Dietary and Health Correlates of Sweetened Beverage Intake: Sources of Variability in the National Health and Nutrition Examination Survey (NHANES)
Recent studies using data from the National Health and Nutrition Examination Survey (NHANES) have used inconsistent approaches to identify and categorize beverages, especially those containing low-calorie sweeteners (LCS), also referred to as low-calorie sweetened beverages (LCSBs). Herein, we inves...
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doaj-8b1017a05d0e42c1a81ba12adb50f57e2021-08-26T14:10:37ZengMDPI AGNutrients2072-66432021-08-01132703270310.3390/nu13082703Dietary and Health Correlates of Sweetened Beverage Intake: Sources of Variability in the National Health and Nutrition Examination Survey (NHANES)Susan E. Swithers0G. R. Bonanno1Janet Figueroa2Jean A. Welsh3Allison C. Sylvetsky4Department of Psychological Sciences, Purdue University, West Lafayette, IN 47907, USADepartment of Psychological Sciences, Purdue University, West Lafayette, IN 47907, USADepartment of Pediatrics, School of Medicine, Emory University, Atlanta, GA 30322, USADepartment of Pediatrics, School of Medicine, Emory University, Atlanta, GA 30322, USADepartment of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USARecent studies using data from the National Health and Nutrition Examination Survey (NHANES) have used inconsistent approaches to identify and categorize beverages, especially those containing low-calorie sweeteners (LCS), also referred to as low-calorie sweetened beverages (LCSBs). Herein, we investigate the approaches used to identify and categorize LCSBs in recent analyses of NHANES data. We reviewed published studies examining LCS consumption in relation to dietary and health outcomes and extracted the methods used to categorize LCS as reported by the authors of each study. We then examined the extent to which these approaches reliably identified LCSBs using the Internet Archive Wayback Machine to examine beverage ingredients lists across three NHANES cycles (2011–2016). None of the four general strategies used appeared to include all LCSBs while also excluding all beverages that did not contain LCS. In some cases, the type of sweetener in the beverage consumed could not be clearly determined; we found 9, 16, and 18 of such “mixed” beverage identifiers in the periods 2011–2012, 2013–2014, and 2015–2016, respectively. Then, to illustrate how heterogeneity in beverage categorization may impact the outcomes of published analyses, we compared results of a previously published analysis with outcomes when “mixed” beverages were grouped either all as LCSBs or all as sugary beverages. Our results suggest that caution is warranted in design and interpretation of studies using NHANES data to examine dietary and health correlates of sweetened beverage intake.https://www.mdpi.com/2072-6643/13/8/2703low-calorie sweetenersdiet beveragessugarobesity |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Susan E. Swithers G. R. Bonanno Janet Figueroa Jean A. Welsh Allison C. Sylvetsky |
spellingShingle |
Susan E. Swithers G. R. Bonanno Janet Figueroa Jean A. Welsh Allison C. Sylvetsky Dietary and Health Correlates of Sweetened Beverage Intake: Sources of Variability in the National Health and Nutrition Examination Survey (NHANES) Nutrients low-calorie sweeteners diet beverages sugar obesity |
author_facet |
Susan E. Swithers G. R. Bonanno Janet Figueroa Jean A. Welsh Allison C. Sylvetsky |
author_sort |
Susan E. Swithers |
title |
Dietary and Health Correlates of Sweetened Beverage Intake: Sources of Variability in the National Health and Nutrition Examination Survey (NHANES) |
title_short |
Dietary and Health Correlates of Sweetened Beverage Intake: Sources of Variability in the National Health and Nutrition Examination Survey (NHANES) |
title_full |
Dietary and Health Correlates of Sweetened Beverage Intake: Sources of Variability in the National Health and Nutrition Examination Survey (NHANES) |
title_fullStr |
Dietary and Health Correlates of Sweetened Beverage Intake: Sources of Variability in the National Health and Nutrition Examination Survey (NHANES) |
title_full_unstemmed |
Dietary and Health Correlates of Sweetened Beverage Intake: Sources of Variability in the National Health and Nutrition Examination Survey (NHANES) |
title_sort |
dietary and health correlates of sweetened beverage intake: sources of variability in the national health and nutrition examination survey (nhanes) |
publisher |
MDPI AG |
series |
Nutrients |
issn |
2072-6643 |
publishDate |
2021-08-01 |
description |
Recent studies using data from the National Health and Nutrition Examination Survey (NHANES) have used inconsistent approaches to identify and categorize beverages, especially those containing low-calorie sweeteners (LCS), also referred to as low-calorie sweetened beverages (LCSBs). Herein, we investigate the approaches used to identify and categorize LCSBs in recent analyses of NHANES data. We reviewed published studies examining LCS consumption in relation to dietary and health outcomes and extracted the methods used to categorize LCS as reported by the authors of each study. We then examined the extent to which these approaches reliably identified LCSBs using the Internet Archive Wayback Machine to examine beverage ingredients lists across three NHANES cycles (2011–2016). None of the four general strategies used appeared to include all LCSBs while also excluding all beverages that did not contain LCS. In some cases, the type of sweetener in the beverage consumed could not be clearly determined; we found 9, 16, and 18 of such “mixed” beverage identifiers in the periods 2011–2012, 2013–2014, and 2015–2016, respectively. Then, to illustrate how heterogeneity in beverage categorization may impact the outcomes of published analyses, we compared results of a previously published analysis with outcomes when “mixed” beverages were grouped either all as LCSBs or all as sugary beverages. Our results suggest that caution is warranted in design and interpretation of studies using NHANES data to examine dietary and health correlates of sweetened beverage intake. |
topic |
low-calorie sweeteners diet beverages sugar obesity |
url |
https://www.mdpi.com/2072-6643/13/8/2703 |
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