Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Maternal and pediatric nutrition

Adolescents’ beverage choice at school and the impact on sugar intake

European Journal of Clinical Nutrition volume 70, pages 243–249 (2016)Cite this article

Subjects

Abstract

Background/Objectives:

To examine students’ beverage choice in school, with reference to its contribution to students’ intake of non-milk extrinsic (NME) sugars.

Subjects/Methods:

Beverage and food selection data for students aged 11–18 years (n=2461) were collected from two large secondary schools in England, for a continuous period of 145 (school A) and 125 (school B) school days. Descriptive analysis followed by cluster analysis of the beverage data were performed separately for each school.

Results:

More than a third of all items selected by students were beverages, and juice-based beverages were students’ most popular choice (school A, 38.6%; school B, 35.2%). Mean NME sugars derived from beverages alone was high (school A, 16.7 g/student-day; school B, 12.9 g/student-day). Based on beverage purchases, six clusters of students were identified at each school (school A: ‘juice-based’, ‘assorted’, ‘water’, ‘cartoned flavoured milk’, ‘bottled flavoured milk’, ‘high volume juice-based’; school B: ‘assorted’, ‘water with juice-based’, ‘sparkling juice/juice-based’, ‘water’, ‘high volume water’, ‘high volume juice-based’). Both schools included ‘high volume juice-based’ clusters with the highest NME sugar means from beverages (school A, 28.6 g/student-day; school B, 24.4 g/student-day), and ‘water’ clusters with the lowest. A hierarchy in NME sugars was found according to cluster; students in the ‘high volume juice-based’ cluster returned significantly higher levels of NME sugars than students in other clusters.

Conclusions:

This study reveals the contribution that school beverages combined with students’ beverage choice behaviour is making to students’ NME sugar intake. These findings inform school food initiatives, and more generally public health policy around adolescents’ dietary intake.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Department of Health National Child Measurement Programme: England, 2012/13 school year, 2013. http://www.hscic.gov.uk/catalogue/PUB13115/nati-chil-meas-prog-eng-2012-2013-rep.pdf.

  2. Ryley A . Children’s BMI, overweight and obesity. In: Craig R, Mindell J (eds) Health Survey for England 2012. The NHS Information Centre: Leeds, UK, 2013: http://www.hscic.gov.uk/catalogue/PUB13218/HSE2012-Ch11-Child-BMI.pdf.

    Google Scholar 

  3. Department for Education Schools, Pupils and Their Characteristics: January 2014 – Statistical First Release SFR 15/2014 2014: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/335176/2014_SPC_SFR_Text_v101.pdf.

  4. Ensaff H, Russell J, Barker ME . Meeting school food standards - students’ food choice and free school meals. Public Health Nutr 2013; 16: 2162–2168.

    Article  Google Scholar 

  5. Department of Education and Employment. Statutory Instrument 2007 No. 2359. The Education (Nutritional Standards and Requirements for School Food) (England) Regulations 2007. The Stationery Office: London, UK 2007.

  6. Department of Education and Employment Statutory Instrument 2008 No. 1800. The Education (Nutritional Standards and Requirements for School Food) (England) (Amendment) Regulations 2008. The Stationery Office: London, UK 2008.

  7. Department of Education and Employment Statutory Instrument 2011 No. 1190. The Education (Nutritional Standards and Requirements for School Food) (England) (Amendment) Regulations 2011. The Stationery Office: London, UK 2011.

  8. Dimbleby H, Vincent J, The School Food Plan. Department for Education: London: London, 2013. http://www.schoolfoodplan.com/wp-content/uploads/2013/07/School_Food_Plan_2013.pdf.

  9. Department of Education and Employment Statutory Instrument 2014 No. 1603. The Requirements for School Food Regulations 2014. The Stationery Office: London, UK 2014.

  10. Children’s Food TrustUpdated list and definition of drinks permitted in schools in England 2008, Available from http://webarchive.nationalarchives.gov.uk/20091012185423/http://schoolfoodtrust.org.uk/UploadDocs/Contents/Documents/sft_summary_drinks_table_Jan09.pdf.

