DefinitionPercentage of adolescents (grades 9-12) responding 1 or more sugary drinks per day on the Youth Risk Behavior Survey (YRBS).
NumeratorWeighted number of adolescents (grades 9-12) responding 1 or more sugary drinks per day on the YRBS.
DenominatorWeighted number of adolescents (grades 9-12) providing complete and valid responses to the YRBS questions on sugary drinks, excluding those with missing, "Don't know/Not sure," and "Refused" responses to either question.
Data Interpretation IssuesThe increasing trend of consumption of 1 or more sugary drinks per day seen by year may be artificially inflated by the increase in the number of questions asked about consumption of various sugary drinks over the survey years. When the term sugary drinks is used, it corresponds to an index derived from all the sugary drink questions on the YRBS for each year. In 2009, 2011 and 2013, an index of sugary drink consumption was derived from only two questions (one about non-diet "soda"; the other a general question about "sugar-sweetened drinks, not including soda"). In 2015, a third question was included to capture information on consumption of "sports drinks" and the general question on sugar-sweetened drinks was reworded to exclude sports drinks. In 2017, a fourth question was included in the sugary drinks index to capture energy drink consumption, and again the wording of the general sugar-sweetened drinks question was changed to exclude this type of drink. Research has shown that sugary drink intake was lower when measured using a 1-question verses a 4-question screener. A single screener question underestimates sugary drink consumption because respondents have difficulty recalling consumption of multiple food or beverage items when asked in one question.^1^ Therefore, the 2017 result based on 4 questions is both higher and a more accurate estimate of sugary drink intake than previous years due to the increased specificity of drink types, and not necessarily an actual change in the prevalence.
The questions on sugary drink consumption for each year on the YRBS can be found under the heading "Alaska YRBS Questionnaires" at: [http://dhss.alaska.gov/dph/Chronic/Pages/yrbs/yrbs.aspx].
Responses for all questions in all years were: (a) I did not drink this/these drinks during the past 7 days; (b) 1 to 3 times during the past 7 days; (c) 4 to 6 times during the past 7 days; (d) 1 time per day; (e) 2 times per day; (f) 3 times per day; or (g) 4 or more times per day.
Why Is This Important?There is strong evidence that consuming sugary drinks is linked to obesity,^2^ type 2 diabetes, heart disease, and tooth decay.^3-7^ The American Heart Association has issued scientific statements describing the risk of added sugars and cardiovascular disease risk in adults and in children.^8,9^ In rural Alaska Native children, the severity of dental caries in primary and permanent teeth has been shown to increase with each reported soda consumed.^10^ Sugary drinks are the number one source of added sugar in American diets. Added sugars contribute an average of 16% of the total calories in American diets; 46% of those calories come from sugary drinks.^11^ Sugary drinks provide empty calories; they are high in calories but low in nutrients.
The 2015-2020 Dietary Guidelines for Americans recommend that less than 10% of calories come from added sugar. These recommendations aim to promote health, prevent chronic disease, and help people reach and maintain a healthy weight.^12^ That 10% equates to less than 200 calories, 50 grams, or 12.5 teaspoons of added sugar for the reference diet of 2,000 calories. One regular 12 ounce can of soda contains 140 calories (or 40 grams or 10 teaspoons) of added sugar. This means that even one sugary drink a day puts most people near their limit of added sugar for the day, increasing their risk of certain diseases.
Nationally, the U.S. mean adjusted intake of added sugars remains high. In 2011-2012, children and adults consumed 326 calories/day and 308 calories/day, respectively, of added sugars, or 14% and 17%, respectively, of total their energy. For both children and adults, there was a considerable increase in calories from added sugars from 1977 to 2003, followed by a substantial decline from 2003 to 2012. Nationally, there was no decline in the percentage of total energy intake from added sugars from 2003 to 2012.^12^
How Are We Doing?In Alaska, sugary drink intake is used as a proxy measure to track added sugar consumption since it accounts for 47% of added sugar in the American diet.^11^
For good health, even one sugary drink a day is too much, but in 2017, half (50.0%) of Alaska adolescents (high school students grades 9-12) drank one or more sugary drinks each day. Those living in the Northern and Southwest public health regions were more likely to drink a sugary drink every day than those in other regions. There were no significant differences between adolescents who were overweight or obese compared to those with a healthy weight in percentages that reported drinking one or more sugary drinks each day.
What Is Being Done?Alaska's Play Every Day public education campaign has resources and materials to help families make personal decisions about their family's sugary drink intake. See [http://dhss.alaska.gov/dph/PlayEveryDay/Pages/default.aspx Play Every Day].
Alaska's Healthy Drinks for Healthy Kids project provides resources to dental professionals to help their patients reduce sugary drink intake. See http://dhss.alaska.gov/dph/Chronic/Pages/Obesity/sugarydrinks and http://dhss.alaska.gov/dph/Chronic/Pages/Obesity/sugarydrinks/healthydrinks.