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In recent years, beverage consumption has become more and more popular among children and teenagers in China (1). For beverages available in the Chinese market, more than half are sugary beverages (2). According to previous studies, excessive consumption of sugary beverages can increase the risk of chronic diseases such as dental cavities and obesity among children and adolescents (3). The Guideline: Sugars Intake for Adults and Children issued by the World Health Organization (WHO) in 2015 claimed that it was important to reduce the intake of free sugars throughout the life cycle (4). The Ending Childhood Obesity report also released by the WHO in 2016 emphasized that comprehensive measures should be applied to promote healthy food intake for children and adolescents and to reduce the intake of sugary beverages (5). This study analyzed the status and features on beverage consumption of Chinese children and adolescents aged 6–17 years and provided scientific support to policymaking.
The data of this study were obtained from the China Nutrition and Health Surveillance of Children and Lactating Mothers in 2016–2017. This study was a cross-sectional study, covering 31 provincial-level administrative divisions (PLADs) including 275 surveillance points in China (6). The survey used multistage stratified random sampling method for nationally and provincially representativeness. Data collection included four parts: interviews to collect demographic information; dietary questionnaires to assess food intake; physical examinations to observe the indicators of growth; and laboratory tests for health conditions. The information on the consumption of beverages was obtained by Food Frequency Questionnaire (FFQ), based on the consumption frequency and consumption of nine types of beverages in the past month. The 9 types of beverages in this study include 100% fruit and vegetable juices, non-100% fruit and vegetable beverages, carbonated beverages, tea beverages, milk-containing beverages, plant protein and cereal beverages, functional beverages, coffee, and other sugary beverages. The samples were grouped by age, sex, and regions. SAS (version 9.4, SAS Institute Inc., Cary, NC, USA) was used to process the quantitative analyses. The protocol of this study was evaluated and approved by the ethical committee China CDC (201614).
A total of 73,427 samples were involved for this report, including 36,701 males (50%) and 36,726 females (50%); and 34,981 (47.6%) in urban areas and 38,446 (52.4%) in rural areas. All subjects were divided into the 6–11 year-old group (44.1%) and 12–17 year-old group (55.9%). The number of children aged 6–11 years was 41,023, including 19,583 (47.7%) in urban areas and 21,440 (52.3%) in rural areas. The number of adolescents aged 12–17 years was 32,404, including 15,398 (47.5%) in urban areas and 17,006 (52.5%) in rural areas.
Table 1 showed that the total beverage consumption rate was 66.2% among children and adolescents aged 6–17 years from 2016 to 2017. The consumption rate was 68.3% for males and 64.1% for females; 71.3% in urban areas and 61.6% in rural areas; and 61.6% for children aged 6–11 years and 72.0% for adolescents aged 12–17 years. The top 3 beverages by consumption rate were carbonated beverages (33.2%), milk-containing beverages (25.0%), and non-100% fruit and vegetable beverages (23.5%). For carbonated beverages, tea beverages, and functional beverages, the consumption rate for males was higher than that for females; for the other six kinds of beverages, the consumption rate for females was higher than that for males.
Beverage categories 6–11 years old 12–17 years old 6–17 years old Male Female Urban Rural Subtotal Male Female Urban Rural Subtotal Male Female Urban Rural Total 100% fruit and vegetable juice 12.9 13.9 21.8 5.8 13.4 12.6 13.6 19.7 7.2 13.1 12.8 13.8 20.9 6.4 13.3 Not 100% fruit and vegetable beverages 21.8 21.6 26.9 16.9 21.7 25.6 26.0 29.6 22.4 25.8 23.5 23.5 28.1 19.3 23.5 Carbonate beverages 31.7 24.7 29.7 26.8 28.2 46.8 32.4 41.1 38.3 39.6 38.4 28.1 34.7 31.9 33.2 Tea beverages 16.9 14.5 18.4 13.3 15.7 33.2 27.0 34.7 26.1 30.1 24.1 20.0 25.6 18.9 22.1 Milk-containing beverages 24.3 26.1 28.9 21.8 25.2 21.0 28.6 25.3 24.3 24.8 22.8 27.2 27.3 22.9 25.0 Vegetable protein and cereal beverages 16.3 16.8 20.1 13.3 16.5 15.4 17.8 19.1 14.3 16.6 15.9 17.2 19.7 13.7 16.6 Functional beverages 8.6 6.0 9.7 5.0 7.3 18.3 9.9 17.0 11.5 14.1 12.9 7.7 12.9 7.9 10.3 Coffee 1.8 1.9 2.3 1.4 1.9 10.0 11.0 14.8 6.7 10.5 5.5 5.9 7.8 3.7 5.7 Other sugary beverages 5.1 5.0 6.3 4.0 5.1 7.7 9.4 9.5 7.7 8.5 6.3 7.0 7.7 5.6 6.6 Total beverages 63.4 59.8 67.5 56.2 61.6 74.5 69.6 76.1 68.4 72.0 68.3 64.1 71.3 61.6 66.2 Table 1. Consumption rate of different types of beverages among children and teenagers aged 6–17 years — China, 2016–2017 (%).
