It is well known that consumption of sugary drinks contributes to a wide array of health consequences in children and adolescents. However, little is known about contextual reasons for consumption among this population. The purpose of this study was to 1) examine when, where and how sugary drinks were obtained among children and adolescents, 2) determine reasons for sugary drink consumption 3) assess how sugary drinks made participants feel, and 4) assess what participants would do if sugary drinks were restricted. Children and adolescents aged 8-14 years-old who consumed at least 12 oz of non-diet caffeinated soda or sweetened tea daily were recruited from community organizations serving low-income families in Washington, D.C.  Focus group discussions among participants (n=38) took place at community centers; group size ranged from 2-8 participants.  Nearly all participants indicated that they obtained sugary drinks from their parents/guardians (82%) and consumed them at home (97%). When participants were asked about reasons for sugary drink consumption, five themes emerged: 1) perceived need (e.g., quench thirst or makes them feel ‘normal’), 2) physical and cognitive benefits (e.g., improve performance), 3) emotional and interpersonal benefits (e.g., increased happiness), 4) sensory properties (e.g., taste), and 5) external cues (e.g., availability and parent/peer modeling). When participants were asked how sugary drinks made them feel, most responses included negative consequences when they consumed “too much” (e.g., stomachache, headache).  Risks related to chronic disease were also mentioned.  Finally, when participants were asked how they would respond if sugary drinks were restricted, many indicated they would do whatever was necessary to obtain these beverages (e.g., hiding/sneaking, disguising containers, or making their own sugary drink alternative).

Study strengths: Small focus group sizes and trained moderators resulted in rich, detailed qualitative data.

Study limitations: This study specifically recruited participants who consumed drinks with both caffeine and sugar. Therefore, the findings may not be applicable to other sugary drinks.  Additionally, the study sample was predominately African-American (81%) from one community and the results are not generalizable.

What this means for your practice: When discussing sugary drinks with patients, keep in mind that children and adolescents may consume sugary drinks for a variety of reasons (perceived need, physical and cognitive benefits, emotional and interpersonal benefits, sensory properties, and external cues).  Additionally, this study confirmed that sugary drinks are often provided by the parent(s) and consumed at home. Therefore, interventions that target the entire family to consume healthy drinks are essential for reducing intake.

Original citation: Sylvetsky, A.C., Visek, A.J., Halberg, S., Keun Rhee, D., Ongaro, Z., Essel, K.D., Dietz, W.H., & Sacheck, J. (2020) Beyond taste and easy access: Physical, cognitive, interpersonal, and emotional reasons for sugary drink consumption among children
and adolescents. Appetite, 155.

About the Author:  Chenin Treftz, Ph.D., R.D.N., is a member of the research faculty at the University of Nevada, Reno.  Dr. Treftz has expertise in research, community nutrition, and higher education. Dr. Treftz has been a member of the Rethink Your Drink team since 2012.

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