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Sugar Consumption: Case Study on

Adolescents Canned Drink Intake
ARTICLE in JOURNAL OF COMPUTATIONAL AND THEORETICAL NANOSCIENCE OCTOBER 2013
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Sugar Consumption: Case Study on Adolescents

Canned Drink Intake

Che Wan Jasimah Wan Mohamed Radzi1 (corresponding author, email: [email protected]) Phoon
Lee Ying1, Phua En Kiat1, Mahnaz Kazemipoor1, Aini Zaharah Jamungi1

1 Department of Science and Technology Studies, Faculty of Science, University of Malaya, 50603
Lembah Pantai, Kuala Lumpur, Malaysia

ABSTRACT:
The worldwide sugar consumption has been increasing from year to year, from 11
million tons in 1900 to 145 million tons in 2009. High sources of sugar can be found in
different types of food and drinks. It is aimed through this study to identify the trend of
canned drink intake among adolescents in selected places in Malaysia, and to identify
factors influencing adolescents intake of canned drinks. About 400 respondents aged
between 13 and 16 participated in this study. The results show that 73% of respondents
consume canned drinks regularly, and 1 can (51.1%) to 2 cans (17.5%) per day, equal to
7 to 14 teaspoons of sugar on average. Data collected also shows that respondents from
lower income families (55.6%) are more likely to consume compared to those from
higher income families (21.9%). Moreover, results indicate that friends of consumers
had high influence on canned drink intake, as 58.8% of the respondents in this study
consumed the same types of canned drinks as their friends. Perceived parenting style is
also associated with the high-intake trend, where 86% of parents allowed their children
to consume canned drinks. Furthermore, environmental availability of canned drinks
also affects the intake trend. Based on the results, respondents can easily obtain canned
drinks from school (9.8%) rather than their home (33.2%). Finally, we can conclude that
canned drinks contribute to the sugar intake in adolescents daily diet; in other words,
roughly 56% of total sugar consumed per day was from canned drinks. This information
can be used accordingly to predict adolescents sugar intake trend.
Keywords: Canned drinks, adolescents, sugar consumption, health.

1. INTRODUCTION
Sugars are a ubiquitous component entering our diets primarily from foods which can be either

naturally occurring or food additives added to foods during processing, preparation, or at the

table1. The worldwide sugar consumption has been increasing from year to year, such that from

11 million tons in 1900 it went up to 145 million tons in 2009, and is expected to reach 176

million tons by 2015 (see Fig 1)2,3. Sugar intake is especially high throughout the developing

countries, most notably in Asia, India and to a lesser extent Latin America and Africa4. Among
the foods and drinks containing sugar, it has been suggested that the highest sugar consumption

is attributed to the popularity of soft drinks and other sweetened drinks which not only affect

sugar intake, but have also become critical elements in changing the worlds diet and the publics

dietary patterns5,6,7,8.

According to previous studies, sugar can lead to addictions which can affect the human brain

in the same way as tobacco and alcohol. Sugar encourages the brain to crave additional intake

due to its addictive properties9. In fact, a healthy diet should include naturally occurring sugars,

as a natural chemical source from plants such as fruits and vegetables10. Sugar is a form of
carbohydrate, thus it can be a source of energy to maintain proper function of the various

systems in the body11. However, the high intake of sugar, especially added sugar, causes some

health effects such as obesity, diabetes, cardiovascular disease and dental caries in the long
term12,13,14.

As such, sugar consumption is of high concern in most countries, especially in terms of

sweetened drink intake. According to Barbara Levine, liquid intake seriously impacts the overall
diet of American children15. This indicates that drink intake behaviour is one of the critical

components in determining human health outcome. Thus, drink intake patterns have become
one of the subjects studied by numerous researches. Moreover, previous studies prove that

excessive consumption of sweetened drinks is one of the causes of health problems including
diabetes, obesity and dental caries12,13,14,16,17.

Studies done by researchers in Malaysia show that the growing industrialization and

urbanization in this country not only have an impact on Malaysians dietary habits, but also
affect disease patterns18. Sugar consumption in Malaysia has been increasing steadily over the

past 20 years with a compound annual growth rate of 4.1%19. According to the Consumers

Association of Penang (CAP), the sugar consumption trend among Malaysians is reflected in the
serious health problems and debilitating diseases striking Malaysians each day20. In regard to the

health effects of high sugar intake, there have been over 78 ailments linked to high sugar

consumption, from obesity, diabetes, osteoporosis, tooth decay to heart and kidney
problems12,13,14,21.

