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Long-term trends in the consumption of sugary and diet soft drinks among adolescents: a cross-national survey in 21 European countries

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Abstract

Purpose

To assess country-level trends in the prevalence of daily consumption of sugary (2002–2018) and diet (2006–2018) soft drinks among European adolescents, overall and by family material affluence.

Methods

We used 2002, 2006, 2010, 2014 and 2018 data from the ‘Health Behaviour in School-aged Children’ survey. Nationally representative samples of adolescents completed a standardised questionnaire at school, including a short food frequency questionnaire (n = 530,976 and 21 countries for sugary soft drinks; n = 61,487 and 4 countries for diet soft drinks). We classified adolescents into three socioeconomic categories for each country and survey year, using the Family Affluence Scale. Multilevel logistic models estimated time trends, by country.

Results

Sugary soft drinks: the prevalence of daily consumption (≥ 1×/day) declined in 21/21 countries (Plinear trends ≤ 0.002). Absolute [range − 31.7 to − 3.4% points] and relative [range − 84.8 to − 22.3%] reductions varied considerably across countries, with the largest declines in Ireland, England and Norway. In 3/21 countries, the prevalence of daily consumption decreased more strongly in the most affluent adolescents than in the least affluent ones (P ≤ 0.002). Daily consumption was more prevalent among the least affluent adolescents in 11/21 countries in 2018 (P ≤ 0.002). Diet soft drinks: overall, daily consumption decreased over time in 4/4 countries (Plinear trends ≤ 0.002), more largely among the most affluent adolescents in 1/4 country (P ≤ 0.002).

Conclusions

Daily consumption of sugary and diet soft drinks in European adolescents decreased between 2002 (2006 for diet drinks) and 2018. Public health interventions should continue discouraging daily soft drink consumption, particularly among adolescents from lower socioeconomic groups.

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Availability of data and materials

HBSC data and questionnaires can be accessed via a request to the HBSC Data Management Centre: dmc@hbsc.org. For further information, see http://www.uib.no/en/hbscdata.

Code availability

Codes are available upon request.

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Acknowledgements

HBSC is an international study carried out in collaboration with World Health Organization Regional Office for Europe. The International Coordinator was Jo Inchley (University of Glasgow) for the 2018 survey and Candace Currie (Glasgow Caledonian University) for the 2002 to 2014 surveys. The Data Bank Manager was Professor Oddrun Samdal (University of Bergen). The survey data included in this study were conducted by the following principal investigators in the 21 countries or regions: Austria (Rosemarie Felder-Puig and Wolfgang Dür), Flemish Belgium (Maxim Dierckens, Bart De Clercq, Carine Vereecken, Anne Hublet, and Lea Maes), French-speaking Belgium (Katia Castetbon, Isabelle Godin and Danielle Piette), Denmark (Mette Rasmussen and Pernille Due), England (Fiona Brooks, Ellen Klemera, and Antony Morgan), Finland (Jorma Tynjälä), France (Emmanuelle Godeau), Germany (Matthias Richter, Petra Kolip, Ulrike Ravens-Sieberer, and Klaus Hurrelmann), Greece (Anna Kokkevi), Iceland (Arsaell M. Arnarsson and Thoroddur Bjarnason), Ireland (Saoirse Nic Gabhainn and Michal Molcho), Italy (Franco Cavallo and Alessio Vieno), Luxembourg (Helmut Willems, Bechara Ziade and Yolande Wagener), the Netherlands (Gonneke Stevens, Saskia van Dorsselaer, Wilma Vollebergh, and Tom de Bogt), Portugal (Margarida Gaspar de Matos), Scotland (Jo Inchley and Candace Currie), Spain (Carmen Moreno), Sweden (Petra Löfstedt, Lilly Augustine, and Ulla Marklund), Switzerland (Marina Delgrande-Jordan, Hervé Kuendig, Emmanuel Kuntsche, and Holger Schmid), and Wales (Chris Roberts). For details, see http://www.hbsc.org. We thank Pierre-Alexandre Fonta for his support in interpreting the ridit-transformation formula. We thank Emma Holmberg for proofreading the article and correcting English grammar.

Funding

HBSC is an international survey carried out in collaboration with the World Health Organization Regional Office for Europe. The data collection for each HBSC survey is funded at the national level. The work related to this paper was possible thanks to financial support by the University of Lausanne, Switzerland (UNIL/CHUV mobility fellowship) and academic support by the Université libre de Bruxelles, Belgium, for AC’s postdoctoral fellowship. The funders had no role in the analysis, decision to publish, or preparation of the manuscript.

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Authors and Affiliations

  1. School of Public Health, Université libre de Bruxelles, Ecole de Santé Publique, CP 598, Route de Lennik 808, 1070, Brussels, Belgium

    Angeline Chatelan, Thérésa Lebacq, Manon Rouche & Katia Castetbon

  2. Health Promotion Research Centre, School of Health Sciences, NUI Galway, Galway, Ireland

    Colette Kelly

  3. Department of Health Promotion and Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Bergen, Norway

    Anne-Siri Fismen

  4. Department of Recreation and Leisure Studies, Faculty of Physical Culture, Palacky University Olomouc, Olomouc, Czechia

    Michal Kalman

  5. Department of Child and Adolescent Health, Institute of Mother and Child, Warsaw, Poland

    Anna Dzielska

Authors
  1. Angeline Chatelan
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  2. Thérésa Lebacq
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  3. Manon Rouche
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  4. Colette Kelly
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  5. Anne-Siri Fismen
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  6. Michal Kalman
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  7. Anna Dzielska
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  8. Katia Castetbon
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Contributions

AC and KC conceived and designed the manuscript. AC defined the methodology, analysed the data, and drafted the manuscript under the supervision of KC. All the co-authors reviewed the manuscript, provided critical recommendations, and approved the final manuscript.

Corresponding author

Correspondence to Angeline Chatelan.

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Conflict of interest

AC, TL, MR, CK, ASF, MK, AD and KC declare no conflicts of interests.

Ethics approval/consent to participate

Data collection was anonymous, and no directly identifiable information on pupils was collected. Ethical consent to conduct the HBSC survey was obtained by national teams from the appropriate local/institutional ethics committee(s). In most countries, parental consent was passive. An information letter was sent out before data collection informing parents/carers about the survey and providing an opt-out response sheet if they did not want their child to take part in the study. Consent was also obtained by pupils, who were reminded verbally and in writing that participation was voluntary.

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Not applicable.

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Chatelan, A., Lebacq, T., Rouche, M. et al. Long-term trends in the consumption of sugary and diet soft drinks among adolescents: a cross-national survey in 21 European countries. Eur J Nutr 61, 2799–2813 (2022). https://doi.org/10.1007/s00394-022-02851-w

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  • DOI: https://doi.org/10.1007/s00394-022-02851-w

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