Borst, Suh Wu, Widjaja Lukito, Wilbur Hadden, Xia Cao, Yi Ma, Yuen Lai, Zaiton Hjdaud, Jennifer Ali, Ron Gravel, Tina Tao, Jacob Lennert Veerman, Mustafa Arici, Demosthenes Panagiotakos, Yanping Li, Gülden Pekcan, Karim Anzid, Anuradha Khadilkar, Veena Ekbote, Irina Kovalskys, Arlappa Nimmathota, Avula Laxmaiah, Balakrishna Nagalla, Brahmam Ginnela, Hemalatha Rajkumar, Indrapal Meshram, Kalpagam Polasa, Licia Iacoviello, Marialaura Bonaccio, Simona Costanzo, Yves Martin-Prevel, Nattinee Jitnarin, Wen-Harn Pan, Yao-Te Hsieh, Sonia Olivares, Gabriela Tejeda, Aida Hadziomeragic, Le Tran Ngoan, Amanda de Moura Souza, Daniel Illescas-Zarate, Inge Huybrechts, Alan de Brauw, Mourad Moursi, Augustin Nawidimbasba Zeba, Maryam Maghroun, Nizal Sarrafzadegan, Noushin Mohammadifard, Lital Keinan-Boker, Rebecca Goldsmith, Tal Shimony, Gudrun B Keding, Shivanand C Mastiholi, Moses Mwangi, Yeri Kombe, Zipporah Bukania, Eman Alissa, Nasser Al-Daghri, Shaun Sabico, Rajesh Jeewon, Martin Gulliford, Tshilenge S Diba, Kyungwon Oh, Sihyun Park, Sungha Yun, Yoonsu Cho, Suad Al-Hooti, Chanthaly Luangphaxay, Daovieng Douangvichit, Latsamy Siengsounthone, Pedro Marques-Vidal, Peter Vollenweider, Constance Rybak, Amy Luke, Nipa Rojroongwasinkul, Noppawan Piaseu, Kalyana Sundram, Jeremy Koster, Donka Baykova, Parvin Abedi, Sandjaja Sandjaja, Fariza Fadzil, Noriklil Bukhary Ismail Bukhary, Pascal Bovet, Yu Chen, Norie Sawada, Shoichiro Tsugane, Lalka Rangelova, Stefka Petrova, Vesselka Duleva, Ward Siamusantu, Lucjan Szponar, Hsing-Yi Chang, Makiko Sekiyama, Khanh Le Nguyen Bao, Sesikeran Boindala, Jalila El Ati, Ivonne Ramirez Silva, Juan Rivera Dommarco, Luz Maria Sanchez-Romero, Simon Barquera, Sonia Rodríguez-Ramírez, Nayu Ikeda, Sahar Zaghloul, Anahita Houshiar-Rad, Fatemeh Mohammadi-Nasrabadi, Morteza Abdollahi, Khun-Aik Chuah, Zaleha Abdullah Mahdy, Alison Eldridge, Eric L Ding, Herculina Kruger, Sigrun Henjum, Milton Fabian Suarez-Ortegon, Nawal Al-Hamad, Veronika Janská, Reema Tayyem, Bemnet Tedla, Parvin Mirmiran, Almut Richter, Gert Mensink, Lothar Wieler, Daniel Hoffman, Benoit Salanave, Shashi Chiplonkar, Anne Fernandez, Androniki Naska, Karin De Ridder, Cho-Il Kim, Rebecca Kuriyan, Sumathi Swaminathan, Didier Garriguet, Anna Karin Lindroos, Eva Warensjo Lemming, Jessica Petrelius Sipinen, Lotta Moraeus, Saeed Dastgiri, Sirje Vaask, Tilakavati Karupaiah, Fatemeh Vida Zohoori, Alireza Esteghamati, Sina Noshad, Suhad Abumweis, Elizabeth Mwaniki, Simon G Anderson, Justin Chileshe, Sydney Mwanza, Lydia Lera Marques, Samuel Duran Aguero, Mariana Oleas, Luz Posada, Angelica Ochoa, Alan Martin Preston, Khadijah Shamsuddin, Zalilah Mohd Shariff, Hamid Jan Bin Jan Mohamed, Wan Manan, Bee Koon Poh, Pamela Abbott, Mohammadreza Pakseresht, Sangita Sharma, Tor Strand, Ute Alexy, Ute Nöthlings, Indu Waidyatilaka, Ranil Jayawardena, Julie M Long, K Michael Hambidge, Nancy F Krebs, Aminul Haque, Liisa Korkalo, Maijaliisa Erkkola, Riitta Freese, Laila Eleraky, Wolfgang Stuetz, Laufey Steingrimsdottir, Inga Thorsdottir, Ingibjorg Gunnarsdottir, Lluis Serra-Majem, Foong Ming Moy, Corina Aurelia Zugravu, Elizabeth Yakes Jimenez, Linda Adair, Shu Wen Ng, Sheila Skeaff, Regina Fisberg, Carol Henry, Getahun Ersino, Gordon Zello, Alexa Meyer, Ibrahim Elmadfa, Claudette Mitchell, David Balfour, Johanna M Geleijnse, Mark Manary, Laetitia Nikiema, Masoud Mirzaei, Rubina Hakeem