It is believed that the high sugar intake is one of the contributing factors to the prevalence of

obesity and diabetes among Malaysians22,23. This increased prevalence has become a serious

epidemic due to the unhealthy dietary habits. Since adolescence is a period of life where
nutritional needs increase and change due to the bodys multiple physiological and psychological

changes, assessing Malaysian adolescents food choices and dietary habits, especially in terms of

sugar intake, is important to prevent the progression of the mentioned conditions and related

co-morbidities into adulthood24,25. Hence, in this study, the consumption trend of canned drinks
can be used to estimate sugar intake. Thus far, several studies have measured the relationship

between sweetened drink intake and health problems among adolescents26,27,28,29,30,31. Therefore,

the focus of this paper was to identify the canned drink intake trend and factors that influence

this intake among adolescents. This information can be used in relation to the sugar intake of
Malaysian adolescents.

Fig 1: Word sugar market indicators from 1990 to 20153

2. METHODS
2.1 Sample Selection and Description
Four hundred adolescents between 13 and 16 years old were randomly selected from Petaling

Jaya, Selangor; Puduraya, Kuala Lumpur; Yong Peng, Johor; and Gopeng, Perak, comprising two
hundred females and two hundred males.
2.2 Data collection and analysis
A self-administered questionnaire was designed to collect the data. It included closed-ended

questions by providing a re-existing set of dichotomous answers, allowing respondents to

choose based on their own perspective and opinion to measure the variables being examined in
this study.

3. RESULTS
3.1 Demographic characteristics
A total of 400 respondents between the ages of 13 and 16 were chosen randomly from selected

places in Malaysia. Of the 400 respondents, 50% were female and 50% were male. In addition,
27% of respondents were 13 years old, 27% were 14 years old, 24% were 15 years old and 22%

of respondents were 16 years old.

Besides, the respondents came from a range of socio-economic backgrounds, of which 43.75%

were from low-income families with monthly household incomes lower than RM1000; 28.5% of

them earned RM1001-RM2000 and 13.25% earned RM2001RM3000. Subsequently, a

minority were from higher monthly income households, of which only 7.75% and 6.75% came
from families who earned RM3001-RM4000, and more than RM4000, respectively.

Table 1: Number of respondents by gender, age group and income

Gender

Male

50%

Total

100%

14

27%

Female
Age

13
15
16

Monthly
income

household

Percentage, %

Total

50%
27%
24%
22%

100%

< RM 1000

43.75%

RM 2001 RM 3000

13.25%

RM 1001 RM 2000
RM 3001 RM 4000
>RM 4000
Total

28.5%
7.75%
6.75%
100%

3.2 Canned drink intake trend

Based on Table 2, in terms of canned drink intake, 73% of respondents were canned drink
consumers and the remaining 27% did not consume such drinks. As for the types of canned
drinks, 30% of respondents preferred carbonated drinks while 43% preferred non-carbonated

drinks.

Besides, it has also been found that the canned drinks intake varied according to monthly

household income. The findings of this study indicate that 35.8% of respondents who consumed

canned drinks were from low income families with monthly household incomes lower than

RM1000, followed by 19.8% who were from families with monthly household incomes in the

range of RM1001 to RM 2000, whereas, only 9.6% of respondents were from higher income

families with more than RM3000. The same results are confirmed by previous studies done in

other countries such as the United States, where low-income individuals were more likely to
consume sweetened drinks than high-income individuals32,33.

In addition, the amount of canned drinks consumed per day was also examined, as it may

reflect a trend in canned drink intake among respondents. According to the results, the majority

of respondents consumed 1 (51.1%) to 2 (17.5%) cans per day (see Table 2). Earlier studies

have also found the same intake trend in the United States, where on average, 13 to 18-year-old
adolescent males consumed had 1 to 2 cans of soda pop a day34.

