A dynamic panel model of the associations of sweetened beverage purchases with dietary quality and food-purchasing patterns
Piernas C., Ng SW., Mendez MA., Gordon-Larsen P., Popkin BM.
© 2015 © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org. Investigating the association between consumption of sweetened beverages and dietary quality is challenging because issues such as reverse causality and unmeasured confounding might result in biased and inconsistent estimates. Using a dynamic panel model with instrumental variables to address those issues, we examined the independent associations of beverages sweetened with caloric and low-calorie sweeteners with dietary quality and food-purchasing patterns. We analyzed purchase data from the Homescan survey, an ongoing, longitudinal, nationally representative US survey, from 2000 to 2010 (n = 34,294). Our model included lagged measures of dietary quality and beverage purchases (servings/day in the previous year) as exposures to predict the outcomes (macronutrient (kilocalories per capita per day; %), total energy, and food purchases) in the next year after adjustment for other sociodemographic covariates. Despite secular declines in purchases (kilocalories per capita per day) from all sources, each 1-serving/day increase in consumption of either beverage type resulted in higher purchases of total daily kilocalories and kilocalories from food, carbohydrates, total sugar, and total fat. Each 1-serving/day increase in consumption of either beverage was associated with more purchases of caloric-sweetened desserts or sweeteners, which accounted for a substantial proportion of the increase in total kilocalories. We concluded that consumers of both beverages sweetened with low-calorie sweeteners and beverages sweetened with caloric sweeteners had poorer dietary quality, exhibited higher energy from all purchases, sugar, and fat, and purchased more caloric-sweetened desserts/caloric sweeteners compared with nonconsumers.