Skip to main content

Sociodemographic, behavioural and environmental correlates of sweetened beverage consumption among pre-school children

  • Roman Pabayo (a1) (a2), John C Spence (a1), Nicoleta Cutumisu (a1), Linda Casey (a3) and Kate Storey (a4)...
Abstract Objective

To identify sociodemographic and environmental correlates of sweetened beverages (regular soft drinks, fruit juice) among children of pre-school age.


Children's dietary intake, food behaviours and screen time were measured by parental report. A Geographic Informational System was used to assess the number of grocery stores and fast-food restaurants available within 1 km of the children's residence. Multivariate log-binomial regression models were constructed to determine correlates of drinking soft drinks during the previous week.


Edmonton region, Canada.


Children aged 4 and 5 years (n 2114) attending a public health unit for immunization were recruited for a cohort study on determinants of childhood obesity, between 2005 and 2007.


Children from neighbourhoods with low socio-economic status (relative risk (RR) = 1·17, 95 % CI 0·98, 1·40) or who participated in >2 h of screen time daily (RR = 1·28, 95 % CI 1·13, 1·45) were significantly more likely to have consumed regular soft drinks within the last week. Those who lived within 1 km of a grocery store were significantly less likely to consume regular soft drinks (RR = 0·84, 95 % CI 0·73, 0·96). Children who participated in >2 h of screen time daily (RR = 1·16, 95 % CI 1·06, 1·27) were more likely to exceed the recommended weekly number of servings of fruit juice.


Socio-economic and built environment factors are associated with soft drink consumption in children of pre-school age. These findings may help health professionals to advocate for policies that reduce soft drink consumption among children.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Sociodemographic, behavioural and environmental correlates of sweetened beverage consumption among pre-school children
      Available formats
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about sending content to Dropbox.

      Sociodemographic, behavioural and environmental correlates of sweetened beverage consumption among pre-school children
      Available formats
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about sending content to Google Drive.