In Table 2, the frequencies of beverage consumption were divided into: ≥1 time/day, 4–6 times/week, 1–3 times/week, and <1 time/week. The percentages among children and adolescents aged 6–17 years were 23.3%, 16.0%, 44.4%, and 16.4%, respectively. The top beverage consumption frequency was 1–3 times per week. The percentage of ≥1 time/day and 4–6 times/week was at a higher rate in males than in females and higher in urban areas and in adolescents aged 12–17 years. The percentages of 1–3 times/week and <1 times/week were at a higher rate in females than in males and higher in rural areas and in children aged 6–11 years. Children aged 6–11 years who consumed functional beverages, coffee, and other sugary beverages had a higher rate of consumption behavior at frequency of <1 time/week, while other groups were involved in a higher frequency of 1–3 times/week. The top 3 beverages presented by frequency of ≥1 time/day were 100% fruit and vegetable juice (13.3%), milk-containing beverages (13.0%), and vegetable protein and cereal beverages (10.2%).
Beverage categories Drinking frequency 6–11 years old 12–17 years old 6–17 years old Male Female Urban Rural Subtotal Male Female Urban Rural Subtotal Male Female Urban Rural Total 100% fruit and vegetable juice ≥1 time/day 11.4 11.9 11.8 11.2 11.7 15.5 15.2 16.4 12.8 15.3 13.2 13.3 13.7 12.0 13.3 4–6 times/week 3.6 3.1 3.5 2.8 3.4 4.6 3.2 3.8 4.2 3.9 4.1 3.2 3.6 3.5 3.6 1–3 times/week 53.9 52.1 52.8 53.3 52.9 54.0 53.1 52.8 55.3 53.5 53.9 52.5 52.8 54.3 53.2 <1 time/week 31.1 32.9 31.9 32.6 32.0 25.9 28.5 27.0 27.7 27.2 28.8 31.0 29.9 30.2 29.9 Not 100% fruit and vegetable beverages ≥1 time/day 5.7 5.4 6.0 4.9 5.5 9.9 8.8 9.6 9.1 9.4 7.7 7.1 7.6 7.1 7.4 4–6 times/week 1.6 1.6 1.6 1.6 1.6 4.8 3.6 4.5 3.8 4.2 3.2 2.5 2.9 2.7 2.8 1–3 times/week 52.7 51.2 51.9 52.0 52.0 59.6 58.7 58.7 59.7 59.1 56.0 54.8 55.1 55.9 55.4 <1 time/week 40.0 41.8 40.6 41.4 40.9 25.7 29.0 27.2 27.5 27.3 33.1 35.6 34.4 34.3 34.3 Carbonate beverages ≥1 time/day 5.1 4.8 4.4 5.6 5.0 10.4 8.1 9.4 9.5 9.4 8.0 6.5 7.0 7.7 7.3 4–6 times/week 2.2 1.3 1.7 2.0 1.8 5.7 3.1 4.8 4.5 4.6 4.1 2.2 3.3 3.3 3.3 1–3 times/week 53.0 51.1 51.0 53.4 52.2 62.2 58.6 60.1 61.4 60.8 58.0 54.9 55.7 57.7 56.7 <1 time/week 39.6 42.7 43.0 39.0 41.0 21.8 30.2 25.7 24.7 25.2 30.0 36.4 34.0 31.4 32.7 Tea beverages ≥1 time/day 5.5 6.0 5.8 5.6 5.7 11.2 9.7 10.5 10.5 10.5 9.0 8.2 8.6 8.6 8.6 4–6 times/week 1.8 1.3 1.4 1.7 1.5 4.7 3.3 4.5 3.7 4.1 3.6 2.5 3.2 2.9 3.1 1–3 times/week 50.5 50.3 49.0 52.2 50.4 61.6 55.9 58.0 60.4 59.1 57.3 53.6 54.4 57.2 55.6 <1 time/week 42.2 42.5 43.7 40.5 42.3 22.4 31.1 27.0 25.5 26.3 30.1 35.7 33.7 31.4 32.7 Milk-containing beverages ≥1 time/day 12.1 11.4 10.7 13.0 11.8 15.4 14.0 14.2 15.0 14.6 13.4 12.6 12.1 13.9 13.0 4–6 times/week 5.0 4.7 4.2 5.6 4.8 6.5 5.6 