Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Aug 7:386:e079234.
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

Laura Lara-Castor  1   2 , Renata Micha  3   4 , Frederick Cudhea  3 , Victoria Miller  3   5   6 , Peilin Shi  3 , Jianyi Zhang  7 , Julia R Sharib  3 , Josh Erndt-Marino  3 , Sean B Cash  8 , Simon Barquera  9 , Dariush Mozaffarian  3   10   11 ; Global Dietary Database
Collaborators, Affiliations

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

Laura Lara-Castor et al. BMJ. .

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.

PubMed Disclaimer

Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at https://www.icmje.org/disclosure-of-interest/ and declare the following: support from the Bill & Melinda Gates Foundation, American Heart Association, and Consejo Nacional de Ciencia y Tecnología in Mexico. LLC reports research funding from the Bill & Melinda Gates Foundation, the American Heart Association, and Consejo Nacional de Ciencia y Tecnología in Mexico (CONACyT), outside of the submitted work. RM reports research funding from the Bill & Melinda Gates Foundation; and (ended) the US National Institutes of Health, Danone, and Nestle. She also reports consulting from Development Initiatives and as IEG chair for the Global Nutrition Report, outside of the submitted work. FC, JZ, and PS report research funding from the Bill & Melinda Gates Foundation, as well as the National Institutes of Health, outside of the submitted work. VM reports research funding the Canadian Institutes of Health Research and from the American Heart Association, outside the submitted work. JRS reports research funding from the Bill & Melinda Gates Foundation, as well as the National Institutes of Health, Nestlé, Rockefeller Foundation, and Kaiser Permanent Fund at East Bay Community Foundation, outside of the submitted work. SBC reports research funding from the US. National Institutes of Health, US. Department of Agriculture, the Rockefeller Foundation, US. Agency for International Development, and the Kaiser Permanente Fund at East Bay Community Foundation, outside the submitted work. SB reports funding from Bloomberg Philanthropies, CONACyT, United Nations International Children’s Emergency Fund (Unicef), and Fundación Rio Arronte, outside the submitted work. DM reports research funding from the US National Institutes of Health, the Bill & Melinda Gates Foundation, the Rockefeller Foundation, Vail Innovative Global Research, and the Kaiser Permanente Fund at East Bay Community Foundation; personal fees from Acasti Pharma, Barilla, Danone, and Motif FoodWorks; is on the scientific advisory board for Beren Therapeutics, Brightseed, Calibrate, Elysium Health, Filtricine, HumanCo, Instacart, January, Perfect Day, Tiny Organics, and (ended) Day Two, Discern Dx, and Season Health; has stock ownership in Calibrate and HumanCo; and receives chapter royalties from UpToDate, outside the submitted work. The investigators did not receive funding from a pharmaceutical company or other agency to write this report, and declare no other relationships or activities that could appear to have influenced the submitted work.