      Sociodemographic, behavioural and environmental correlates of sweetened beverage consumption among pre-school children
      Available formats
Corresponding author
*Corresponding author: Email
Hide All
1. Tremblay MS, Shields M, Laviolette M et al. (2010) Fitness of Canadian children and youth: results from the 2007–2009 Canadian Health Measures Survey. Health Rep 21, 720.
2. Poirier P, Giles TD, Bray GA et al. (2006) Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss: an update of the 1997 American Heart Association Scientific Statement on Obesity and Heart Disease from the Obesity Committee of the Council on Nutrition, Physical Activity, and Metabolism. Circulation 113, 898918.
3. Kaur H, Hyder ML & Poston WS (2003) Childhood overweight: an expanding problem. Treat Endocrinol 2, 375388.
4. James WP (2008) The epidemiology of obesity: the size of the problem. J Intern Med 263, 336352.
5. Bray GA (2010) Soft drink consumption and obesity: it is all about fructose. Curr Opin Lipidol 21, 5157.
6. Malik VS, Schulze MB & Hu FB (2006) Intake of sugar-sweetened beverages and weight gain: a systematic review. Am J Clin Nutr 84, 274288.
7. Thundiyil JG, Christiano-Smith D, Greenberger S et al. (2010) Trimming the fat: identification of risk factors associated with obesity in a pediatric emergency department. Pediatr Emerg Care 26, 709715.
8. French SA, Lin BH & Guthrie JF (2003) National trends in soft drink consumption among children and adolescents age 6 to 17 years: prevalence, amounts, and sources, 1977/1978 to 1994/1998. J Am Diet Assoc 103, 13261331.
9. Rajeshwari R, Yang SJ, Nicklas TA et al. (2005) Secular trends in children's sweetened-beverage consumption (1973 to 1994): the Bogalusa Heart Study. J Am Diet Assoc 105, 208214.
10. Naska A, Bountziouka V & Trichopoulou A (2010) Soft drinks: time trends and correlates in twenty-four European countries. A cross-national study using the DAFNE (Data Food Networking) databank. Public Health Nutr 13, 13461355.
11. Nelson MC, Neumark-Sztainer D, Hannan PJ et al. (2009) Five-year longitudinal and secular shifts in adolescent beverage intake: findings from project EAT (Eating Among Teens)-II. J Am Diet Assoc 109, 308312.
12. Duffey KJ & Popkin BM (2007) Shifts in patterns and consumption of beverages between 1965 and 2002. Obesity (Silver Spring) 15, 27392747.
13. Alberta Health and Wellness, Population Health Strategies Branch, Public Health Division (2008) Alberta Nutrition Guidelines For Children and Youth: A Childcare, School and Recreation/Community Centre Resource Manual. Edmonton, AB: Government of Alberta.
14. Health Canada (2007) Eating Well with Canada's Food Guide. Ottawa: Minister of Public Works and Government Services Canada.
15. Davison KK & Birch LL (2001) Childhood overweight: a contextual model and recommendations for future research. Obes Rev 2, 159171.
16. Swinburn B, Egger G & Raza F (1999) Dissecting obesogenic environments: the development and application of a framework for identifying and prioritizing environmental interventions for obesity. Prev Med 29, 563570.
17. Swinburn B & Egger G (2002) Preventive strategies against weight gain and obesity. Obes Rev 3, 289301.
18. Galvez MP, Pearl M & Yen IH (2010) Childhood obesity and the built environment. Curr Opin Pediatr 22, 202207.
19. Barnett E & Casper M (2001) A definition of ‘social environment’. Am J Public Health 91, 465.
20. Campbell KJ, Crawford DA & Hesketh KD (2007) Australian parents’ views on their 5–6-year-old children's food choices. Health Promot Int 22, 1118.
21. Birch LL & Fisher JO (1998) Development of eating behaviors among children and adolescents. Pediatrics 101, 539549.
22. Benton D (2004) Role of parents in the determination of the food preferences of children and the development of obesity. Int J Obes Relat Metab Disord 28, 858869.
23. Savage JS, Fisher JO & Birch LL (2007) Parental influence on eating behavior: conception to adolescence. J Law Med Ethics 35, 2234.
24. Vereecken C & Maes L (2010) Young children's dietary habits and associations with the mothers’ nutritional knowledge and attitudes. Appetite 54, 4451.
25. Grimm GC, Harnack L & Story M (2004) Factors associated with soft drink consumption in school-aged children. J Am Diet Assoc 104, 12441249.
26. Nickelson J, Roseman MG & Forthofer MS (2010) Associations between parental limits, school vending machine purchases, and soft drink consumption among Kentucky middle school students. J Nutr Educ Behav 42, 115122.
27. Thomson M, Spence JC, Raine K et al. (2008) The association of television viewing with snacking behavior and body weight of young adults. Am J Health Promot 22, 329335.
28. Keller KL, Kirzner J, Pietrobelli A et al. (2009) Increased sweetened beverage intake is associated with reduced milk and calcium intake in 3- to 7-year-old children at multi-item laboratory lunches. J Am Diet Assoc 109, 497501.
29. Fiorito LM, Marini M, Mitchell DC et al. (2010) Girls’ early sweetened carbonated beverage intake predicts different patterns of beverage and nutrient intake across childhood and adolescence. J Am Diet Assoc 110, 543550.
30. Sweetman C, Wardle J & Cooke L (2008) Soft drinks and ‘desire to drink’ in preschoolers. Int J Behav Nutr Phys Act 5, 60.
31. Denney-Wilson E, Crawford D, Dobbins T et al. (2009) Influences on consumption of soft drinks and fast foods in adolescents. Asia Pac J Clin Nutr 18, 447452.
32. Simen-Kapeu A, Kuhle S & Veugelers PJ (2010) Geographic differences in childhood overweight, physical activity, nutrition and neighbourhood facilities: implications for prevention. Can J Public Health 101, 128132.
33. Spence JC, Cutumisu N, Edwards J et al. (2008) Influence of neighbourhood design and access to facilities on overweight among preschool children. Int J Pediatr Obes 3, 109116.
34. Bere E, Glomnes ES, te Velde SJ et al. (2008) Determinants of adolescents’ soft drink consumption. Public Health Nutr 11, 4956.
