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Total Sugar-Sweetened Beverage Intake Among US Adults Was Lower When Measured Using a 1-Question Versus 4-Question
Elizabeth A Lundeen1, Sohyun Park1, Carrie Dooyema1
11 Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Purpose:
To compare the performance of a 1-question survey screener measuring total sugar-sweetened beverage (SSB) intake to a screener measuring SSB types separately using 4 questions.
Design:
Cross-sectional.
Setting:
Web-based 2014 SummerStyles survey.
Participants:
A total of 4167 US adults (≥18 years).
Measures:
Frequency of SSB intake measured using a 1-question screener was compared to frequency using a 4-question screener (regular soda, fruit drinks, sports/energy drinks, sweetened coffee/tea). SSB intake (number of time/day) was categorized as 0, >0 to <1, and ≥1 time/day; difference in mean intake was calculated between 4 questions versus 1.
Analysis:
Paired t tests were used, and agreement was evaluated using weighted κ and Lin's concordance correlation coefficient (CCC).
Results:
Mean SSB intake was 1.7 (95% confidence interval [CI]: 1.65-1.79) times/day using 4 questions and 0.6 (95% CI: 0.56-0.62) times/day using 1 question ( P < .001). Intake frequency based on 4 questions versus 1 was 16.0% versus 38.5% for 0 time/day, 15.6% versus 42.5% for >0 to <1 time/day, and 68.4% versus 18.9% for ≥1 time/day. There was fair agreement for the 3 SSB intake categories (κ: .27) and poor absolute agreement between the 2 continuous measures (Lin's CCC: 0.31).
Conclusion:
Daily SSB intake was significantly lower using a 1-question screener versus a 4-question screener. Researchers should assess SSB types separately or consider that daily SSB intake is likely underestimated with 1 question.
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