6.0 5.9 6.0 5.6 5.1 4.9 5.7 5.3 1–3 times/week 55.3 55.6 54.3 56.9 55.5 57.0 57.7 57.0 57.8 57.4 56.0 56.6 55.4 57.3 56.3 <1 time/week 27.6 28.3 30.8 24.5 28.0 21.2 22.7 22.8 21.4 22.1 25.0 25.7 27.5 23.0 25.4 Vegetable protein and cereal beverages ≥1 time/day 8.2 9.1 8.0 9.5 8.7 11.8 12.4 12.7 11.3 12.1 9.7 10.6 10.0 10.4 10.2 4–6 times/week 3.3 3.0 3.1 3.1 3.1 5.0 4.0 4.3 4.6 4.5 4.0 3.4 3.6 3.8 3.7 1–3 times/week 49.8 49.8 49.2 50.6 49.8 54.5 54.4 54.1 54.9 54.4 51.8 51.9 51.3 52.6 51.8 <1 time/week 38.6 38.2 39.7 36.7 38.4 28.8 29.3 28.9 29.2 29.1 34.4 34.2 35.1 33.3 34.3 Functional beverages ≥1 time/day 4.6 5.0 4.7 4.8 4.8 7.5 7.0 7.8 6.8 7.4 6.5 6.1 6.5 6.1 6.3 4–6 times/week 1.1 1.0 0.9 1.4 1.1 3.1 1.4 2.5 2.6 2.5 2.4 1.2 1.8 2.2 2.0 1–3 times/week 42.6 38.9 41.5 40.2 41.1 56.0 50.4 53.3 55.0 54.0 51.0 45.4 48.3 49.8 48.9 <1 time/week 51.7 55.1 52.8 53.6 53.1 33.4 41.2 36.5 35.5 36.1 40.2 47.2 43.4 42.0 42.8 Coffee ≥1 time/day 8.5 5.0 7.4 5.7 6.7 9.6 9.7 9.8 9.5 9.7 9.4 8.9 9.4 8.7 9.1 4–6 times/week 2.1 1.1 1.8 1.3 1.6 5.8 5.6 6.0 5.0 5.7 5.1 4.8 5.3 4.3 4.9 1–3 times/week 33.1 36.9 33.6 37.1 35.0 51.8 47.3 50.0 48.4 49.5 48.3 45.5 47.3 46.0 46.8 <1 time/week 56.3 57.1 57.2 55.9 56.7 32.8 37.4 34.3 37.1 35.2 37.2 40.9 38.1 41.0 39.1 Other sugary beverages ≥1 time/day 7.3 5.0 4.8 8.2 6.2 10.6 9.9 9.3 11.2 10.2 9.1 7.9 7.3 10.0 8.5 4–6 times/week 2.2 1.6 1.5 2.6 1.9 4.3 3.0 3.6 3.7 3.6 3.4 2.5 2.6 3.2 2.9 1–3 times/week 43.4 44.4 40.4 48.8 43.9 56.0 52.9 52.5 56.3 54.3 50.2 49.5 47.0 53.4 49.8 <1 time/week 47.1 48.9 53.3 40.4 48.0 29.0 34.2 34.6 28.8 31.9 37.3 40.2 43.1 33.4 38.8 Total beverages ≥1 time/day 18.1 17.9 19.7 16.1 18.0 30.8 27.3 31.9 26.4 29.1 24.2 22.4 25.4 21.1 23.3 4–6 times/week 14.1 13.6 15.4 12.1 13.8 18.9 17.6 18.9 17.7 18.3 16.4 15.5 17.0 14.9 16.0 1–3 times/week 47.9 47.9 45.9 50.1 47.9 39.3 41.9 38.2 42.9 40.5 43.7 45.0 42.3 46.5 44.4 <1 time/week 20.0 20.7 19.0 21.8 20.3 11.0 13.2 11.1 13.0 12.0 15.7 17.1 15.3 17.5 16.4 Table 2. The distribution of beverage consumption frequency in consumers aged 6–17 years — China, 2016–2017 (%).
Table 3 indicated that among the children and adolescents aged 6–17 years who consumed beverages, the average amount of consumption was 193.8 g/d, which was higher in males (210.6 g/d), urban areas (204.7 g/d), and adolescents aged 12–17 years (259.0 g/d). The top 3 beverages for consumers were tea beverages (100.9 g/d), carbonated beverages (91.6 g/d), and 100% fruit and vegetable juice (81.5 g/d). For children aged 6–11 years old, the top 3 beverages were milk beverages (67.4 g/d), 100% fruit and vegetable juice (66.2 g/d), and tea beverages (65.1 g/d). For the 12–17 year-old group, the top 3 beverages were tea beverages (128.7 g/d), carbonated beverages (122.3 g/d), and 100% fruit and vegetable juice (98.7 g/d).
