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Inequalities in energy drink consumption among UK adolescents: a mixed-methods study

Inequalities in energy drink consumption among UK adolescents: a mixed-methods study
Inequalities in energy drink consumption among UK adolescents: a mixed-methods study

Objective: To examine energy drink consumption among adolescents in the United Kingdom (UK) and associations with deprivation and dietary inequalities.

Design: Quantitative dietary and demographic data from the National Diet and Nutrition Survey (NDNS) repeated cross-sectional survey were analysed using logistic regression models. Qualitative data from semi-structured interviews were analysed using inductive thematic analysis.

Setting: UK.

Participants: Quantitative data: nationally representative sample of 2587 adolescents aged 11-18 years. Qualitative data: 20 parents, 9 teachers, and 28 adolescents from Hampshire, UK.

Results: NDNS data showed adolescents' consumption of energy drinks was associated with poorer dietary quality (OR 0.46 per SD; 95% CI 0.37, 0.58; p<0.001). Adolescents from more deprived areas and lower income households were more likely to consume energy drinks than those in more affluent areas and households (OR 1.40; 95%CI 1.16, 1.69; p<0.001; OR 0.98 per £1000; 95%CI, 0.96, 0.99; p<0.001 respectively). Between 2008 and 2016, energy drink consumption among adolescents living in the most deprived areas increased, but decreased among those living in the most affluent neighbourhoods (p=0.04). Qualitative data identified three themes. First, many adolescents drink energy drinks because of their friends and because the unbranded drinks are cheap. Second, energy drink consumption clusters with other unhealthy eating behaviours and adolescents don't know why energy drinks are unhealthy. Third, adolescents believe voluntary bans in retail outlets and schools do not work.

Conclusions: This study supports the introduction of age-dependent legal restrictions on the sale of energy drinks which may help curb existing socio-economic disparities in adolescents' energy drink intake.

Adolescents, Diet, Energy drinks, Inequalities, Policy
1368-9800
575-585
Vogel, Christina
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Shaw, Sarah
9629b12a-8ee2-4483-a9ca-6efb4eef74c8
Strömmer, Sofia
ee8d3856-3148-4df6-b2c7-582af21e92a8
Crozier, Sarah
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Jenner, Sarah
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Cooper, Cyrus
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Baird, Janis
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Inskip, Hazel
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Barker, Mary
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Vogel, Christina
708e7fda-a6d3-4362-b5f8-69fe2b3e9d7b
Shaw, Sarah
9629b12a-8ee2-4483-a9ca-6efb4eef74c8
Strömmer, Sofia
ee8d3856-3148-4df6-b2c7-582af21e92a8
Crozier, Sarah
9c3595ce-45b0-44fa-8c4c-4c555e628a03
Jenner, Sarah
6de57ea6-89f7-4bed-8e76-bad5ed5957e8
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Baird, Janis
f4bf2039-6118-436f-ab69-df8b4d17f824
Inskip, Hazel
5fb4470a-9379-49b2-a533-9da8e61058b7
Barker, Mary
374310ad-d308-44af-b6da-515bf5d2d6d2

Vogel, Christina, Shaw, Sarah, Strömmer, Sofia, Crozier, Sarah, Jenner, Sarah, Cooper, Cyrus, Baird, Janis, Inskip, Hazel and Barker, Mary (2023) Inequalities in energy drink consumption among UK adolescents: a mixed-methods study. Public Health Nutrition, 26 (3), 575-585. (doi:10.1017/S1368980022002592).

Record type: Article

Abstract

Objective: To examine energy drink consumption among adolescents in the United Kingdom (UK) and associations with deprivation and dietary inequalities.

Design: Quantitative dietary and demographic data from the National Diet and Nutrition Survey (NDNS) repeated cross-sectional survey were analysed using logistic regression models. Qualitative data from semi-structured interviews were analysed using inductive thematic analysis.

Setting: UK.

Participants: Quantitative data: nationally representative sample of 2587 adolescents aged 11-18 years. Qualitative data: 20 parents, 9 teachers, and 28 adolescents from Hampshire, UK.

