Surveys Reveal Trends in Global Consumption of Sugary Beverages, Fruit Juices and Milk

Newswise — BOSTON (August 5, 2015, 2 PM ET)—Data on beverage intakes in 187 countries reveal diversity in existing intakes and trends in global consumption of sugar-sweetened beverages, fruit juices and milk. A research team led by scientists from the Friedman School of Nutrition Science and Policy at Tufts University reported today in PLOS ONE that the consumption of all three types of beverages was lowest in East Asia and sugar-sweetened beverage consumption was highest in the Caribbean. Overall, younger adults consumed the highest levels of sugar-sweetened beverages, while older adults consumed more milk. Young men in the Caribbean (ages 20-39) were found to have the highest average consumption: 3.4 servings of sweetened beverages per day.

“Our analysis highlights the enormous spectrum of beverage intakes worldwide, by country, age and sex. While we know that different beverages substantially impact health, comprehensive and detailed estimates of intakes of sugar-sweetened beverages, fruit juices and milk at the global, regional and national levels by age and sex had not been available until this study,” said Gitanjali Singh, M.P.H., Ph.D., first author and research assistant professor at the Friedman School of Nutrition Science and Policy at Tufts University. “The team’s results identify important variation among different international subgroups and can inform efforts to measure the impact of these beverages on global health and aid in developing targeted health-oriented nutrition policies for specific populations.”

An international team of scientists – the Global Burden of Diseases Nutrition and Chronic Diseases Expert Group – contributed to this analysis. The team assessed data from 195 dietary surveys, representing over half of the world’s population, and also incorporated food availability data in 187 countries between 1990 and 2010. Taking into account differences in these sources of data, statistical analyses determined the average consumption levels of sugar-sweetened beverages, fruit juices and milk in 1990 and 2010 among men and women (age 20 years and older) in seven age groups in 187 countries. Sugar-sweetened beverages were defined as sodas, fruit drinks, sports/energy drinks, sweetened iced teas and homemade sugary beverages such as frescas.

Global trends in 2010 revealed:

• Major variation by region, with highest sugar-sweetened beverage intake in the Americas, particularly in parts of Latin America and the Caribbean; highest fruit juice intake in Australasia; and highest milk intake in Northern Europe.• Large variation by age, with higher intake of sugar-sweetened beverages in younger adults and higher intake of milk in older adults.

In 2010, average global consumption of these beverages was as follows:

Sugar-sweetened beverages (SSBs)• Globally, SSB consumption was highest in men ages 20-39: 1.04 8-oz. servings per day. This varied across regions, and was lowest in East Asia and highest in the Caribbean.• In comparison, globally, women over age 60 had the lowest consumption: 0.34 servings per day.• SSB consumption was highest in the Caribbean with adults consuming on average 2 servings per day. • The lowest consumption occurred in East Asia: 0.20 servings per day. • Adults in the U.S. had the 26th-highest consumption of sugar-sweetened beverages out of 187 countries, averaging 1 serving per day.

Fruit juices (beverages containing 100% fruit or vegetable juice with no added sweeteners)• Fruit juice consumption was highest in women ages 20-39: 0.23 8-oz. servings per day.• On average, fruit juice consumption increased with country income level; rates were the highest in high-income countries and lowest in low-income countries.• In the U.S., adults consumed about 0.36 servings of fruit juice per day, the 21st highest consumption out of 187 countries.

Milk (skim, low fat, whole and other dairy drinks) • Women over age 60 consumed the most milk: 0.68 8-oz. servings per day.• Men ages 20-39 consumed 0.51 servings of milk per day.• Adults in wealthier countries typically drank more milk than those in poorer countries. • Adults in Sweden and Iceland consumed the most milk at 1.6 servings per day, and adults in Finland also consumed over 1.3 servings per day. • In the U.S., adults consumed on average 0.69 servings per day, the 64th highest consumption out of 187 countries.

Overall, the research demonstrated that average beverage consumption varied significantly by age and region, but there were only minor differences between men and women.

“Geographic location was the most critical factor in the varying consumption levels for these beverages. For example, consumption of sugar-sweetened beverages was very high in the Caribbean and Mexico, where both commercial and homemade sugary drinks are widely consumed,” said Dariush Mozaffarian, M.D., Dr.P.H., corresponding author, chair of the Global Burden of Diseases Nutrition and Chronic Diseases Expert Group, and dean of the Friedman School. “With this data, we can begin to establish and improve policies that promote the consumption of beverages low in sugar within specific countries, which may be more effective than one-size-fits-all interventions.”

Further research efforts, which include data from children, are now underway. Data for the present study was collected as part of the 2010 Global Burden of Diseases, Injuries, and Risk Factors study – the largest systematic effort to describe the global distribution and causes of major diseases, injuries, and health risk factors.

Additional authors of this study are Renata Micha, Ph.D., co-first author, research assistant professor at the Friedman School and survey director at Agricultural University of Athens, Shahab Khatibzadeh, M.D., Ph.D., M.P.H., postdoctoral fellow in the department of epidemiology at Harvard T.H. Chan School of Public Health, Peilin Shi, statistical programmer in the department of epidemiology at the Friedman School, Stephen Lim, Ph.D., associate professor of global health at the Institute for Health Metrics and Evaluation at University of Washington, Kathryn G. Andrews, M.P.H., former post-bachelor fellow at the Institute for Health Metrics and Evaluation at University of Washington, Rebecca E. Engell, former post-bachelor fellow at Institute for Health Metrics and Evaluation at the University of Washington, and Majid Ezzati, Ph.D., M.A., M.Eng., professor and chair of the department of global environmental health at Imperial College, London.

Dr. Singh was supported by a T32 Training award in Academic Nutrition (DK007703) from the National Institute of Diabetes and Digestive and Kidney Diseases and a K99/R00 Pathway to Independence Award (1K99HL124321) from the National Heart, Lung, and Blood Institute, all a part of the National Institutes of Health. Initial data collection for the work was supported by a grant award from the Bill & Melinda Gates Foundation to the 2010 Global Burden of Diseases study. See the paper for conflict of interest disclosures.

Singh, G., Micha, R., Khatibzadeh, S., Shi, P., Lim, S., Andrews, K.G., Engell, R.E., Ezzati, M., & Mozaffarian, D. (2015). “Global, regional, and national consumption levels of sugar sweetened beverages, fruit juice, and milk: A systematic assessment of beverage intake in 187 countries.” PLoS ONE.

About the Friedman School of Nutrition Science and PolicyThe Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy at Tufts University is the only independent school of nutrition in the United States. The school's eight degree programs – which focus on questions relating to nutrition and chronic diseases, molecular nutrition, agriculture and sustainability, food security, humanitarian assistance, public health nutrition, and food policy and economics – are renowned for the application of scientific research to national and international policy.

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