title: Global, Regional, and National Consumption of Sugar-Sweetened Beverages, Fruit Juices, and Milk: A Systematic Assessment of Beverage Intake in 187 Countries.
abstract: BACKGROUND
  Sugar-sweetened beverages (SSBs), fruit juice, and milk are components of diet of major public health interest. To-date, assessment of their global distributions and health impacts has been limited by insufficient comparable and reliable data by country, age, and sex.
  
  
  OBJECTIVE
  To quantify global, regional, and national levels of SSB, fruit juice, and milk intake by age and sex in adults over age 20 in 2010.
  
  
  METHODS
  We identified, obtained, and assessed data on intakes of these beverages in adults, by age and sex, from 193 nationally- or subnationally-representative diet surveys worldwide, representing over half the world's population. We also extracted data relevant to milk, fruit juice, and SSB availability for 187 countries from annual food balance information collected by the United Nations Food and Agriculture Organization. We developed a hierarchical Bayesian model to account for measurement incomparability, study representativeness, and sampling and modeling uncertainty, and to combine and harmonize nationally representative dietary survey data and food availability data.
  
  
  RESULTS
  In 2010, global average intakes were 0.58 (95%UI: 0.37, 0.89) 8 oz servings/day for SSBs, 0.16 (0.10, 0.26) for fruit juice, and 0.57 (0.39, 0.83) for milk. There was significant heterogeneity in consumption of each beverage by region and age. Intakes of SSB were highest in the Caribbean (1.9 servings/day; 1.2, 3.0); fruit juice consumption was highest in Australia and New Zealand (0.66; 0.35, 1.13); and milk intake was highest in Central Latin America and parts of Europe (1.06; 0.68, 1.59). Intakes of all three beverages were lowest in East Asia and Oceania. Globally and within regions, SSB consumption was highest in younger adults; fruit juice consumption showed little relation with age; and milk intakes were highest in older adults.
  
  
  CONCLUSIONS
  Our analysis highlights the enormous spectrum of beverage intakes worldwide, by country, age, and sex. These data are valuable for highlighting gaps in dietary surveillance, determining the impacts of these beverages on global health, and targeting dietary policy.
authors.affiliation: Friedman School of Nutrition Science and Health Policy, Tufts University, Boston, MA, United States of America.
authors.forename: Gitanjali M
authors.initials: GM
authors.lastname: Singh
authors.affiliation: Friedman School of Nutrition Science and Health Policy, Tufts University, Boston, MA, United States of America; Department of Food Science and Human Nutrition, Agricultural University of Athens, Athens, Greece.
authors.forename: Renata
authors.initials: R
authors.lastname: Micha
authors.affiliation: Department of Epidemiology, Harvard School of Public Health, Boston, MA, United States of America.
authors.forename: Shahab
authors.initials: S
authors.lastname: Khatibzadeh
authors.affiliation: Friedman School of Nutrition Science and Health Policy, Tufts University, Boston, MA, United States of America.
authors.forename: Peilin
authors.initials: P
authors.lastname: Shi
authors.affiliation: Institute of Health Metrics and Evaluation, Seattle, WA, United States of America.
authors.forename: Stephen
authors.initials: S
authors.lastname: Lim
authors.affiliation: Institute of Health Metrics and Evaluation, Seattle, WA, United States of America.
authors.forename: Kathryn G
authors.initials: KG
authors.lastname: Andrews
authors.affiliation: Institute of Health Metrics and Evaluation, Seattle, WA, United States of America.
authors.forename: Rebecca E
authors.initials: RE
authors.lastname: Engell
authors.affiliation: Department of Global Environmental Health, School of Public Health, Imperial College London, London, United Kingdom.
authors.forename: Majid
authors.initials: M
authors.lastname: Ezzati
authors.affiliation: Friedman School of Nutrition Science and Health Policy, Tufts University, Boston, MA, United States of America.
authors.forename: Dariush
authors.initials: D
authors.lastname: Mozaffarian
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D001499:Bayes Theorem; D001628:Beverages / Q000032:analysis; D004040:Dietary Carbohydrates; D005247:Feeding Behavior; D005260:Female; D000067030:Fruit and Vegetable Juices; D014943:Global Health; D006801:Humans; D008297:Male; D008875:Middle Aged; D008892:Milk; D009749:Nutrition Surveys; D013549:Sweetening Agents; D055815:Young Adult
chemical_list: D004040:Dietary Carbohydrates; D013549:Sweetening Agents