  11. Department for Education Schools, Pupils and Their Characteristics: January 2011 – Statistical First Release SFR12/2011. Department for Education 2011: http://www.education.gov.uk/rsgateway/DB/SFR/s001012/index.shtml.

  12. Knol LL, Haughton B, Fitzhugh EC . Dietary patterns of young, low-income US children. J Am Diet Assoc 2005; 105: 1765–1773.

    Article  Google Scholar 

  13. Duffey KJ, Steffen LM, Van Horn L, Jacobs DR, Popkin BM . Dietary patterns matter: diet beverages and cardiometabolic risks in the longitudinal Coronary Artery Risk Development in Young Adults (CARDIA) Study. Am J Clin Nutr 2012; 95: 909–915.

    Article  CAS  Google Scholar 

  14. Danyliw AD, Vatanparast H, Nikpartow N, Whiting SJ . Beverage intake patterns of Canadian children and adolescents. Public Health Nutr 2011; 14: 1961–1969.

    Article  Google Scholar 

  15. Smith ADAC, Emmett PM, Newby PK, Northstone K . A comparison of dietary patterns derived by cluster and principal components analysis in a UK cohort of children. Eur J Clin Nutr 2011; 65: 1102–1109.

    Article  CAS  Google Scholar 

  16. Northstone K, ADAC Smith, Newby PK, Emmett PM . Longitudinal comparisons of dietary patterns derived by cluster analysis in 7- to 13-year-old children. Br J Nutr 2013; 109: 2050–2058.

    Article  CAS  Google Scholar 

  17. Schröder H, Mendez MA, Ribas L, Funtikova AN, Gomez SF, Fíto M et al. Caloric beverage drinking patterns are differentially associated with diet quality and adiposity among Spanish girls and boys. Eur J Pediatr 2014; 173: 1169–1177.

    Article  Google Scholar 

  18. Dennison BA . Fruit juice consumption by infants and children: a review. J Am Coll Nutr 1996; 15: 4S–11S.

    Article  CAS  Google Scholar 

  19. Mintel Fruit juice, juice drinks and smoothies – UK. Mintel: London 2013.

  20. Caswell H . The role of fruit juice in the diet: an overview. Nutr Bull 2009; 34: 273–288.

    Article  Google Scholar 

  21. Popkin BM . Patterns of beverage use across the lifecycle. Physiol Behav 2010; 100: 4–9.

    Article  CAS  Google Scholar 

  22. Coppinger T, Jeanes Y, Mitchell M, Reeves S . Beverage consumption and BMI of British schoolchildren aged 9–13 years. Public Health Nutr 2011; 16: 1244–1249.

    Article  Google Scholar 

  23. Garriguet D . Beverage consumption of children and teens. Health Rep 2008; 19: 17–22.

    PubMed  Google Scholar 

  24. Ng SW, Ni Mhurchu C, Jebb SA, Popkin BM . Patterns and trends of beverage consumption among children and adults in Great Britain, 1986–2009. Br J Nutr 2012; 108: 536–551.

    Article  CAS  Google Scholar 

  25. Wescott RF, Fitzpatrick BM, Phillips E . Industry self-regulation to improve student health: quantifying changes in beverage shipments to schools. Am J Public Health 2012; 102: 1928–1935.

    Article  Google Scholar 

  26. LaRowe TL, Moeller SM, Adams AK . Beverage patterns, diet quality, and body mass index of US preschool and school-aged children. J Am Diet Assoc 2007; 107: 1124–1133.

    Article  CAS  Google Scholar 

  27. Lambert N, Plumb J, Looise B, Johnson IT, Harvey I, Wheeler C et al. Using smart card technology to monitor the eating habits of children in a school cafeteria: 1. Developing and validating the methodology. J Hum Nutr Diet 2005; 18: 243–254.

    Article  CAS  Google Scholar 

  28. O’Neil CE, Nicklas TA, Kleinman R . Relationship between 100% juice consumption and nutrient intake and weight of adolescents. Am J Heal Promot 2010; 24: 231–237.

