Increased sugar-sweetened beverage consumption is associated with poorer dietary quality: A cross-sectional population-based study

ABSTRACT Objective To evaluate the association between sugar-sweetened beverages consumption and dietary quality in adolescents, adults, and older adults living in São Paulo, Brazil. Methods Data were drawn from a cross-sectional population-based study conducted in 2008 in a representative urban city sample involving 1494 consumers of sugar-sweetened beverages. Dietary intake was evaluated through two 24-Hour Dietary Recalls, and the usual sugar-sweetened beverages consumption was estimated using the Multiple Source Method. Dietary quality was evaluated using the Brazilian Healthy Eating Index – Revised. The association between total score of the revised index and components with sugar-sweetened beverages consumption tertiles was assessed using multiple linear regression models for each age group, considering the sample design. Results Regardless of age group, the increase of sugar-sweetened beverages consumption was associated with a decrease in the total Healthy Eating Index – Revised score and in the components “total fruit”; “whole fruit”; “meat, eggs and legumes”, and the “solid fat, alcohol and added sugar”. Conclusion The results of our study suggest that higher sugar-sweetened beverages consumption was associated with poorer dietary quality. Planning public health policies aimed at decreasing sugar-sweetened beverages consumption is essential to increase dietary quality and reduce the incidence of noncommunicable diseases.摘要 研究目的：旨在评估巴西圣保罗地区青少年、成年人及老年人的含糖饮料摄入量与膳食质量之间的关联。研究方法：本研究数据取自2008年开展的一项横断面人群基础研究，该研究纳入了圣保罗地区具有代表性的城市样本，共纳入1494名含糖饮料消费者。通过两次24小时膳食回顾法（24-Hour Dietary Recalls）评估膳食摄入情况，并采用多源法（Multiple Source Method）估算受试者日常含糖饮料摄入量；采用巴西修订版健康饮食指数（Brazilian Healthy Eating Index – Revised）评估膳食质量。针对各年龄组，结合抽样设计，采用多元线性回归模型分析该修订指数总分及其各维度与含糖饮料摄入量三分位数之间的关联。研究结果：无论属于哪个年龄组，含糖饮料摄入量的增加均与巴西修订版健康饮食指数总分及"总水果""完整水果""肉类、蛋类与豆类""固态脂肪、酒精与添加糖"这几个维度的得分降低显著相关。研究结论：本研究结果表明，更高的含糖饮料摄入量与更差的膳食质量相关。制定旨在减少含糖饮料摄入量的公共卫生政策，对于提升膳食质量、降低非传染性疾病的发病率至关重要。