Affiliations

¹ Food is Medicine Institute, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA [email protected].
² Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
³ Food is Medicine Institute, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.
⁴ University of Thessaly, Volos, Greece.
⁵ Department of Medicine, McMaster University, Hamilton, ON, Canada.
⁶ Population Health Research Institute, Hamilton, ON, Canada.
⁷ Center for Surgery and Public Health, Brigham and Women's Hospital Boston, MA, USA.
⁸ Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.
⁹ Research Center on Nutrition and Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
¹⁰ Tufts University School of Medicine, Boston, MA, USA.
¹¹ Division of Cardiology, Tufts Medical Center, Boston, MA, USA.

Abstract

Objective: To quantify global intakes of sugar sweetened beverages (SSBs) and trends over time among children and adolescents.

Design: Population based study.

Setting: Global Dietary Database.

Population: Children and adolescents aged 3-19 years in 185 countries between 1990 and 2018, jointly stratified at subnational level by age, sex, parental education, and rural or urban residence.

Results: In 2018, mean global SSB intake was 3.6 (standardized serving=248 g (8 oz)) servings/week (1.3 (95% uncertainly interval 1.0 to 1.9) in south Asia to 9.1 (8.3 to 10.1) in Latin America and the Caribbean). SSB intakes were higher in older versus younger children and adolescents, those resident in urban versus rural areas, and those of parents with higher versus lower education. Between 1990 and 2018, mean global SSB intakes increased by 0.68 servings/week (22.9%), with the largest increases in sub-Saharan Africa (2.17 servings/week; 106%). Of 185 countries included in the analysis, 56 (30.3%) had a mean SSB intake of ≥7 servings/week, representing 238 million children and adolescents, or 10.4% of the global population of young people.

Conclusion: This study found that intakes of SSBs among children and adolescents aged 3-19 years in 185 countries increased by 23% from 1990 to 2018, parallel to the rise in prevalence of obesity among this population globally. SSB intakes showed large heterogeneity among children and adolescents worldwide and by age, parental level of education, and urbanicity. This research should help to inform policies to reduce SSB intake among young people, particularly those with larger intakes across all education levels in urban and rural areas in Latin America and the Caribbean, and the growing problem of SSBs for public health in sub-Saharan Africa.

MeSH terms

Adolescent
Child
Child, Preschool
Female
Global Health
Humans
Male
Rural Population / statistics & numerical data
Sugar-Sweetened Beverages* / adverse effects
Sugar-Sweetened Beverages* / statistics & numerical data
Young Adult