    Article  Google Scholar 

  29. Ruxton CHS . Smoothies: one portion or two? Nutr Bull 2008; 33: 129–132.

    Article  Google Scholar 

  30. Moynihan PJ . Dietary advice in dental practice. Br Dent J 2002; 193: 563–568.

    Article  CAS  Google Scholar 

  31. Gill JM, Sattar N . Fruit juice: just another sugary drink? Lancet Diabetes Endocrinol 2014; 2: 444–446.

    Article  Google Scholar 

  32. Bazzano LA, Li TY, Joshipura KJ, Hu FB . Intake of fruit, vegetables, and fruit juices and risk of diabetes in women. Diabetes Care 2008; 31: 1311–1317.

    Article  CAS  Google Scholar 

  33. Odegaard AO, Koh WP, Arakawa K, Yu MC, Pereira MA . Soft drink and juice consumption and risk of physician-diagnosed incident type 2 diabetes: The Singapore Chinese health study. Am J Epidemiol 2010; 171: 701–708.

    Article  Google Scholar 

  34. Muraki I, Imamura F, Manson JE, Hu FB, Willett WC, van Dam RM et al. Fruit consumption and risk of type 2 diabetes: results from three prospective longitudinal cohort studies. BMJ 2013; 347: f5001.

    Article  Google Scholar 

  35. Patel AI, Bogart LM, Elliott MN, Lamb S, Uyeda KE, Hawes-Dawson J et al. Increasing the availability and consumption of drinking water in middle schools: a pilot study. Prev Chronic Dis 2011; 8: A60.

    PubMed  PubMed Central  Google Scholar 

  36. Muckelbauer R, Libuda L, Clausen K, Toschke AM, Reinehr T, Kersting M . Promotion and provision of drinking water in schools for overweight prevention: randomized, controlled cluster trial. Pediatrics 2009; 123: e661–e667.

    Article  Google Scholar 

  37. Monsivais P, Rehm CD . Potential nutritional and economic effects of replacing juice with fruit in the diets of children in the United States. Arch Pediatr Adolesc Med 2012; 166: 459–464.

    Article  Google Scholar 

  38. Daniels MC, Popkin BM . Impact of water intake on energy intake and weight status: A systematic review. Nutr Rev 2010; 68: 505–521.

    Article  Google Scholar 

  39. Sartor F, Donaldson LF, Markland DA, Loveday H, Jackson MJ, Kubis HP . Taste perception and implicit attitude toward sweet related to body mass index and soft drink supplementation. Appetite 2011; 57: 237–246.

    Article  Google Scholar 

  40. Holsten JE, Deatrick JA, Kumanyika S, Pinto-Martin J, Compher CW . Children’s food choice process in the home environment. A qualitative descriptive study. Appetite 2012; 58: 64–73.

    Article  Google Scholar 

Download references

Acknowledgements

We are very grateful to the two schools and Local Authority catering service for participating in the study.

Author contributions

HE conceived the study and recruited the schools and catering company with advice from MEB. HE, MEB and JR designed the study. JR constructed the data sets and conducted the analysis. HE wrote the first draft of the article with advice from MEB and JR. All authors contributed to the drafting and approval of the final manuscript.

Author information

Author notes

  1. H Ensaff

    Present address: 3Current address: Nutrition & Dietetics, Leeds Metropolitan University, Leeds, UK.,

Authors and Affiliations

  1. Department of Oncology, Human Nutrition Unit, The Medical School, University of Sheffield, Sheffield, UK

    H Ensaff & M E Barker

  2. Corporate Information and Computing Services, University of Sheffield, Sheffield, UK

    J Russell

Authors
  1. H Ensaff
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J Russell
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M E Barker
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to H Ensaff.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Appendix

Appendix

Table A1 Provision of beverages in schools as outlined in the school food standards, compiled from Nutritional Standards and Requirements for School Food Regulations5, 6, 7, 10 with notable adjustments as stipulated by the new standards for food in schools9
Full size table

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ensaff, H., Russell, J. & Barker, M. Adolescents’ beverage choice at school and the impact on sugar intake. Eur J Clin Nutr 70, 243–249 (2016). https://doi.org/10.1038/ejcn.2015.158

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ejcn.2015.158

Search

Advanced search

Quick links