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Dietary and Health Correlates of Sweetened Beverage Intake: Sources of Variability in WWEIA/NHANESGabrielle Riley Bonanno (12126753) 18 April 2022 (has links)
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<p>Recent studies using data from the National Health and Nutrition Examination Survey
(NHANES) have used inconsistent approaches to identify and categorize beverages, especially
those containing low-calorie sweeteners (LCS), also referred to as low-calorie sweetened
beverages (LCSB). Herein, we investigate the approaches used to identify and categorize LCSB
in recent analyses of NHANES data. We reviewed published studies examining LCS consumption
in relation to dietary and health outcomes and extracted the methods used to categorize LCS as
reported by the authors of each study. We then examined the extent to which these approaches
reliability identified LCSBs using the Internet Archive Wayback Machine to examine beverage
ingredients lists across 3 NHANES cycles (2011-2016). None of the four general strategies
appeared to include all LCSB while also excluding all beverages that did not contain LCS. In some
cases, the type of sweetener in the beverage consumed could not be clearly determined; we found
9, 16, and 18 of such “mixed” beverage identifiers in 2011-12, 2013-14, and 2015-15, respectively.
Then, to illustrate how heterogeneity in beverage categorization may impact the outcomes of
published analyses, we compared results of a previously published analysis with outcomes when
“mixed” beverages were grouped either all as LCSB or all as sugary beverages. Our results suggest
that caution is warranted in design and interpretation of studies using NHANES data to examine
dietary and health correlates of sweetened beverage intake.
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