title: Low-calorie- and calorie-sweetened beverages: diet quality, food intake, and purchase patterns of US household consumers.
abstract: BACKGROUND
  Few studies have investigated the diet quality of consumers of low-calorie-sweetened (LCS) and calorie-sweetened (CS) beverages.
  
  
  OBJECTIVE
  The objective was to examine the dietary quality and adherence to dietary purchasing and consumption patterns of beverage consumers from 2000 to 2010.
  
  
  METHODS
  We analyzed purchases for 140,352 households from the Homescan longitudinal data set 2000-2010 and dietary intake from NHANES 2003-2010 (n = 34,393). We defined mutually exclusive consumer profiles as main exposures: LCS beverages, CS beverages, LCS & CS beverages, and non/low consumers. As main outcomes, we explored dietary quality by using total energy and macronutrients (kcal/d). We performed factor analyses and applied factor scores to derive dietary patterns as secondary outcomes. Using multivariable linear (NHANES) and random-effects (Homescan) models, we investigated the associations between beverage profiles and dietary patterns.
  
  
  RESULTS
  We found "prudent" and "breakfast" patterns in Homescan and NHANES, "ready-to-eat meals/fast-food" and "prudent/snacks/LCS desserts" patterns in Homescan, and "protein/potatoes" and "CS desserts/sweeteners" patterns in NHANES. In both data sets, compared with non/low consumers, both CS- and LCS-beverage consumers had a significantly higher total energy from foods, higher energy from total and SFAs, and lower probability of adherence to prudent and breakfast patterns. In Homescan, LCS-beverage consumers had a higher probability of adherence to 2 distinct patterns: a prudent/snacks/LCS dessert pattern and a ready-to-eat meals/fast-food purchasing pattern.
  
  
  CONCLUSIONS
  Our findings suggest that overall dietary quality is lower in LCS-, CS-, and LCS & CS-beverage consumers relative to non/low consumers. Our study highlights the importance of targeting foods that are linked with sweetened beverages (either LCS or CS) in intervention and policy efforts that aim to improve nutrition in the United States.
authors.affiliation: Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
authors.forename: Carmen
authors.initials: C
authors.lastname: Piernas
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Mendez
authors.forename: Shu Wen
authors.initials: SW
authors.lastname: Ng
authors.forename: Penny
authors.initials: P
authors.lastname: Gordon-Larsen
authors.forename: Barry M
authors.initials: BM
authors.lastname: Popkin
mesh_terms: D001628:Beverages / Q000009:adverse effects* / Q000032:analysis / Q000191:economics; D003257:Consumer Product Safety; D004032:Diet / Q000009:adverse effects* / Q000191:economics; D004038:Diet, Reducing / Q000009:adverse effects / Q000191:economics; D002149:Energy Intake; D005163:Factor Analysis, Statistical; D005191:Family Characteristics; D063427:Food Quality; D006293:Health Promotion; D006801:Humans; D008137:Longitudinal Studies; D008954:Models, Biological; D064306:Non-Nutritive Sweeteners / Q000009:adverse effects* / Q000032:analysis / Q000191:economics; D018673:Nutrition Policy; D009749:Nutrition Surveys; D064427:Nutritive Sweeteners / Q000009:adverse effects* / Q000032:analysis / Q000191:economics; D010349:Patient Compliance; D014481:United States
chemical_list: D064306:Non-Nutritive Sweeteners; D064427:Nutritive Sweeteners