Sugars in the U.S. Diet: A Description of Consumption Patterns by Type and Purchasing Practices of Adolescent Consumers Pubblico

Brumme, Christina Marie (2015)

Permanent URL: https://etd.library.emory.edu/concern/etds/1831ck45s?locale=it
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Abstract

Introduction: There are many types of sugars consumed by individuals living in the United States, and the consumption patterns of these different sugars is not known. The purpose of the first study in this thesis is to estimate the amount of each type of sugar consumed among demographic groups: age, gender, income, and race or ethnicity The purpose of the second study is to understand where sugar-containing foods and beverages are purchased and consumed by adolescents.

Data/Methods: For the first study, nationally representativeNHANES data from the combined 09-10 and 11-12 cycles were used to describe sugar intake among different demographic groups. For the second study, NHANES data from the 2011-2012 cycle were used to estimate sugar content of foods and beverages consumed by adolescents aged 12 to 19 years (n=1152) based on purchase location. For both studies, food codes were categorized as dairy or non-dairy and as food or beverage according to the Food and Nutrient Database for Dietary Studies (FNDDS) codes. Added sugar values were acquired from the Food Patterns Equivalence Database to determine content of added and natural sugars in each dairy, non-dairy, food, and beverage group were calculated for both studies.

Results: Among all age groups, adolescents aged 12-19 years consumed the most added sugars from all sources at 91.4 (95% CI 87.0, 95.7) grams each day. More than half of this added sugar comes from non-dairy beverages at 47.2 (95% CI 43.1, 51.4) grams. The average amount of added sugar in a non-dairy beverage from a restaurant with a server is 51.4 (95% CI 45.0, 57.8) grams of added sugar, versus the next-highest amount from convenience stores of 42.7 (95% CI 34.6, 50.8).

Discussion/Conclusion: Consumption of sugars peaks in adolescence, particularly of added sugars in non-dairy beverages; as such, efforts to reduce consumption of added sugars should focus on adolescents. Large differences are seen in average sugar content by purchase locations, such as the sugar content of beverages purchased at restaurants compared to other purchase locations. There is a need to determine what causes these differences in sugar intake among adolescents and sugar content from different locations.

Table of Contents

Chapter 1: Introduction. 1

I. Introduction. 1

A. Rationale. 1

B. Objectives. 4

C. Study Purpose. 4

D. Public Health Relevance. 5

Chapter 2: Review of the Literature. 7

II. Background. 7

A. Sources of Foods and Beverages. 7

1. Home Cooking. 7

2. Restaurants. 8

3. Other Sources of Foods and Beverages. 10

B. Sugar Consumption. 10

C. Nutrition in Adolescence. 12

Chapter 3: Sugar Intake in the U.S. Diet: Consumption Patterns of Added and Naturally Occurring Sugars in Liquid and Solid Form. 14

I. Abstract. 14

II. Contribution of the Student. 15

III. Introduction. 16

IV. Data & Methods. 18

V. Results. 20

A. Sugar consumption by age group. 21

B. Sugar consumption and other characteristics. 23

VI. Discussion. 24

VII. Conclusions. 25

VIII. Tables & Figures. 26

Table 1: Age Group, Race/Ethnicity, Income, Weight Status, and Gender of US population (NHANES 09-12) (n=16,973). 26

Table 2: Percent intake of naturally occurring and added sugars from foods vs. beverages among US children, stratified by age (NHANES 09-12). 27

Figure 1: Contribution of Each Type of Sugar Intake (gm) to Overall Intake by Age Group (NHANES 09-12). 29

Table 3: Percent intake of naturally occurring and added sugars from foods vs. beverages among US adults stratified by age (NHANES 09-12). 30

Table 4: Absolute intake (gm) of naturally occurring and added sugars from foods vs. beverages among US racial and ethnic groups (NHANES 09-12). 32

Chapter 4: The Sweet Life of America's Teens: Where Sugar-containing Foods and Beverages are Purchased by US Adolescents. 34

I. Abstract. 34

II. Contribution of the Student. 35

III. Introduction. 36

IV. Data. 38

V. Methods. 40

A. Variables. 42

VI. Results. 43

A. Sugar consumed at home versus away from home. 44

B. Sugars obtained from grocery stores, convenience stores, restaurants, schools, and other sources. 44

VII. Discussion. 47

VIII. Tables & Figures. 50

Table 1: Gender, Age, and Race/Ethnicity of US teens (NHANES 11-12). 50

Table 2: Average Sugar Content of Beverage and Food Items Consumed by Teens at Home versus Away from Home in one day (grams) NHANES 11-12. 51

Table 3: Average Amount of Sugar in Foods and Beverages Consumed by US teens by Place of Purchase in one day (grams) NHANES 11-12. 52

Table 4: Contribution of Sugars from Grocery Stores, Convenience Stores, and Fast Food Restaurants to the Overall Diet by Purchase Location, Gender, Race/Ethnicity, and Poverty Status (NHANES 11-12). 54

Table 5: Contribution of Sugars from Grocery Stores, Convenience Stores, and Fast Food Restaurants to the Overall Diet by Purchase Location, Gender, Race/Ethnicity, and Poverty Status (NHANES 11-12). 55

Appendix 1: Contribution of Sugars from Grocery Stores, Convenience Stores, and Fast Food Restaurants to the Overall Sugar Intake by Purchase Location, Gender, Race/Ethnicity, and Poverty Status (NHANES 11-12). 56

Chapter 5: Conclusions and Recommendations.. 57

IX. Conclusions. 57

X. Recommendations. 59

A. References. 62

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