Examining inequalities in sugar sweetened beverage consumption using the 2004 and 2015 Canadian Community Health Surveys

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Date
2025-04-29
Authors
Kidson, Mya
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Abstract

Background: Sugar-sweetened beverages (SSBs) are associated with type 2 diabetes and other metabolic disorders, and as such, have become a popular health policy target. Reduction strategies include excise taxation, health education, and restrictions on the sale and marketing of SSBs in schools and public settings. Despite endorsement by health organizations and researchers, there is concern that these policies will not reduce health inequities for marginalized groups that consume SSB at higher frequencies and amounts. It is critical to examine changes in inequalities in SSB intake over time and in response to SSB policies. To examine inequalities in SSB intake, we are particularly interested in examining the association between smoking and SSB consumption. Objectives: Manuscript 1.0 aims to examine the associations between smoking and SSB consumption in 2004 and 2015. Manuscript 2.0 aims to examine the associations between relative income deprivation score and SSB consumption, comparing between 2004 and 2015. Methods: The 2004 and 2015 Canadian Community Health Surveys (CCHS) were used, which include representative samples of the Canadian population and detailed dietary data collected through 24-hour dietary recalls. Descriptive and analytical statistics were carried out to achieve the listed objectives, including developing logistic and linear regression models to determine the influence of predictors, such as relative income deprivation score (RID) and smoking, on binary SSB consumption and SSB-derived sugar amount. Results: Current smoking is associated with higher odds of SSB consumption (aOR: 1.86 [95% CI, 1.29, 2.68]), but not with SSB-derived sugar intake (Coeff: 0.10 [95% CI, -0.03, 0.23]), after adjusting for confounders. RID based on sex and province was not associated with SSB consumption in 2004 and 2015. Indigenous individuals had higher odds of consuming SSBs compared to non-Indigenous individuals (2004 OR = 2.65 [95% CI, 1.35, 5.20]), and 2015 (OR = 2.77 [95% CI, 1.39, 5.54]) with no significant change over time. There was no significant association between food insecurity and SSB consumption. Conclusion: Current smoking is associated with SSB intake, pointing to potential shared behavioural and socio-economic drivers. Persisting inequalities in SSB consumption between Indigenous and non-Indigenous populations emphasize the need for more equitable public health policies.

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Keywords
sugar-sweetened beverage, smoking, health equity, health policy, Indigenous health, statistical analysis
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