Age groups Beverage categories The number of consumer Male Female Urban Rural Total Mean P50 Mean P50 Mean P50 Mean P50 Mean P50 6–11 years old 100% fruit and vegetable juice 5,512 67.1 29.6 65.3 28.6 66.7 28.6 64.4 28.6 66.2 28.6 Not 100% fruit and vegetable beverages 8,897 58.5 28.6 54.1 28.6 56.4 28.6 56.3 28.6 56.3 28.6 Carbonate beverages 11,561 65.2 32.9 57.4 28.6 56.0 28.6 67.6 34.3 61.8 32.9 Tea beverages 6,444 67.0 32.9 62.8 32.9 59.6 28.6 72.0 35.7 65.1 32.9 Milk-containing beverages 10,323 68.4 35.7 66.5 35.7 62.3 29.6 73.6 41.1 67.4 35.7 Vegetable protein and cereal beverages 6,786 57.8 28.6 58.2 28.6 56.5 28.6 60.1 31.4 58.0 28.6 Functional beverages 2,981 54.0 24.6 47.2 19.7 48.1 21.4 56.6 23.7 51.2 21.4 Coffee 757 33.3 9.9 27.9 9.2 32.0 9.9 28.4 8.2 30.6 9.9 Other sugary beverages 2,085 51.5 21.4 40.4 16.4 38.9 16.4 56.1 28.6 46.0 19.7 Total beverages 25,280 138.3 71.4 128.6 71.4 140.5 71.4 126.0 71.4 133.6 71.4 12–17 years old 100% fruit and vegetable juice 4,251 104.1 52.6 98.7 42.9 103.5 42.9 95.8 42.9 101.3 42.9 Not 100% fruit and vegetable beverages 8,362 109.7 65.7 89.0 42.9 99.8 57.1 98.7 57.1 99.3 57.1 Carbonate beverages 12,842 130.9 71.4 100.5 57.1 114.6 71.4 122.3 71.4 118.5 71.4 Tea beverages 9,767 139.4 71.4 106.0 57.1 121.0 71.4 128.7 71.4 124.5 71.4 Milk-containing beverages 8,023 92.3 57.1 84.1 45.7 86.9 48.6 88.2 57.1 87.6 51.4 Vegetable protein and cereal beverages 5,376 81.5 42.9 80.5 35.7 82.3 35.7 79.3 41.1 81.0 35.8 Functional beverages 4,563 99.7 50.0 76.1 35.7 93.5 42.9 88.7 49.3 91.5 43.4 Coffee 3,411 64.4 28.6 58.3 28.6 63.1 28.6 57.5 28.6 61.2 28.6 Other sugary beverages 2,765 95.1 42.9 77.6 35.7 82.2 35.7 89.2 42.9 85.5 36.1 Total beverages 23,342 287.9 157.1 227.9 121.4 277.2 149.5 240.7 135.7 259.0 142.9 6–17 years old 100% fruit and vegetable juice 9,763 83.3 38.8 79.8 32.9 82.0 35.7 79.9 34.3 81.5 35.7 Not 100% fruit and vegetable beverages 17,259 83.2 42.9 71.1 35.7 76.5 35.7 78.1 35.7 77.2 35.7 Carbonate beverages 24,403 100.7 54.2 79.2 35.7 86.5 42.9 96.7 49.3 91.6 42.9 Tea beverages 16,211 111.2 57.1 88.4 42.9 96.3 49.3 106.6 57.1 100.9 50.0 Milk-containing beverages 18,346 78.1 42.9 74.6 35.7 72.3 35.7 80.4 42.9 76.2 40.0 Vegetable protein and cereal beverages 12,162 68.0 34.3 68.3 32.9 67.5 31.4 69.0 35.7 68.2 34.3 Functional beverages 7,544 82.7 35.9 63.6 29.1 74.4 32.9 77.3 35.7 75.6 35.7 Coffee 4,168 58.6 28.6 52.9 21.4 57.9 28.6 51.4 21.4 55.7 26.3 Other sugary beverages 4,850 75.1 32.9 62.5 28.6 62.4 28.6 76.1 35.7 68.5 28.6 Total beverages 48,622 210.6 107.1 175.9 85.7 204.7 101.4 182.3 88.6 193.8 98.6 Table 3. Daily consumption of beverages of consumers aged 6–17 years — China, 2016–2017 (g/d).
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