Shining a light on sugary drinks

by Eric Schroeder
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Approximately one-half of the U.S. population consumes sugar drinks each day, and 5% consumes the equivalent of more than four 12-oz cans of soda, according to a report published Aug. 31 by the National Center for Health Statistics of the Centers for Disease Control and Prevention.

The findings were based on data from more than 17,000 individuals in the National Health and Nutrition Examination Survey (NHANES) between 2005-08. Sugar drinks were defined as fruit drinks, sodas, energy drinks, sports drinks and sweetened bottled waters. Diet drinks, 100% fruit juice, sweetened teas and flavored milks were not included as sugar drinks.

The American Heart Association has recommended a consumption goal of no more than 450 kilocalories (kcal) of sugar-sweetened beverages — or fewer than three 12-oz cans of carbonated cola — per week by 2020. But data from the NHANES survey suggest Americans are far exceeding that target.

As part of the study, the C.D.C. found males consume an average of 175 kcal from sugar drinks each day, while females consume 94 kcal. Seventy per cent of males ages 2 to 19 years consume sugar drinks on a given day, while 55% of males 20 and older do. For females ages 2 to 19 the percentage is 60%, while 40% of females ages 20 and older consume sugar drinks on a given day.

In general, the survey found consumption of sugar drinks increases until the ages of 12 to 19 years, at which point the rate of consumption decreases with age.

“About 50% of the population consumes no sugar drinks; 25% consumes some sugar drinks but less than 200 kcal (more than one 12-oz can of cola); and 5% consumes at least 567 kcal from sugar drinks on a given day (more than four 12-oz cans of cola),” the C.D.C. said.

Looking at where sugar drinks are consumed, the survey found 52% of sugar drink kilocalories were consumed in the home. Most of the kilocalories (92%) were purchased in stores, while a little more than 6% were purchased in restaurants or fast-food establishments. Of the 48% consumed away from home, 43% were purchased in stores, 35.5% in restaurants or fast-food establishments, and 1.4% in schools or day care settings, the C.D.C. said. More than 20% of sugar drink kilocalories consumed away from home were obtained in other places such as vending machines, cafeterias, street vendors and community food programs.

The C.D.C. report also found differences between kilocalorie intake among income brackets. Among households with income below 130% of the poverty line, the mean percentage of total kilocalories consumed from sugar drinks was 8.2%, higher than the 6.7% consumed among those living at or above 350% of the poverty line.

Similarly, among adults living below 130% of the poverty line, mean kilocalories from sugar drinks was 8.8% of total kilocalories; among those living between 130% and 350% of the poverty line, mean kilocalories from sugar drinks was 6.2%; and among those at or above 350% of the poverty line, mean kilocalories was 4.4%.

Rachel Johnson, the Robert L. Bickford Jr. Green and Gold Professor in the Department of Nutrition and Food Sciences at the University of Vermont and a spokesperson for the A.H.A., said that the findings are not surprising, and confirm that sugary drinks are the No. 1 source of added sugars in the diet.

“What is useful is that it gives us some more descriptions in terms of age, sex and race,” Dr. Johnson said. “It tells us who is drinking the most. In terms of developing messages, that could be really helpful.”

And while some progress has been made in cutting sugary drinks out of consumers’ diets, she stressed that the data indicate just how much work needs to be done to get to the A.H.A.’s recommended per capita consumption goal of no more than 450 kilocalories (kcal) of sugar-sweetened beverages per week.

That goal is also part of the “Life’s Sweeter with Fewer Sugary Drinks” campaign that was launched Aug. 31 by a coalition of groups, including the A.H.A., the Center for Science in the Public Interest, the American Diabetes Association and several health departments in major cities. The coalition hopes to achieve the goal by 2020.

Responding to the campaign launch and the C.D.C. study findings, the American Beverage Association suggested that the coalition’s effort is misguided, citing sales data and some other research that show sales of full-calorie soft drinks have been declining.

“Contrary to what may be implied by the introductory statement of this data brief that reaches back 30 years, sugar-sweetened beverages are not driving health issues like obesity and diabetes,” the A.B.A. said. “In fact, recently published data from C.D.C. researchers show that sugar-sweetened beverages play a declining role in the American diet while obesity is increasing.

“According to an analysis of federal government data presented to the 2010 Dietary Guidelines Committee, all sugar-sweetened beverages (soft drinks, juice drinks, sports drinks, flavored waters, etc.) account for only 7% of the calories in the average American’s diet. That means Americans get 93% of their calories from other foods and beverages.

“In July, The American Journal of Clinical Nutrition published a report, ‘Consumption of added sugars is declining in the United States,’ from researchers at Emory University and the C.D.C., which found that Americans consumed nearly a quarter less added sugars in 2008 than they did in 1999, which was mostly the result of people drinking less sugar-sweetened beverages.

“Moreover, the total number of calories from beverages that our member companies have brought to market decreased by 21% from 1998 to 2008, according to Beverage Marketing Corporation data. This is due in part to industry’s innovation in bringing more no- and low-calorie beverage options to market. And according to Beverage Digest, sales of full-calorie soft drinks have declined by 12.5% from 1999 to 2010.

“Yet despite this decrease in added sugars intake — and consumption of regular soft drinks — obesity rates have continued to climb during the same time period. Balancing calories from all foods and beverages with those burned through physical activity and exercise is essential to maintaining a balanced, active and healthy lifestyle.”

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