35. Striegel-Moore RH, Thompson D, Affenito SG et al. (2006) Correlates of beverage intake in adolescent girls: the National Heart, Lung, and Blood Institute Growth and Health Study. J Pediatr 148, 183187.
36. Spence JC, Carson V, Casey L et al. (2011) Examining behavioural susceptibility to obesity among Canadian pre-school children: the role of eating behaviours. Int J Pediatr Obes 6, e501e507.
37. Carson V, Spence JC, Cutumisu N et al. (2010) Seasonal variation in physical activity among preschool children in a northern Canadian city. Res Q Exerc Sport 81, 392399.
38. Statistics Canada (2008) Postal Code Conversion File (PCCFF), Reference Guide. March 2008 Postal codes. Statistics Canada Catalogue no. 92-153-G. Ottawa: Ministry of Industry.
39. Statistics Canada (2008) 2006 Census of Population. Catalogue no. 94-581-XCB2006002. Ottawa, ON: Statistics Canada.
40. Demissie K, Hanley JA, Menzies D et al. (2000) Agreement in measuring socio-economic status: area-based versus individual measures. Chronic Dis Can 21, 17.
41. Wardle J, Guthrie CA, Sanderson S et al. (2001) Development of the children's eating behaviour questionnaire. J Child Psychol Psychiatry 42, 963970.
42. Krebs NF & Jacobson MS (2003) Prevention of pediatric overweight and obesity. Pediatrics 112, 424430.
43. Canadian Paediatric Society (2003) Impact of media use on children and youth. Paediatr Child Health 8, 301306.
44. Council on Sports Medicine and Fitness & Council on School Health (2006) Active healthy living: prevention of childhood obesity through increased physical activity. Pediatrics 117, 18341842.
45. Tremblay MS, Leblanc AG, Janssen I et al. (2011) Canadian sedentary behaviour guidelines for children and youth. Appl Physiol Nutr Metab 36, 5964; 65–71.
46. Alberta First Business Directory (2007) (accessed March 2007).
47. Spence JC, Cutumisu N, Edwards J et al. (2009) Relation between local food environments and obesity among adults. BMC Public Health 9, 192.
48. Beyer HL (2006) Hawth's Analysis Tools for ArcGIS, version 3.26. (assessed June 2010).
49. Moudon A, Chanam L, Lee C et al. (2006) Operational definitions of walkable neighborhood: theoretical and empirical insights. J Phys Act Health 3, Suppl. 1, S99S117.
50. Vartanian LR, Schwartz MB & Brownell KD (2007) Effects of soft drink consumption on nutrition and health: a systematic review and meta-analysis. Am J Public Health 97, 667675.
51. Marshall TA, Eichenberger Gilmore JM, Broffitt B et al. (2005) Diet quality in young children is influenced by beverage consumption. J Am Coll Nutr 24, 6575.
52. de Bruijn GJ & van den Putte B (2009) Adolescent soft drink consumption, television viewing and habit strength. Investigating clustering effects in the Theory of Planned Behaviour. Appetite 53, 6675.
53. Kremers SP, van der Horst K & Brug J (2007) Adolescent screen-viewing behaviour is associated with consumption of sugar-sweetened beverages: the role of habit strength and perceived parental norms. Appetite 48, 345350.
54. Plotnikoff RC, Karunamuni N, Spence JC et al. (2009) Chronic disease-related lifestyle risk factors in a sample of Canadian adolescents. J Adolesc Health 44, 606609.
55. Carson V, Spence JC, Cutumisu N et al. (2010) Association between neighborhood socioeconomic status and screen time among pre-school children: a cross-sectional study. BMC Public Health 10, 367.
56. Gordon-Larsen P, Griffiths P, Bentley ME et al. (2004) Barriers to physical activity: qualitative data on caregiver–daughter perceptions and practices. Am J Prev Med 27, 218223.
57. Hanson MD & Chen E (2007) Socioeconomic status, race, and body mass index: the mediating role of physical activity and sedentary behaviors during adolescence. J Pediatr Psychol 32, 250259.
58. Sacks G, Veerman JL, Moodie M et al. (2011) ‘Traffic-light’ nutrition labelling and ‘junk-food’ tax: a modelled comparison of cost-effectiveness for obesity prevention. Int J Obes (Lond) 35, 10011009.
59. Bond ME, Williams MJ, Crammond B et al. (2010) Taxing junk food: applying the logic of the Henry tax review to food. Med J Aust 193, 472473.
60. Rudd Center For Food Policy & Obesity (2009) Soft Drink Taxes: A Policy Brief. New Haven,CT: Rudd Center For Food Policy & Obesity, Yale University.
61. Fletcher JM, Frisvold D & Tefft N (2010) Can soft drink taxes reduce population weight? Contemp Econ Policy 28, 2335.
62. Drewnowski A (2003) Fat and sugar: an economic analysis. J Nutr 133, issue 3, 838S840S.
63. Drewnowski A & Specter SE (2004) Poverty and obesity: the role of energy density and energy costs. Am J Clin Nutr 79, 616.
64. Drewnowski A (2007) The real contribution of added sugars and fats to obesity. Epidemiol Rev 29, 160171.
65. Janssen I, Katzmarzyk PT, Boyce WF et al. (2004) Overweight and obesity in Canadian adolescents and their associations with dietary habits and physical activity patterns. J Adolesc Health 35, 360367.
66. Faulkner G, Grootendorst P, Nguyen V et al. (2010) Economic Policy, Obesity and Health: A Scoping Review. Final report submitted to the Heart and Stroke Foundation of Canada. Toronto, ON: Exercise Psychology Unit.
67. Bodor JN, Rice JC, Farley TA et al. (2010) The association between obesity and urban food environments. J Urban Health 87, 771781.
68. Li F, Harmer P, Cardinal BJ et al. (2009) Obesity and the built environment: does the density of neighborhood fast-food outlets matter? Am J Health Promot 23, 203209.
69. Rothman KJ, Greenland S & Lash TL (2008) Modern Epidemiology, 3rd ed. Philadelphia, PA: Lippincott Williams & Wilkins.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Public Health Nutrition
  • ISSN: 1368-9800
  • EISSN: 1475-2727
  • URL: /core/journals/public-health-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Altmetric attention score

Full text views

Total number of HTML views: 27
Total number of PDF views: 186 *
Loading metrics...

Abstract views

Total abstract views: 439 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 16th January 2018. This data will be updated every 24 hours.