Table 2: Canned drink intake trend of respondents

Intake canned drinks

Yes
No

Respondents that consume

canned drinks (based on
monthly household income)

Total

<RM 1000

RM 1000 RM 2000
RM 2001 RM 3000
RM 3001 RM 4000
>RM 4000

Types of canned drinks

Total

Carbonated

Non-carbonated
Amount of daily canned
drinks intake

Total

Percentage, %
73%
27%

100%

35.8%
19.8%
8.0%
5.3%
4.3%
73%
30%
43%
73%

1 can

51.1%

3 cans

2.9%

2 cans
>3 cans
Total

17.5%
1.5%
73%

3.3 Factors that influence the intake of canned drinks

Influence of friends and parents
Based on the results, friends and parents were the two main factors influencing the intake trend

of canned drinks. Regarding friends, the finding clearly shows that 81% of respondents friends

consumed canned drinks, and as many as 58.8% of respondents consumed the same types of

canned drinks as their friends (see Table 3). According to previous studies, friend influence (also
known as peer pressure) was one of the main factors associated with sweetened drink
consumption, with findings showing that peer pressure and peer modelling influenced the

intake frequency of sweetened drinks among children in India35. This implies that friends can

influence the trend of canned drink intake among adolescents.

While in terms of parental influence, the study shows that 86% of parents allowed their

children to consume canned drinks; out of these, 45% consumed canned drinks themselves.

This is an indication that parenting style and practices can influence their children, with less

restrictive parenting styles leading to a higher intake trend. As stated in previous studies done in
Saudi Arabia, perceived parenting style and practices were associated with intake of sweetened
beverages, where higher perceived restrictive parenting practices were found to be associated

with less sweetened drink consumption; children were more likely to consume sweetened
drinks when their parents consumed sweetened drinks too36,37.

Table 3: Influence of friends and parents on the canned drink intake among respondents

Percentage, %

Friends influence

Friends also consumed canned drinks

Consumed same types of canned drinks with

Parents Influence

friends

Parents also consumed canned drinks

Consumed same types of canned drinks with

parents

Allowed to consume canned rinks by parents

81%

58.8%
45%
28%
86%

Availability of canned drinks

In addition, the availability of canned drinks is another one of the factors affecting intake.
Depending on how easy it was for the respondents to access canned drinks, the intake trend was

affected significantly (Table 4). In terms of home environment, the study found that only 33.2%

of respondents could obtain canned drinks at home and 75.8% stayed in locations where they

can purchase canned drinks from nearby shops selling canned drinks. The same results were

found in previous studied, where home environment variables influenced sweetened drink
consumption. The intake trend was high when sweetened drinks were available at home and
when they could be easily obtained from nearby shops38.

Considering the school environment, the majority of respondents school canteens (96.8%)

sell canned drinks, even though canned drink vending machines are available in certain schools

(10%) only. As a result, as many as 60.5% of respondents purchase canned drinks at school.

Similar findings were observed in America, where the availability of sweetened drinks in schools
through their venues has raised the consumption rate 33,39.

Table 4: Availability of canned drinks in the home and school environments of respondents

Percentage, %

Home

factor

environmental Canned drinks

available at home

House is near shops selling canned

drinks

Purchase canned drinks from nearby

shops

33.2%
75.8%
49.8%

(among those whose homes are nearby

shops selling canned drinks)

School
factor

environmental Canned drinks available at school

Canned drinks vending machines

available at school

Will purchase canned drinks in school

(among those who consume canned

96.8%
10%

60.5%

drinks)

4. DISCUSSION
The convenience of aluminium cans which enable storage of foods and beverages for a long shelf

life and are always ready-to-serve, has lead to the introduction of canned drinks by almost all
beverage companies with the selling point of ready-to-drink. As such, canned drinks potentially

increase the consumption rate of sweetened drinks since it is convenient to do so anytime,

anywhere, without worrying about spilling or preparation. Because canned drinks seem to be

one of the major sources of sugar among adolescents, it is necessary to examine the canned
drink intake trend among this group.

Based on the study, the canned drink intake trend among the respondents was high (73%).

This implies that canned drinks are popular with adolescents. Besides, the result also suggests

that the respondents from lower household income families were more likely to consume
canned drinks than those from higher income household families. This reveals that

socioeconomic status (SES) and parents education background are the two main factors

influencing the canned drink intake trend among adolescents, as confirmed by previous studies

which claim there is a high association between lower socioeconomic status (SES) and the
consumption of energy-dense diets but that are nutrient poor40,41,42.

