Poster Topical Area: Community and Public Health Nutrition
Poster Board Number: 116
Objectives: To describe characteristics of youth beverage purchases in chain restaurants, to identify predictors of those purchases, and to examine differences by household income.
Methods: Data were obtained from the 2012-2013 U.S. Department of Agriculture National Household Food Acquisition and Purchase Survey, which includes information about all foods and beverages acquired by a nationally representative sample of households over seven days (n=4,826), oversampling low-income households. Purchases made at the 76 top-earning chain restaurants that contained a beverage and were consumed by at least one child aged 2-18 years were analyzed (n=1,567). Logistic regressions assessed predictors of purchasing a sugar-sweetened beverage (SSB), a healthy beverage (water, seltzer, milk), and a beverage from the kids' menu. Linear regressions estimated predictors of per capita beverage calories and grams of sugar per purchase as well as differences by household income. All analyses controlled for individual, household, and restaurant characteristics; standard errors accounted for the complex survey design.
Results: Overall, 65% of youth purchases included a beverage and 75% of youth beverage purchases included an SSB. Most beverages (82%) were purchased at fast-food restaurants, 43% were part of a combination meal, and 6% were from the kids' menu. In fully adjusted models, purchases were significantly more likely to include an SSB if at a fast-food vs. fast-casual or full-service restaurant (79% vs. 66% vs. 54%) and if part of a combination meal vs. a single item (81% vs. 72%). Beverages purchased by adolescents in the poorest households contained significantly more calories (348 vs. 254) and grams of sugar (74 vs. 58) than those purchased by adolescents in the wealthiest households (p=0.008; p=0.03).
Conclusions: The food environment strongly influences youth beverage purchases. Beverages purchased at fast-food restaurants or as part of a combination meal were more likely to be SSBs, and purchases by adolescents in the poorest households contained more calories and sugar than purchases in the wealthiest households. Policies that remove SSBs from combination meals and reduce fast-food advertising towards low-income adolescents may reduce SSB consumption and socioeconomic inequities.
Harvard T.H. Chan School of Public Health