Results: NDNS data showed adolescents' consumption of energy drinks was associated with poorer dietary quality (OR 0.46 per SD; 95% CI 0.37, 0.58; p<0.001). Adolescents from more deprived areas and lower income households were more likely to consume energy drinks than those in more affluent areas and households (OR 1.40; 95%CI 1.16, 1.69; p<0.001; OR 0.98 per £1000; 95%CI, 0.96, 0.99; p<0.001 respectively). Between 2008 and 2016, energy drink consumption among adolescents living in the most deprived areas increased, but decreased among those living in the most affluent neighbourhoods (p=0.04). Qualitative data identified three themes. First, many adolescents drink energy drinks because of their friends and because the unbranded drinks are cheap. Second, energy drink consumption clusters with other unhealthy eating behaviours and adolescents don't know why energy drinks are unhealthy. Third, adolescents believe voluntary bans in retail outlets and schools do not work.

Conclusions: This study supports the introduction of age-dependent legal restrictions on the sale of energy drinks which may help curb existing socio-economic disparities in adolescents' energy drink intake.

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Accepted/In Press date: 29 November 2022
e-pub ahead of print date: 6 December 2022
Published date: 1 March 2023
Additional Information: Funding Information: S.Sh., S.C., S.J. and H.I. have no conflicts of interests to declare. C.V. and J.B. have a non-financial research collaboration with a UK supermarket chain. M.B., J.B. and S.St. have received grant research support from Danone Nutricia Early Life Nutrition. C.C. has received consultancy, lecture fees and honoraria from AMGEN, GSK, Alliance for Better Bone Health, MSD, Eli Lilly, Pfizer, Novartis, Servier, Medtronic and Roche. The study described in this manuscript is not related to any of these relationships. Funding Information: Acknowledgements: We are grateful to the participants who took part in the qualitative study. We would like to thank Daniella Watson (DW), Daniel Penn-Newman (DPN) and Taylor Morris (TM) for their assistance with data collection and also acknowledge the contributions of the EACH-B study team. Financial support: This research and the authors of this paper are supported by the following funding sources: UK Medical Research Council, UK NIHR Programme Grants for Applied Research (RP-PG-0216-20004) and NIHR Southampton Biomedical Research Centre. The views expressed in this publication are those of the author(s) and not necessarily those of the National Health Service, the NIHR, the UK Department of Health and Social Care. For the purpose of open access, the authors have applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. Authorship: C.V. conceived of this study with input from M.B., H.I. and J.B. who developed and lead the EACH-B study. S.St. managed the EACH-B developmental work which provided the qualitative data for this study. S.St., S.Sh., S.J. conducted the qualitative data collection. C.V., S.J., S.St. and S.Sh. completed thematic analysis with inputs from M.B. S.C completed the quantitative data analyses in discussion with C.V., S.Sh., J.B., H.M.I. and C.C. C.V., S.Sh., S.St., S.C. and S.J. wrote the first draft of this manuscript. All authors provided input on revisions and approved the final version. Ethics of human subject participation: This study was conducted according to the guidelines laid down in the Declaration of Helsinki and all procedures involving research participants were approved by the University of Southampton, Faculty of Medicine Ethics Committee (ethics approval number 30054) and written informed consent was obtained from all participants. Publisher Copyright: © The Author(s), 2022. Published by Cambridge University Press on behalf of The Nutrition Society.
Keywords: Adolescents, Diet, Energy drinks, Inequalities, Policy

Identifiers

Local EPrints ID: 475716
URI: http://eprints.soton.ac.uk/id/eprint/475716
ISSN: 1368-9800
PURE UUID: 449edc64-5079-4cf9-adb7-5b2ecc02a97b
ORCID for Sarah Shaw: ORCID iD orcid.org/0000-0002-2206-6858
ORCID for Sarah Crozier: ORCID iD orcid.org/0000-0002-9524-1127
ORCID for Sarah Jenner: ORCID iD orcid.org/0000-0002-4644-5027
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for Janis Baird: ORCID iD orcid.org/0000-0002-4039-4361
ORCID for Hazel Inskip: ORCID iD orcid.org/0000-0001-8897-1749
ORCID for Mary Barker: ORCID iD orcid.org/0000-0003-2976-0217

Catalogue record

Date deposited: 27 Mar 2023 16:30
Last modified: 12 Jun 2024 02:00

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Contributors

Author: Christina Vogel
Author: Sarah Shaw ORCID iD
Author: Sofia Strömmer
Author: Sarah Crozier ORCID iD
Author: Sarah Jenner ORCID iD
Author: Cyrus Cooper ORCID iD
Author: Janis Baird ORCID iD
Author: Hazel Inskip ORCID iD
Author: Mary Barker ORCID iD

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