title: A dynamic panel model of the associations of sweetened beverage purchases with dietary quality and food-purchasing patterns.
abstract: Investigating the association between consumption of sweetened beverages and dietary quality is challenging because issues such as reverse causality and unmeasured confounding might result in biased and inconsistent estimates. Using a dynamic panel model with instrumental variables to address those issues, we examined the independent associations of beverages sweetened with caloric and low-calorie sweeteners with dietary quality and food-purchasing patterns. We analyzed purchase data from the Homescan survey, an ongoing, longitudinal, nationally representative US survey, from 2000 to 2010 (n = 34,294). Our model included lagged measures of dietary quality and beverage purchases (servings/day in the previous year) as exposures to predict the outcomes (macronutrient (kilocalories per capita per day; %), total energy, and food purchases) in the next year after adjustment for other sociodemographic covariates. Despite secular declines in purchases (kilocalories per capita per day) from all sources, each 1-serving/day increase in consumption of either beverage type resulted in higher purchases of total daily kilocalories and kilocalories from food, carbohydrates, total sugar, and total fat. Each 1-serving/day increase in consumption of either beverage was associated with more purchases of caloric-sweetened desserts or sweeteners, which accounted for a substantial proportion of the increase in total kilocalories. We concluded that consumers of both beverages sweetened with low-calorie sweeteners and beverages sweetened with caloric sweeteners had poorer dietary quality, exhibited higher energy from all purchases, sugar, and fat, and purchased more caloric-sweetened desserts/caloric sweeteners compared with nonconsumers.
authors.forename: Carmen
authors.initials: C
authors.lastname: Piernas
authors.forename: Shu Wen
authors.initials: SW
authors.lastname: Ng
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Mendez
authors.forename: Penny
authors.initials: P
authors.lastname: Gordon-Larsen
authors.forename: Barry M
authors.initials: BM
authors.lastname: Popkin
mesh_terms: D001628:Beverages / Q000706:statistics & numerical data*; D004032:Diet / Q000706:statistics & numerical data*; D005260:Female; D005502:Food / Q000706:statistics & numerical data*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical
keywords: beverages; caloric sweeteners; dietary quality; low-calorie sweeteners; purchases
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