Background China has undergone rapid Westernization and established dramatic social reforms since the early 21st century. However, health issues led to challenges in the lives of the Chinese residents. Western fast food and sweetened beverages, two food options associated with chronic diseases and obesity, have played key roles to alter adolescents' dietary patterns. This study aims to examine the association between adolescents' visits to Western fast food restaurants and sweetened beverage consumption. Methods Applying three waves of the China Health and Nutrition Study (CHNS) between 2006 and 2011 (n = 1063), we used generalized Poisson regression (GPR) to investigate the association between adolescents' Western fast food restaurant visits and sweetened beverage consumption, as the popularity of fast food and sweetened beverages has skyrocketed among adolescents in contemporary China. A linear-by-linear association test was used as a trend test to study general patterns between sweetened beverage consumption and Western fast food restaurant visits. We adjusted all models with sweetened beverage consumption frequency, four food preferences (fast food, salty snacks, fruits and vegetables), school status, gross household income, provinces, rural/urban regions, age and gender. Results From the results of the trend test, frequent sweetened beverage consumption was highly associated with more Western fast food restaurant visits among Chinese adolescents in the three waves (p < 0.001). Furthermore, we observed that adolescents, who had less than monthly sweetened beverage consumption or did not drink them at all, had much less likelihood of visiting Western fast food restaurants (p < 0.05), compared with those daily consumers. Conclusion Adolescents' sweetened beverage consumption was highly associated with Western fast food restaurant visits in contemporary China. Further actions are needed from the Chinese central government to create a healthier dietary environment for adolescents.
Keywords: China; Western fast food; Westernization; adolescents; sweetened beverage.