This study was performed to investigate the factors related to consumption of sugar based on social cognitive theories and the association between sugar-sweetened beverage (SSB) intake and dietary quality in adults. Another purpose of this study was to provide baseline data for reducing sugar intake...
This study was performed to investigate the factors related to consumption of sugar based on social cognitive theories and the association between sugar-sweetened beverage (SSB) intake and dietary quality in adults. Another purpose of this study was to provide baseline data for reducing sugar intake in adults by analyzing the factors that affect a coffee shop user's perception and behavioral intention of reducing sugar intake.
1. Factors related to consumption of sugar in adults based on social cognitive theory
This study investigated the factors related to consumption of sugar based on social cognitive theories. An online survey was conducted with 1,071 adults aged 19 to 49 in the city of Daegu in Korea. The participants responded to a questionnaire on intake frequency of sugar source food, social cognitive theory factors related to sugar intake, perceptions related to sugar intake, health-related factors, and nutrition quotient. After excluding incomplete responses, the data of 1,022 participants were used for analysis. The participants were categorized into tertiles (T1, T2, T3) on the basis of the daily frequency of sugar source food, and factors related to sugar intake based on social cognitive factors were analyzed.
The daily intake frequency of sugar source food for the total participants was 4.0 times, and drinks (1.8 times/d) among food groups and sweetened coffee (0.8 times/d) among food types had the highest intake frequency. The daily intake of sugar source food of the total participants was 554.3 g, and drinks (420.4 g/d) among food groups and sweetened coffee (192.6 g/d) among food types had the highest intake. Both the frequency and amount of daily sugar intake were higher in men than in women, the highest for those 19~29 years old, and the lowest for those 40~49 years old, but the frequency and amount of consumption of sweetened coffee were the highest in the age group of those 40~49 years old. Awareness of national policies to reduce sugar intake was low (44.1%), but awareness of the necessity of efforts to reduce sugar intake was high (79.8%). Men in group T3 had a higher rate of smokers than those in group T1. Men and women in group T3 showed a higher preference for sweets when under stress and a higher sugar intake attitude toward sweet food than those in group T1. Among men and women, it was found that the group with a high frequency of sugar source food had a high negative outcome expectation for reducing sugar intake, had dietary behavior that increased sugar intake, and was in a home environment and social environment with easy access to sweet food. The group with a high frequency of sugar source food intake showed low self-efficacy and low practice of behavioral capability in reducing sugar intake in women. Self-control had the lowest average score among social cognitive theory factors (2.6 points), and nutritional knowledge related to sugar was low (5.42 points based on 10 points). As a result of analyzing the correlation between social cognitive theory factors and the frequency of sugar source food, the factors that showed a significant positive correlation with the frequency of sugar intake in men and women were negative results, dietary behavior, home environment, and social environment. In addition, the factors that showed a high correlation between social cognitive theory factors were behavioral capability and self-control, home environment and dietary behavior for both men and women. As a result of regression analysis, the factors that showed a positive relationship with frequency of sugar source food were dietary behavior, home environment, smoking, and occupation that increased sugar intake. The factors that showed a negative relationship with intake frequency were positive outcome expectation and age.
These study results suggest that dietary education and nutrition interventions including changes in the home environment should be provided to adults to improve their consumption of sugar-related diets and raise positive expectations for reducing sugar intake.
2. Association between sugar-sweetened beverage intake and dietary quality
This study investigated the association between sugar-sweetened beverage (SSB) intake and the dietary quality of adults. Daily intake of SSB was obtained by the food frequency questionnaire, and the dietary quality was assessed using the nutrition quotient (NQ) for Korean adults. Based on the daily intake of SSB, participants were classified into tertiles (T1, T2, T3) stratified by sex. Multiple logistic regression analysis was used to estimate the association between dietary quality and daily intake of SSB in adults. Daily intake of SSB was 463.6 g/d for total participants and the highest intakes were sweetened coffee (192.7 g/d) followed by carbonated drinks (77.1 g/d) and fruit/vegetable drinks (42.8 g/d), and men were higher than women. The consumption of carbonated drinks and fruit/vegetable drinks was higher for those in their 20s, and the consumption of sweetened coffee was higher for those in their 40s. Higher intake of SSB was associated with higher frequency of intake of fast food or sweet and greasy bread, processed beverages, ramen, eating out or delivery food and night snacks, and also associated with a lower frequency of water, breakfast intake and nutrition label checking by men and women. Men and women who had a higher SSB intake had significantly greater odds for being in the low grade of NQ (p for trend<0.001 for men, p for trend=0.001 for women), especially in the moderation factor (p for trend, <0.001 for men and women). Only women had significantly greater odds for being in the low grade of dietary behavior.
This study showed that high SSB intake was significantly associated with low dietary quality evaluated through the Nutrition Index in women and men, especially the low score in the moderation factor, and was also related to undesirable dietary behavior in women. These study results suggest that nutrition education programs and guidelines should be provided to adults for improving their consumption of SSB and related diets.
