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Research Letter
April 22, 2019

Association of Caloric Intake From Sugar-Sweetened Beverages With Water Intake Among US Children and Young Adults in the 2011-2016 National Health and Nutrition Examination Survey

Author Affiliations
  • 1Department of Biobehavioral Health, Pennsylvania State University, University Park
  • 2Department of Anthropology, Pennsylvania State University, University Park
JAMA Pediatr. 2019;173(6):602-604. doi:10.1001/jamapediatrics.2019.0693

Sugar-sweetened beverages (SSBs) add empty calories to children’s diets1 and may increase the risk of weight gain, obesity, and diabetes.2 Substituting water for SSBs may reduce total energy intake.3 Furthermore, school-based interventions to displace SSBs by increasing water access were associated with decreased body mass index.4 However, how water consumption in daily life is associated with children’s caloric intake from SSBs is unclear. We examined whether the number of calories and percentage of total energy intake from SSBs differs among US children by water intake status on a given day.

The National Health and Nutrition Examination Survey (NHANES) uses a complex, multistage probability design to obtain representative samples of the noninstitutionalized civilian US population. This analysis used data from the 2011 to 2016 NHANES cross-sectional survey waves. Response rates ranged from 77.0% (2011-2012) to 64.6% (2015-2016). NHANES is approved by the research ethics review board of the National Center for Health Statistics. Parents provided written informed consent, and children aged 7 to 17 years provided written assent.