Associations between Knowledge of Health Risks and Sugar-Sweetened Beverage Intake among US Adolescents

Abstract

Background: Sugar-sweetened beverage (SSB) intake is associated with adverse health outcomes. Objective: We examined associations between the knowledge of health risks related to SSB and SSB intake among adolescents. Design: A cross-sectional study using 2021 YouthStyles survey data. Participants/settings: 831 US adolescents (12–17 years old). Main outcome measures: The outcome variable was SSB intake (none, 1–6 times/week, and ≥1 time/day). Exposure variables were knowledge of seven SSB-related health risks. Statistical analyses performed: Seven multinomial regressions were used to estimate adjusted odds ratios (AOR) for drinking SSB, according to knowledge of SSB-related health risks and after controlling for sociodemographics. Results: Overall, 29% of adolescents consumed SSB ≥1 time/day. Although most adolescents identified cavities (75.4%), weight gain (74.6%), and diabetes (69.7%) as being related to drinking SSB, fewer adolescents identified related conditions such as high blood pressure (31.7%), high cholesterol (25.8%), heart disease (24.6%), and some cancers (18.0%). Compared to non-SSB consumers, drinking SSB ≥1 time/day was significantly higher among adolescents who lacked knowledge of associations between SSB intake and weight gain (AOR = 2.0), heart disease (AOR = 1.9), or some cancers (AOR = 2.3) after controlling for covariates. Conclusions: Among US adolescents, knowledge of SSB-related health risks varied by condition, ranging from 18% (some cancers) to 75% (cavities and weight gain). There were increased odds of drinking SSB among those unaware that weight gain, heart disease, and some cancers are associated with SSB intake. Intervention could evaluate whether increasing certain types of knowledge may influence youth SSB intake.