3. Daegu citizens' perceptions and factors affecting behavioral intentions to reduce sugars in coffee shop beverages
This study aimed to provide baseline data for establishing a sugar reduction policy in coffee shops by analyzing the factors that affect a coffee shop user's perception and behavioral intention of reducing sugar intake. An online survey was conducted involving 1,274 Daegu citizens aged 19 to 49 who had visited coffee shops within the last month. Of the total participants, 48.7% preferred sweet food, 25.9% had a usual sweet eating habit, and the preference for sweets and a sweet eating habit were higher in the younger age group (p<0.001, p=0.002). When visiting a coffee shop, the purchase of sweet drinks was higher for women in the younger age group (p<0.05, p<0.001), and the addition of syrup or sugar was higher in men and the older age group (p<0.001, p<0.01). The most ordered side menu was a piece of cake (62.3%), and was higher for women and the 30-39 age group (p<0.001, p<0.05). When choosing a drink in a coffee shop, the items with high importance were both hygiene and taste regardless of gender and age, and the items with low importance were nutrients (calories, sugars, etc.). Of the total respondents, 42.1% were aware that some coffee shops accommodate reduced sugar requests, 57.9% perceived the need to reduce sugar in coffee shop beverages and 22.3% had purchased beverages intending to reduce their sugar intake. When a method to reduce sugar intake in coffee shops was provided, items with high effectiveness and intention to use were “guiding the choice of sweetness levels when ordering” and “providing sugar-reduced beverage events,” while items with the lowest effectiveness and intention to use were “selling small-sized beverages.” In addition, 59.7% knew about sugar nutrition labeling, and 68.8% perceived the need for nutrition labeling for sugar. When purchasing beverages, 35.6% checked the nutrition labeling, and 77.2% purchased alternative drinks when the sugar content was high. Factors that had a positive effect on the behavioral intention to reduce sugar intake in coffee shop beverages were “perception of the need for reducing sugars in coffee shop beverages” (β=0.559, p<0.001) and “has experienced purchasing a beverage by considering reduced sugar intake” (β=0.112, p<0.001), whereas the factor with a negative effect was “habit of eating sweets” (β=-0.678, p=0.042).
Although the overall awareness and practice of reducing the sugar intake among coffee shop users were low, the behavioral intention to reduce sugar was positive, and this was most affected by the perception of the need to reduce sugar. Therefore, there is a need for differentiated education and promotion for each age group to recognize the necessity and outline methods for reducing sugar intake. Furthermore, coffee shops should reflect customer's sugar reduction needs.
This study was performed to investigate the factors related to consumption of sugar based on social cognitive theories and the association between sugar-sweetened beverage (SSB) intake and dietary quality in adults. Another purpose of this study was to provide baseline data for reducing sugar intake in adults by analyzing the factors that affect a coffee shop user's perception and behavioral intention of reducing sugar intake.
1. Factors related to consumption of sugar in adults based on social cognitive theory
This study investigated the factors related to consumption of sugar based on social cognitive theories. An online survey was conducted with 1,071 adults aged 19 to 49 in the city of Daegu in Korea. The participants responded to a questionnaire on intake frequency of sugar source food, social cognitive theory factors related to sugar intake, perceptions related to sugar intake, health-related factors, and nutrition quotient. After excluding incomplete responses, the data of 1,022 participants were used for analysis. The participants were categorized into tertiles (T1, T2, T3) on the basis of the daily frequency of sugar source food, and factors related to sugar intake based on social cognitive factors were analyzed.
The daily intake frequency of sugar source food for the total participants was 4.0 times, and drinks (1.8 times/d) among food groups and sweetened coffee (0.8 times/d) among food types had the highest intake frequency. The daily intake of sugar source food of the total participants was 554.3 g, and drinks (420.4 g/d) among food groups and sweetened coffee (192.6 g/d) among food types had the highest intake. Both the frequency and amount of daily sugar intake were higher in men than in women, the highest for those 19~29 years old, and the lowest for those 40~49 years old, but the frequency and amount of consumption of sweetened coffee were the highest in the age group of those 40~49 years old. Awareness of national policies to reduce sugar intake was low (44.1%), but awareness of the necessity of efforts to reduce sugar intake was high (79.8%). Men in group T3 had a higher rate of smokers than those in group T1. Men and women in group T3 showed a higher preference for sweets when under stress and a higher sugar intake attitude toward sweet food than those in group T1. Among men and women, it was found that the group with a high frequency of sugar source food had a high negative outcome expectation for reducing sugar intake, had dietary behavior that increased sugar intake, and was in a home environment and social environment with easy access to sweet food. The group with a high frequency of sugar source food intake showed low self-efficacy and low practice of behavioral capability in reducing sugar intake in women. Self-control had the lowest average score among social cognitive theory factors (2.6 points), and nutritional knowledge related to sugar was low (5.42 points based on 10 points). As a result of analyzing the correlation between social cognitive theory factors and the frequency of sugar source food, the factors that showed a significant positive correlation with the frequency of sugar intake in men and women were negative results, dietary behavior, home environment, and social environment. In addition, the factors that showed a high correlation between social cognitive theory factors were behavioral capability and self-control, home environment and dietary behavior for both men and women. As a result of regression analysis, the factors that showed a positive relationship with frequency of sugar source food were dietary behavior, home environment, smoking, and occupation that increased sugar intake. The factors that showed a negative relationship with intake frequency were positive outcome expectation and age.
