Consumption of sugar-sweetened beverages and its association with nutrient intakes and diet quality in German children and adolescents

In the present study the relationship of sugar-sweetened beverage (SSB) consumption with the intake of single nutrients and total diet quality in German children and adolescents was evaluated using a repeated-measures regression analysis model. We used dietary data from 7 145 three-day weighed records of 1069 subjects aged 2-19 years participating in the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) Study. Intake of macronutrients as percentage of total energy intake (%En), intake of micronutrients as percentage of German reference values (intake quality score) and nutritional quality index (NQI) as an indicator of diet quality were chosen as separate dependent variables. SSB consumption was positively associated with %En from carbohydrates (boys v. girls: +4.00 v. +4.09 En%/MJ from SSB) and added sugars (boys v. girls: +7.36 v. +9.52 En%/MJ from SSB) and negatively with %En from protein (boys v. girls: -1.25 v. -1.31 En%/MJ from SSB) and fat (boys: -2.82 v. -2.73 En%/MJ from SSB). With respect to micronutrients, SSB consumption was negatively associated with folate and Ca intake, for which mean intake levels were inadequate in girls. Absolute diet quality was negatively associated with SSB consumption, whereas the effect was larger for girls (boys v. girls: -1.41 v. -2.63 points of NQI/MJ from SSB). Overall, results show a diluting effect of SSB consumption on micronutrient intake and diet quality. This effect might be relevant especially in girls as the association with diet quality was larger and mean NQI levels were lower in comparison with boys.