Figures

Fig 1
Fig 1
National mean intakes of SSBs (standardized 248 g (8 oz) serving/week for this analysis) in children and adolescents aged 3-19 years across 185 countries in 2018. SSBs were defined as any beverage with added sugars and ≥209 kJ (50 kcal) per 237 g serving, including commercial or homemade beverages, soft drinks, energy drinks, fruit drinks, punch, lemonade, and aguas frescas. This definition excludes 100% fruit and vegetable juices, non-caloric artificially sweetened drinks, and sweetened milk. For this visual representation, values were truncated at 21 servings/week to better reflect the distribution of intakes globally. The figure was created using the rworldmap package (v1.3-6). SSB=sugar sweetened beverage
Fig 2
Fig 2
Global and regional intakes of SSBs (standardized 248 g (8 oz) serving/week for this analysis) by age in children and adolescents aged 3-19 years in 2018. SSBs were defined as any beverage with added sugars and ≥209 kJ (50 kcal) per 237 g serving, including commercial or homemade beverages, soft drinks, energy drinks, fruit drinks, punch, lemonade, and aguas frescas. This definition excludes 100% fruit and vegetable juices, non-caloric artificially sweetened drinks, and sweetened milk. The filled circles represent the mean SSBs intake (248 g (8 oz) serving/week) and the error bars the 95% UIs. In previous Global Dietary Database reports, the region central and eastern Europe and central Asia was referred to as the former Soviet Union, and southeast and east Asia was referred to as Asia. SSBs=sugar sweetened beverages; UI=uncertainty interval
Fig 3
Fig 3
Global and regional mean SSB intakes (standardized 248 g (8 oz) serving/week for this analysis) in children and adolescents aged 3-19 years by area of residence and parental education level in 2018. SSBs were defined as any beverage with added sugars and ≥209 kJ (50 kcal) per 237 g serving, including commercial or homemade beverages, soft drinks, energy drinks, fruit drinks, punch, lemonade, and aguas frescas. This definition excludes 100% fruit and vegetable juices, non-caloric artificially sweetened drinks, and sweetened milk. Error bars represent 95% UIs. Values were truncated at 11.5 servings/week to better reflect the distribution of intakes. Upper 95% UIs above that value are shown with a dashed line. In previous Global Dietary Database reports, the region central and eastern Europe and central Asia was referred to as the former Soviet Union, and southeast and east Asia was referred to as Asia. SSBs=sugar sweetened beverages; UI=uncertainty interval
Fig 4
Fig 4
(Top panel) Mean SSB intakes (standardized 248 g (8 oz) serving/week for this analysis) by world region in 1990, 2005, and 2018, and absolute changes from 1990 to 2005, 2005-18, and 1990-2018 in children and adolescents aged 3-19 years. (Bottom panel) Absolute changes in SSB intakes from 1990-2005, 2005-18, and 1990-2018. SSBs were defined as any beverage with added sugars and ≥209 kJ (50 kcal) per 237 g serving, including commercial or homemade beverages, soft drinks, energy drinks, fruit drinks, punch, lemonade, and aguas frescas. This definition excludes 100% fruit and vegetable juices, non-caloric artificially sweetened drinks, and sweetened milk. Error bars represent 95% UIs. In previous Global Dietary Database reports, the region central and eastern Europe and central Asia was referred to as the former Soviet Union, and southeast and east Asia was referred to as Asia. SSBs=sugar sweetened beverages; UI=uncertainty interval
None
See this image and copyright information in PMC

References

    1. Lee EY, Yoon K-H. Epidemic obesity in children and adolescents: risk factors and prevention. Front Med 2018;12:658-66. 10.1007/s11684-018-0640-1 - DOI - PubMed
    1. Mahumud RA, Sahle BW, Owusu-Addo E, Chen W, Morton RL, Renzaho AMN. Association of dietary intake, physical activity, and sedentary behaviours with overweight and obesity among 282,213 adolescents in 89 low and middle income to high-income countries. Int J Obes (Lond) 2021;45:2404-18. 10.1038/s41366-021-00908-0 - DOI - PubMed
    1. Yoshida Y, Simoes EJ. Sugar-Sweetened Beverage, Obesity, and Type 2 Diabetes in Children and Adolescents: Policies, Taxation, and Programs. Curr Diab Rep 2018;18:31. 10.1007/s11892-018-1004-6 - DOI - PMC - PubMed
    1. Weihrauch-Blüher S, Wiegand S. Risk Factors and Implications of Childhood Obesity. Curr Obes Rep 2018;7:254-9. 10.1007/s13679-018-0320-0 - DOI - PubMed
    1. Potvin Kent M, Pauzé E, Roy E-A, de Billy N, Czoli C. Children and adolescents’ exposure to food and beverage marketing in social media apps. Pediatr Obes 2019;14:e12508. 10.1111/ijpo.12508 - DOI - PMC - PubMed

LinkOut - more resources