Is there a soft drink vs. alcohol seesaw? A cross-sectional analysis of dietary data in the Australian Health Survey 2011–12

  • Tommy H. T. Wong
  • Anette E. Buyken
  • Jennie C. Brand-Miller
  • Jimmy Chun Yu LouieEmail author
Original Contribution



Previous studies in older Australians have reported higher alcohol intake in those with low added sugar intake, yet the relationship between energy in liquid form [alcoholic beverages vs. sugar-sweetened beverages (SSB)] and measures of obesity has not been evaluated. We aimed to assess the association between the energy derived from SSB and alcoholic beverages, and to model the association between the substitution of SSB with alcoholic beverages and waist circumference.


In this cross-sectional analysis, dietary data from the Australian Health Survey 2011–12 were analyzed. Participants with implausible dietary intake were excluded by applying the Goldberg cut-off. Usual SSB intake of adults ≥ 19 years old was estimated using the Multiple Source Method and participants were classified into zero-, low- or high-SSB consumers according to their usual SSB intake. Energy from alcoholic beverages in the three SSB consumption groups was compared using multivariable general linear models. A substitution model was used to assess the association between the replacement of SSB with alcoholic beverages and waist circumference.


Zero-SSB consumers made up 33% of the included participants. In all age groups, zero-SSB consumers had significantly higher energy intakes from alcoholic beverages than low- and high-SSB consumers. Low- and high-SSB consumers had similar consumption of alcoholic beverages. Substituting SSB intake with alcoholic beverage intake was not associated with significant differences in waist circumference in most age groups.


Australian adults who avoid SSB are common but consume substantially more energy in the form of alcoholic beverages. An increase in alcoholic beverage intake could be an ‘unintended consequence’ of strictly discouraging SSB consumption.


Australian adults Sugar-sweetened beverage Alcoholic beverage Substitution model Energy intake 


Author contributions

Designed research: JBM, AEB, JCYL; analyzed data or performed statistical analysis: THTW, AEB, JCYL; wrote paper: THTW, AEB, JBM, JCYL; JCYL had primary responsibility for final content.


This study was not supported by any external funding.

Compliance with ethical standards

Conflict of interest

AEB is a member of the ILSI Europe Carbohydrate Task Force and the International Carbohydrate Quality Consortium (ICQC). JBM received research grants from the Australian National Health and Medical Research Council, the European Union, and the Glycemic Index Foundation; and received royalties for books on nutrition that recommend a low glycemic index diet. She oversees a glycemic index testing service at the University of Sydney and is the president and non-executive director of the Glycemic Index Foundation. THTW and JCYL have no conflict of interest to declare.

Supplementary material

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Supplementary material 1 (PPTX 42 kb)
394_2019_2084_MOESM2_ESM.docx (42 kb)
Supplementary material 2 (DOCX 41 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.School of Biological SciencesThe University of Hong KongPokfulamChina
  2. 2.Faculty of Natural Sciences, Institute of Nutrition, Consumption and HealthPaderborn UniversityPaderbornGermany
  3. 3.Charles Perkins CentreThe University of SydneySydneyAustralia
  4. 4.School of Life and Environmental SciencesThe University of SydneySydneyAustralia

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