Knowledge and intake of sugary drinks: a cross-sectional study from the International Food Policy Study.

BACKGROUND: Lack of knowledge about sugary drinks may contribute to the high prevalence of consumption. OBJECTIVES: This study aimed to assess knowledge of 1) sugar content, and 2) health effects of sugary drinks and associations with intake. DESIGN: Annual cross-sectional data from the International Food Policy Study were analyzed. Using pooled data from 2018 to 2021, Study 1 assessed knowledge of sugar content of sugary drinks within ±4 grams (1 teaspoon) of the actual value for 1 of 7 beverage types. Using data from 2019 and 2020 only, Study 2 assessed knowledge of health effects (obesity, diabetes, and tooth decay) with true/false measures. Sugary drink frequency of intake was assessed using a Beverage Frequency Questionnaire. PARTICIPANTS/SETTINGS: A total of 61,002 and 37,965 adults (aged 18 and over) from Australia, Canada, Mexico, the United Kingdom, and the United States were included in Studies 1 and 2, respectively. MAIN OUTCOME MEASURES: The main outcome measures were self-reported knowledge and intake of sugary drinks. STATISTICAL ANALYSIS PERFORMED: Negative binomial regressions examined the association between knowledge and sugary drink frequency of intake. Logistic regression models examined differences in knowledge of health effects between countries. RESULTS: Few participants correctly estimated the sugar content of beverages, except for water. Underestimation was most frequent for chocolate milk (34.9%) and 100% juice (29.7%), and overestimation most frequent for energy and diet soft drinks (51.3% and 50.5%, respectively). Most participants agreed sugary drink consumption can cause obesity (93.3%), diabetes (92.3%), and tooth decay (94.5%), with highest overall agreement in Mexico and Australia. In relatively few countries, knowledge of the sugar content of sports drinks, 100% juices, and diet soft drinks, as well as knowledge of health effects of sugary drinks, were associated with intake. No associations were found for chocolate milk, iced tea, and energy drinks. CONCLUSION: Findings indicate high awareness of the health effects of sugary drinks, but lower knowledge of their sugar content. The inconsistent findings between knowledge and intake indicate that measures only targeting knowledge may have limited impact.