Health Policy Fact Sheet April 2018 One in Three Young Children in California Consumed One or More Sugary Beverages a Day in 2013-14 Susan H. Babey and Joelle Wolstein B everages with added sugar, such as soda, energy drinks, and sports drinks, are the largest source of added sugar in the of more nutritious foods such as milk, fruits, and vegetables.2-9 In California, nearly one in three children diets of both children and adults in the U.S.1 Consuming beverages that have added caloric ages 2-11 (31 percent) consumed one or sweeteners (e.g., sucrose or high fructose more sugary beverages per day in 2013- corn syrup) is associated with overweight 14. This percentage is higher than the and obesity, increased risk of type 2 diabetes, percentages of children who consumed metabolic syndrome, liver disease, and dental sugary beverages every day in 2009 or in decay, as well as with decreased consumption 2011-12. Between 2003 and 2009, the Exhibit 1 Percent of Children Ages 2-11 Consuming One or More Sugary Beverages per Day, California, 2003 to 2013-14 60% 49* 50% 41* 40% 32 31 27* 30% 26* 20% 10% 0% 2003 2005 2007 2009 2011-12 2013-14 Source: 2003 through 2013-14 California Health Interview Survey *Significantly different from 2013-14. UCLA CENTER FOR HEALTH POLICY RESEARCH Exhibit 2 Percent of Children Ages 2-11 Consuming One or More Sugary Beverages per Day in California’s Most Populous Counties, 2013-14 County Percent 95% Confidence Interval Los Angeles 30.8 24.6 - 37.0 San Diego 28.9 21.9 - 36.0 Orange 35.5 23.9 - 47.2 Riverside 37.9 23.7 - 52.1 San Bernardino 38.7 26.4 - 50.9 California 30.9 28.3 - 33.5 Source: 2013-14 California Health Interview Survey proportion of children consuming at least with a relative lack of access to affordable one sugary drink per day decreased from 49 healthy options has been linked to percent to 26 percent (Exhibit 1). However, unhealthy eating behaviors, such as greater since 2009, this number has increased to 31 consumption of fast foods and soda, as well percent. Although consumption levels are as obesity.10-13 still not as high as they were in 2003, this trend is troubling because it suggests that the Discussion reductions in consumption observed among National health organizations recommend ‘‘ children may be reversing. reducing consumption of beverages with added sugar or other caloric sweeteners to This trend There is considerable variation in the consumption of sugary drinks across help prevent obesity and improve public health.14 Sugary beverage consumption is troubling California counties. Exhibit 2 shows the is influenced by a variety of social and because it prevalence of consumption of sugary drinks environmental factors, including the food suggests that among children ages 2-11 in the five most populous counties in California in 2013-14. environment, marketing, education, and norms. The recent increase in consumption the reductions Nearly 40 percent of young children in San of sugary drinks among California children in consumption Bernardino County consumed at least one suggests that continued education and observed among sugary beverage per day, compared to less than 30 percent in San Diego County. This policy efforts are needed to reduce sugary beverage consumption. children may regional variation is likely due to a number of ’’ be reversing. factors, including differences in demographic, social, economic, and environmental characteristics, as well as differences in local Data Source and Methods This fact sheet examines the prevalence of consumption of sugar-sweetened beverages among California children ages 2-11 using policies and programs. Additionally, the food data from the 2003, 2005, 2007, 2009, 2011- environment in California varies greatly from 12, and 2013-14 California Health Interview place to place. Some counties have limited Survey (CHIS). Each year, CHIS completes availability of stores offering affordable fresh interviews with adults, adolescents, and parents produce and other healthy options compared of children in more than 20,000 households, to the availability of convenience stores and drawn from every county in the state. Interviews are conducted in English, Spanish, fast-food restaurants, which tend to offer less Chinese (both Mandarin and Cantonese), healthy options. Living in food environments Vietnamese, and Korean. In this fact sheet, the UCLA CENTER FOR HEALTH POLICY RESEARCH term “sugary beverages” refers to regular soda, Endnotes sports drinks, energy drinks, and juice drinks with 1 Welsh JA, Sharma AJ, Grellinger L, Vos MB. 2011. Consumption of Added Sugars Is Decreasing in the added caloric sweeteners. It does not include diet United States. American Journal of Clinical Nutrition beverages or 100 percent fruit juice. 