Besides, both friends and parents play a role in influencing the canned drink intake trend

among adolescents. Principally, friends or peer groups strongly affect adolescents beverage

choices. This is due to the peer pressure created when they try to join or fit in a group of friends,

as suggested in previous studies as well43,44,45. This argument is in further agreement with the
data collected, which shows that 58.8% of respondents consumed the same types of canned

drinks as their friends. Peer pressure seems to have large part in the respondents consumption

of canned drinks, because friends are likely to consume the same canned drinks as their friends
in order to join a certain group.

Other than that, it was found that parents may also play a role in influencing their childrens

beverage choices, since parents are the key factor affecting their childrens nutritional

knowledge and eating behaviour36. The majority of parents (86%) allowed their children to

consume canned drinks, implying that the freedom given by parents, or less parental limits, to
consume canned drinks contribute to the high canned drink intake among adolescents. In other

words, the high canned drink intake among adolescents is associated with less restrictive
parenting practices.

Furthermore, the availability of canned drinks in the home and school environments can

also influence adolescents tendency to consume canned drinks. The study shows that canned

drinks were only available in 33.2% of the respondents homes and 49.8% of them purchase
canned drinks from nearby shops. This implies that the availability and accessibility of sugary
beverages at home as well as their living environment is important because the drinks offered

there can affect the beverage choices of adolescents46,47,48. In addition, according to Haerens et al.

(2007), people were likely to consume unhealthy food and beverage products when these

products were available at home, and less likely to consume them when fewer unhealthy food

and beverages products were available at home49. In terms of school environment, the study
indicates that canned drinks were available at 96.8% of respondents school canteens and out of

those, 60.5% purchased canned drinks at school. Inevitably, the easy accessibility and

availability of canned drinks at school encourages students to consume more canned drinks50.

The canned drink intake can be used to estimate the sugar intake of adolescents by knowing

the sugar content of these beverages (see Figure 2)12,13,14,51. On average, respondents consumed
1 to 2 cans of canned drinks a day. For example, one can of Coca-Cola contains 7 teaspoons of

sugar20, meaning that respondents consumed 7 to 14 teaspoons of sugar per day just from

having canned drinks. According to the Dietary Reference Intake (DRIs), the maximal intake of

added sugar for adolescents is 25 teaspoons, or 100grams, of which 1 teaspoon is equal to 4

grams52. As such, we can estimate that about 56% of total sugar consumed by respondents per
day came from canned drinks. As we know, canned drinks are not the only dietary component
and cannot replace main meals in our daily life. It is still necessary to consume other foods,

especially foods that contain carbohydrates, which can be converted to sugar and energy as

main energy sources for humans to survive. Thus, there is a tendency for an over-intake of

sugar for those consuming 3 or more cans per day.

Fig 2: Sugar content of some canned drinks20

5. CONCLUSION
The findings suggest that canned drinks are a common snack food among adolescents, and
comprise one of the main contributors of sugar in adolescents diets. The canned drink intake

trend is high among adolescents, especially those from lower socio-economic background.
Friends and parents are the two major factors influencing the trend of canned drink intake
among adolescents. Even if canned beverages are not available at home, they may still be easily
accessible at nearby shops. In addition, the presence of vending machines and availability of

canned drinks at schools is sending the wrong message that students are encouraged to
consume canned drinks. Hence, both the availability of canned drinks in the home and school

environments can greatly influence canned drink intake among adolescents. Besides, there is a

high tendency for adolescents to over-intake sugar, with about 56% of total sugar that

respondents consumed in a day coming from canned drinks. Finally, the health impact of high
sweetened drink intake has been of high concern. Regarding this, previous research works

found that the high intake of sugar, especially added sugar, can cause health problems. Sugar has

been linked to over 60 ailments, from dental caries, diabetes, osteoporosis, heart problems to
asthma and allergies12,13,14. Thus, future research can be done to find efficient solutions to reduce

sugar intake, especially among adolescents.

Acknowledgements: We would like to acknowledge the University Malaya Research Grant

(UMRG) Project No: RG108/11SUS for funding this research.

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