These study results suggest that dietary education and nutrition interventions including changes in the home environment should be provided to adults to improve their consumption of sugar-related diets and raise positive expectations for reducing sugar intake.
2. Association between sugar-sweetened beverage intake and dietary quality
This study investigated the association between sugar-sweetened beverage (SSB) intake and the dietary quality of adults. Daily intake of SSB was obtained by the food frequency questionnaire, and the dietary quality was assessed using the nutrition quotient (NQ) for Korean adults. Based on the daily intake of SSB, participants were classified into tertiles (T1, T2, T3) stratified by sex. Multiple logistic regression analysis was used to estimate the association between dietary quality and daily intake of SSB in adults. Daily intake of SSB was 463.6 g/d for total participants and the highest intakes were sweetened coffee (192.7 g/d) followed by carbonated drinks (77.1 g/d) and fruit/vegetable drinks (42.8 g/d), and men were higher than women. The consumption of carbonated drinks and fruit/vegetable drinks was higher for those in their 20s, and the consumption of sweetened coffee was higher for those in their 40s. Higher intake of SSB was associated with higher frequency of intake of fast food or sweet and greasy bread, processed beverages, ramen, eating out or delivery food and night snacks, and also associated with a lower frequency of water, breakfast intake and nutrition label checking by men and women. Men and women who had a higher SSB intake had significantly greater odds for being in the low grade of NQ (p for trend<0.001 for men, p for trend=0.001 for women), especially in the moderation factor (p for trend, <0.001 for men and women). Only women had significantly greater odds for being in the low grade of dietary behavior.
This study showed that high SSB intake was significantly associated with low dietary quality evaluated through the Nutrition Index in women and men, especially the low score in the moderation factor, and was also related to undesirable dietary behavior in women. These study results suggest that nutrition education programs and guidelines should be provided to adults for improving their consumption of SSB and related diets.
3. Daegu citizens' perceptions and factors affecting behavioral intentions to reduce sugars in coffee shop beverages
This study aimed to provide baseline data for establishing a sugar reduction policy in coffee shops by analyzing the factors that affect a coffee shop user's perception and behavioral intention of reducing sugar intake. An online survey was conducted involving 1,274 Daegu citizens aged 19 to 49 who had visited coffee shops within the last month. Of the total participants, 48.7% preferred sweet food, 25.9% had a usual sweet eating habit, and the preference for sweets and a sweet eating habit were higher in the younger age group (p<0.001, p=0.002). When visiting a coffee shop, the purchase of sweet drinks was higher for women in the younger age group (p<0.05, p<0.001), and the addition of syrup or sugar was higher in men and the older age group (p<0.001, p<0.01). The most ordered side menu was a piece of cake (62.3%), and was higher for women and the 30-39 age group (p<0.001, p<0.05). When choosing a drink in a coffee shop, the items with high importance were both hygiene and taste regardless of gender and age, and the items with low importance were nutrients (calories, sugars, etc.). Of the total respondents, 42.1% were aware that some coffee shops accommodate reduced sugar requests, 57.9% perceived the need to reduce sugar in coffee shop beverages and 22.3% had purchased beverages intending to reduce their sugar intake. When a method to reduce sugar intake in coffee shops was provided, items with high effectiveness and intention to use were “guiding the choice of sweetness levels when ordering” and “providing sugar-reduced beverage events,” while items with the lowest effectiveness and intention to use were “selling small-sized beverages.” In addition, 59.7% knew about sugar nutrition labeling, and 68.8% perceived the need for nutrition labeling for sugar. When purchasing beverages, 35.6% checked the nutrition labeling, and 77.2% purchased alternative drinks when the sugar content was high. Factors that had a positive effect on the behavioral intention to reduce sugar intake in coffee shop beverages were “perception of the need for reducing sugars in coffee shop beverages” (β=0.559, p<0.001) and “has experienced purchasing a beverage by considering reduced sugar intake” (β=0.112, p<0.001), whereas the factor with a negative effect was “habit of eating sweets” (β=-0.678, p=0.042).
Although the overall awareness and practice of reducing the sugar intake among coffee shop users were low, the behavioral intention to reduce sugar was positive, and this was most affected by the perception of the need to reduce sugar. Therefore, there is a need for differentiated education and promotion for each age group to recognize the necessity and outline methods for reducing sugar intake. Furthermore, coffee shops should reflect customer's sugar reduction needs.
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