94(3):726-734. 2 Malik VS, Schulze MB, Hu FB. 2006. Intake of The California Health Interview Survey is a Sugar-Sweetened Beverages and Weight Gain: A Systematic Review. American Journal of Clinical collaboration of the UCLA Center for Health Nutrition 84(2):274-288. Policy Research, the California Department of 3 Schulze MB, Manson JE, Ludwig DS, et al. 2004. Public Health, the California Department of Sugar-Sweetened Beverages, Weight Gain, and Health Care Services, and the Public Health Incidence of Type 2 Diabetes in Young and Middle- Aged Women. Journal of the American Medical Institute. For funders and additional information Association 292(8):927-934. on CHIS, visit www.chis.ucla.edu. 4 Hu FB. 2013. Resolved: There Is Sufficient Scientific Evidence That Decreasing Sugar-Sweetened Beverage Author Information Consumption Will Reduce the Prevalence of Obesity and Obesity-Related Diseases. Obesity Review Susan H. Babey, PhD, is a senior research scientist at 14(8):606-619. the UCLA Center for Health Policy Research. Joelle 5 Freedman DS, Mei Z, Srinivasan SR, Berenson GS, Wolstein, PhD, MPP, is a research scientist at the Dietz WH. 2007. Cardiovascular Risk Factors and Excess Adiposity Among Overweight Children and UCLA Center for Health Policy Research. Adolescents: The Bogalusa Heart Study. Journal of Pediatrics 150(1):12-17 e12. Funding 6 Guo SS, Wu W, Chumlea WC, Roche AF. 2002. Predicting Overweight and Obesity in Adulthood This fact sheet was published with funding from from Body Mass Index Values in Childhood and The California Endowment. Adolescence. American Journal of Clinical Nutrition 76(3):653-658. 7 Malik VS, Popkin BM, Bray GA, Despres JP, Willett Suggested Citation WC, Hu FB. 2010. Sugar-Sweetened Beverages and Babey SH and Wolstein J. 2018. One in Three Young Risk of Metabolic Syndrome and Type 2 Diabetes: A Meta-Analysis. Diabetes Care 33(11):2477-2483. Children in California Consumed One or More Sugary 8 Vos MB, Lavine JE. 2013. Dietary Fructose in Beverages a Day in 2013-14. Los Angeles, CA: UCLA Nonalcoholic Fatty Liver Disease. Hepatology Center for Health Policy Research. 57(6):2525-2531. 9 Gortmaker S, Long M, Wang YC. 2009. The Negative Impact of Sugar-Sweetened Beverages on Children’s Health: A Research Synthesis. The Robert Wood Johnson Foundation. http://healthyeatingresearch.org/research/the- negative-impact-of-sugar-sweetened-beverages-on-childrens- health-a-research-synthesis/. 10 Babey SH, Diamant AL, Hastert TA, et al. 2008. Designed for Disease: The Link Between Local Food Environments and Obesity and Diabetes. Los Angeles, CA: California Center for Public Health Advocacy, PolicyLink, and the UCLA Center for Health Policy Research. 11 Babey SH, Wolstein J, Diamant AL. 2011. Food Environments Near Home and School Related to Consumption of Soda and Fast Food. Los Angeles, CA: UCLA Center for Health Policy Research. 12 Morland K, Diez Roux AV, Wing S. 2006. Supermarkets, Other Food Stores, and Obesity: The Atherosclerosis Risk in Communities Study. American Journal of Preventive Medicine 30(4):333-339. 13 Morland K, Wing S, Diez Roux A. 2002. The Contextual Effect of the Local Food Environment on Residents’ Diets: The Atherosclerosis Risk in Communities Study. American Journal of Public Health 92(11):1761-1767. 14 U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015. 2015 – 2020 Read this publication Dietary Guidelines for Americans. 8th ed. https://health. online gov/dietaryguidelines/2015/guidelines/. Accessed January 7, 2016. FS2018-4