Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Am J Clin Nutr. 2021 Mar 11;113(3):657-664. doi: 10.1093/ajcn/nqaa342.
Since 2003-4, the United States has seen large declines in sugar-sweetened beverage (SSB) intake overall, especially among non-Hispanic white (NHW) subpopulations. However, obesity prevalence has not shown comparable declines in the 2 highest SSB-consuming groups, adolescents and young adults. Little is understood about the quality of the diet excluding SSBs (non-SSB diet).
The objective of this study was to evaluate differences in non-SSB diet quality in SSB consumers and nonconsumers in adolescents and young adults and in the 3 major race/ethnic subgroups.
This study utilized data from the NHANES, a cross-sectional, nationally representative survey of the US population. Data from 6426 participants aged 12-29 y from the NHANES (2009-2014) was included. Quality of the non-SSB diet was measured using the 2015 Healthy Eating Index (HEI). Multivariate linear regressions controlled for sociodemographic characteristics and included interactions by race/ethnicity [NHWs, non-Hispanic blacks (NHBs), Hispanics]. Individuals were classified as non-, low- (<10% of daily calories), or high-SSB consumers (≥10% of daily calories), according to the US Dietary Guidelines added sugar intake recommendation.
Non-SSB HEI scores differed among SSB consumer groups (53 for adolescent nonconsumers compared with 46 for high consumers, P < 0.001; 57 for young adult nonconsumers compared with 45 for high consumers, P < 0.001), although all scores were low and require improvement. Among NHBs, significant differences in non-SSB HEI were found only between non- and low-SSB consumers. In Hispanics, associations varied by age group, with significant differences found for young adults but no association found for adolescents.
Low non-SSB HEI scores in SSB consumers suggest that reducing SSB consumption alone will not be a sufficient strategy for improving dietary quality in adolescents and young adults. Future policies must also consider improving the non-SSB diet.
自 2003-4 年以来，美国的含糖饮料（SSB）总摄入量大幅下降，尤其是在非西班牙裔白人（NHW）亚群中。然而，在两个 SSB 摄入量最高的群体，青少年和年轻人中，肥胖率并没有出现可比的下降。对于不包括 SSB 的饮食质量（非 SSB 饮食）知之甚少。
本研究旨在评估 SSB 消费者和非消费者在青少年和年轻人以及三个主要种族/族裔亚组中 SSB 消费人群和非 SSB 消费人群的非 SSB 饮食质量差异。
本研究利用了来自 NHANES 的数据，这是一项对美国人口进行的横断面、全国代表性调查。NHANES（2009-2014 年）中 6426 名 12-29 岁的参与者的数据被纳入本研究。非 SSB 饮食质量采用 2015 年健康饮食指数（HEI）进行测量。多元线性回归控制了社会人口统计学特征，并包括了种族/族裔的交互作用[非西班牙裔白人、非西班牙裔黑人（NHB）、西班牙裔]。根据美国膳食指南添加糖摄入量建议，个体被分为非 SSB 消费者（<10%的每日卡路里）、低 SSB 消费者（<10%的每日卡路里）或高 SSB 消费者（≥10%的每日卡路里）。
SSB 消费者群体之间的非 SSB HEI 评分不同（青少年非消费者为 53，高消费者为 46，P<0.001；年轻成人非消费者为 57，高消费者为 45，P<0.001），尽管所有评分都较低，需要改善。在 NHB 中，仅在非 SSB 消费者和低 SSB 消费者之间发现非 SSB HEI 存在显著差异。在西班牙裔中，年龄组之间的相关性不同，年轻成人有显著差异，而青少年没有相关性。
SSB 消费者的低非 SSB HEI 评分表明，仅减少 SSB 消费不足以改善青少年和年轻人的饮食质量。未来的政策还必须考虑改善非 SSB 饮食。
