Interrelationships of Added Sugars Intake, Socioeconomic Status, and Race/ethnicity in Adults in the United States: National Health Interview Survey, 2005

Overview

Journal J Am Diet Assoc

Publisher Elsevier

Specialty Nutritional Sciences

Date 2009 Jul 28

PMID 19631043

Citations 83

Authors

Frances E Thompson

Timothy S McNeel

Emily C Dowling

Douglas Midthune

Meredith Morrissette

Christopher A Zeruto

Affiliations

Soon will be listed here.

Abstract

Background: The consumption of added sugars (eg, white sugar, brown sugar, and high-fructose corn syrup) displaces nutrient-dense foods in the diet. The intake of added sugars in the United States is excessive. Little is known about the predictors of added sugar intake.

Objective: To examine the independent relationships of socioeconomic status and race/ethnicity with added sugar intake, and to evaluate the consistency of relationships using a short instrument to those from a different survey using more precise dietary assessment.

Design: Cross-sectional, nationally representative, interviewer-administered survey.

Subjects/setting: Adults (aged > or = 18 years) participating in the 2005 US National Health Interview Survey Cancer Control Supplement responding to four added sugars questions (n=28,948).

Statistical Analyses Performed: The intake of added sugars was estimated using validated scoring algorithms. Multivariate analysis incorporating sample weights and design effects was conducted. Least squares means and confidence intervals, and significance tests using Wald F statistics are presented. Analyses were stratified by sex and controlled for potential confounders.

Results: The intake of added sugars was higher among men than women and inversely related to age, educational status, and family income. Asian Americans had the lowest intake and Hispanics the next lowest intake. Among men, African Americans had the highest intake, although whites and American Indians/Alaskan Natives also had high intakes. Among women, African Americans and American Indians/Alaskan Natives had the highest intakes. Intake of added sugars was inversely related to educational attainment in whites, African Americans, Hispanic men, and American Indians/Alaskan Native men, but was unrelated in Asian Americans. These findings were generally consistent with relationships in National Health and Nutrition Examination Survey 2003-2004 (using one or two 24-hour dietary recalls).

Conclusions: Race/ethnicity, family income, and educational status are independently associated with intake of added sugars. Groups with low income and education are particularly vulnerable to diets with high added sugars. Differences among race/ethnicity groups suggest that interventions to reduce intake of added sugars should be tailored. The National Health Interview Survey added sugars questions with accompanying scoring algorithms appear to provide an affordable and useful means of assessing relationships between various factors and added sugars intake.

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References

Papas A, Joshi A, Palmer C, Giunta J, Dwyer J . Relationship of diet to root caries. Am J Clin Nutr. 1995; 61(2):423S-429S. DOI: 10.1093/ajcn/61.2.423S. View

Deshmukh-Taskar P, Nicklas T, Yang S, Berenson G . Does food group consumption vary by differences in socioeconomic, demographic, and lifestyle factors in young adults? The Bogalusa Heart Study. J Am Diet Assoc. 2007; 107(2):223-34. PMC: 2769987. DOI: 10.1016/j.jada.2006.11.004. View

Walker A, Cleaton-Jones P . Sugar intake and dental caries. Br Dent J. 1992; 172(1):7. DOI: 10.1038/sj.bdj.4807739. View

McLaren L . Socioeconomic status and obesity. Epidemiol Rev. 2007; 29:29-48. DOI: 10.1093/epirev/mxm001. View

Sun S, Empie M . Lack of findings for the association between obesity risk and usual sugar-sweetened beverage consumption in adults--a primary analysis of databases of CSFII-1989-1991, CSFII-1994-1998, NHANES III, and combined NHANES 1999-2002. Food Chem Toxicol. 2007; 45(8):1523-36. DOI: 10.1016/j.fct.2007.02.012. View

Drewnowski A, Darmon N . The economics of obesity: dietary energy density and energy cost. Am J Clin Nutr. 2005; 82(1 Suppl):265S-273S. DOI: 10.1093/ajcn/82.1.265S. View

Drewnowski A, Specter S . Poverty and obesity: the role of energy density and energy costs. Am J Clin Nutr. 2003; 79(1):6-16. DOI: 10.1093/ajcn/79.1.6. View

Fitzsimons D, Dwyer J, Palmer C, Boyd L . Nutrition and oral health guidelines for pregnant women, infants, and children. J Am Diet Assoc. 2003; 98(2):182-6, 189; quiz 187-8. DOI: 10.1016/S0002-8223(98)00044-3. View

Bachman J, Reedy J, Subar A, Krebs-Smith S . Sources of food group intakes among the US population, 2001-2002. J Am Diet Assoc. 2008; 108(5):804-14. DOI: 10.1016/j.jada.2008.02.026. View

10.

French S, Story M, Jeffery R . Environmental influences on eating and physical activity. Annu Rev Public Health. 2001; 22:309-35. DOI: 10.1146/annurev.publhealth.22.1.309. View

11.

Yang E, Chung H, Kim W, Bianchi L, Song W . Chronic diseases and dietary changes in relation to Korean Americans' length of residence in the United States. J Am Diet Assoc. 2007; 107(6):942-50. DOI: 10.1016/j.jada.2007.03.005. View

12.

Andrieu E, Darmon N, Drewnowski A . Low-cost diets: more energy, fewer nutrients. Eur J Clin Nutr. 2005; 60(3):434-6. DOI: 10.1038/sj.ejcn.1602331. View

13.

Ballew C, WHITE L, Strauss K, Benson L, Mendlein J, Mokdad A . Intake of nutrients and food sources of nutrients among the Navajo: findings from the Navajo Health and Nutrition Survey. J Nutr. 1997; 127(10 Suppl):2085S-2093S. DOI: 10.1093/jn/127.10.2085S. View

14.

Malik V, Schulze M, Hu F . Intake of sugar-sweetened beverages and weight gain: a systematic review. Am J Clin Nutr. 2006; 84(2):274-88. PMC: 3210834. DOI: 10.1093/ajcn/84.1.274. View

15.

Popkin B, Nielsen S . The sweetening of the world's diet. Obes Res. 2003; 11(11):1325-32. DOI: 10.1038/oby.2003.179. View

16.

Drewnowski A . The real contribution of added sugars and fats to obesity. Epidemiol Rev. 2007; 29:160-71. DOI: 10.1093/epirev/mxm011. View

17.

Harnack L, Sherwood N, Story M . Diet and physical activity patterns of urban American Indian women. Am J Health Promot. 1999; 13(4):233-6, iii. DOI: 10.4278/0890-1171-13.4.233. View

18.

Park S, Murphy S, Sharma S, Kolonel L . Dietary intakes and health-related behaviours of Korean American women born in the USA and Korea: the Multiethnic Cohort Study. Public Health Nutr. 2005; 8(7):904-11. DOI: 10.1079/phn2005740. View

19.

Zephier E, Ballew C, Mokdad A, Mendlein J, Smith C, Yeh J . Intake of nutrients related to cardiovascular disease risk among three groups of American Indians: the Strong Heart Dietary Study. Prev Med. 1997; 26(4):508-15. DOI: 10.1006/pmed.1997.0164. View

20.

West D, Bursac Z, Quimby D, Prewitt T, Spatz T, Nash C . Self-reported sugar-sweetened beverage intake among college students. Obesity (Silver Spring). 2006; 14(10):1825-31. DOI: 10.1038/oby.2006.210. View