Sugar-Sweetened Beverage Consumption, Perceptions, and Disparities in Children and Adolescents

Abstract

Objective: To examine the association between sugar-sweetened beverage (SSB) perceptions-knowledge, attitudes, and norms and media literacy-and beverage consumption, and to identify differences in beverage consumption and SSB perceptions by race/ethnicity and socioeconomic status.

Design: Cross-sectional.

Setting: Diverse California school district.

Participants: A total of 992 fifth-grade (elementary), seventh-grade (middle), and ninth-12th-grade (high school) students.

Main outcome measures: Questionnaire-assessed continuous beverage consumption and perceptions.

Analysis: Linear regression adjusting for school, grade, gender, race/ethnicity, and free and reduced-price meal (FRPM) eligibility.

Results: Knowledge, attitudes, and norms, and media literacy items were associated with SSB consumption in expected directions (P < 0.05). Among elementary students, FRPM-eligible and Black students had higher SSB consumption (P < 0.01). In middle/high school, non-Hispanic White students consumed fewer SSBs than all other racial/ethnic groups (P < 0.01). There were differences in SSB-related perceptions by race/ethnicity and socioeconomic status (eg, Black students perceived sugary drinks as less unhealthy); Black, Hispanic, and FRPM-eligible students expressed less distrust of food/beverage advertisements; and Black, Hispanic, Asian, multirace, and FRPM-eligible students perceived more frequent SSB consumption among their peers (P < 0.05).

Conclusions and implications: Sugar-sweetened beverage perceptions were associated with SSB consumption. There were racial/ethnic and socioeconomic disparities in SSB consumption and perceptions. Sugar-sweetened beverage perceptions and related social and commercial determinants like marketing may be useful targets for reducing SSB consumption.

Keywords: attitudes; knowledge; norms; school; sugar-sweetened beverages.