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. 2015 Aug 5;10(8):e0124845.
doi: 10.1371/journal.pone.0124845. eCollection 2015.

Global, Regional, and National Consumption of Sugar-Sweetened Beverages, Fruit Juices, and Milk: A Systematic Assessment of Beverage Intake in 187 Countries

Collaborators, Affiliations

Global, Regional, and National Consumption of Sugar-Sweetened Beverages, Fruit Juices, and Milk: A Systematic Assessment of Beverage Intake in 187 Countries

Gitanjali M Singh et al. PLoS One. .

Erratum in

Abstract

Background: Sugar-sweetened beverages (SSBs), fruit juice, and milk are components of diet of major public health interest. To-date, assessment of their global distributions and health impacts has been limited by insufficient comparable and reliable data by country, age, and sex.

Objective: To quantify global, regional, and national levels of SSB, fruit juice, and milk intake by age and sex in adults over age 20 in 2010.

Methods: We identified, obtained, and assessed data on intakes of these beverages in adults, by age and sex, from 193 nationally- or subnationally-representative diet surveys worldwide, representing over half the world's population. We also extracted data relevant to milk, fruit juice, and SSB availability for 187 countries from annual food balance information collected by the United Nations Food and Agriculture Organization. We developed a hierarchical Bayesian model to account for measurement incomparability, study representativeness, and sampling and modeling uncertainty, and to combine and harmonize nationally representative dietary survey data and food availability data.

Results: In 2010, global average intakes were 0.58 (95%UI: 0.37, 0.89) 8 oz servings/day for SSBs, 0.16 (0.10, 0.26) for fruit juice, and 0.57 (0.39, 0.83) for milk. There was significant heterogeneity in consumption of each beverage by region and age. Intakes of SSB were highest in the Caribbean (1.9 servings/day; 1.2, 3.0); fruit juice consumption was highest in Australia and New Zealand (0.66; 0.35, 1.13); and milk intake was highest in Central Latin America and parts of Europe (1.06; 0.68, 1.59). Intakes of all three beverages were lowest in East Asia and Oceania. Globally and within regions, SSB consumption was highest in younger adults; fruit juice consumption showed little relation with age; and milk intakes were highest in older adults.

Conclusions: Our analysis highlights the enormous spectrum of beverage intakes worldwide, by country, age, and sex. These data are valuable for highlighting gaps in dietary surveillance, determining the impacts of these beverages on global health, and targeting dietary policy.

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Conflict of interest statement

Competing Interests: The authors would like to provide the following disclosures: Dr. Mozaffarian reports research grants from GlaxoSmithKline, Sigma Tau, Pronova, and the National Institutes of Health for a completed investigator-initiated, not-for-profit, randomized clinical trial of fish oil supplements for the prevention of post-surgical complications; ad hoc travel reimbursement and/or honoraria for one-time scientific presentations or reviews on diet and cardiometabolic diseases from Bunge, Pollock Institute, Quaker Oats, and Life Sciences Research Organization (each modest); ad hoc consulting fees from McKinsey Health Systems Institute, Foodminds, and Nutrition Impact (each modest); Unilever North America Scientific Advisory Board membership (modest); and royalties from UpToDate, for an online chapter on fish oil (modest). Harvard University has filed a provisional patent application, that has been assigned to Harvard University, listing Dr. Mozaffarian as a co-inventor to the US Patent and Trademark Office for use of trans-palmitoleic acid to prevent and treat insulin resistance, type 2 diabetes, and related conditions (Patent name: “Use of trans-palmitoleate in identifying and treating metabolic disease”; Patent number: 8,889,739). All other authors declare that they have no conflicts of interest. This information does not alter the authors' adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Consumption of non-alcoholic caloric beverages in 187 countries worldwide.
A) SSBs, B) Fruit juice, C) Milk. Mean country-level beverage consumption levels in servings/day are represented by the color scales in each panel. Note that the scale range differs in each panel.
Fig 2
Fig 2. Global non-alcoholic caloric beverage consumption in 21 regions by age.
A) SSBs, B) Fruit juice, C) Milk. Consumption levels are shown in four age groups for each region and each region is color-coded as shown in the legend.
Fig 3
Fig 3. Regional age and time trends in SSB consumption and BMI.
Each three-dimensional plot shows age, mean BMI, and mean SSB intake on the x-, y-, and z-axes respectively. Each point represents one age group in one country and the points are color-coded by super-region as shown in the legend. The top panel shows data from 1990 and the bottom panel shows data from 2010.

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