Understanding sugar-sweetened beverage purchases at fast food restaurants

introduction: Approximately 50% of adults consume SSBs daily, many at fast food restaurants. We examine fast food purchases to understand which consumers order sugar-sweetened beverages (SSBs), particularly large size SSBs.

 methods: Receipts and surveys were collected from customers exiting chain fast food restaurants in New York City, NY, and Newark and Jersey City, NJ during 2013-2014. Multiple locations of the 5 biggest chains were included. Among respondents who ordered a beverage, regression analysis was conducted to predict the number of beverage calories, sugar (grams), and fluid ounces purchased for the respondent (N=4,127). Separate logistic regressions were used to predict the odds of ordering a SSB (vs another type of beverage) and a large size fountain SSB.  Covariates included demographic and behavioral factors.

 results: Mean beverage calories ordered was 175.53;  66% of respondents ordered an SSB, and 9% a large SSB. Respondents ordered more beverage calories if they also ordered a large combo meal (+96 kcal, P=0.002) or if the restaurant had a large cup size >30 ounces (+18 kcal, P=0.005).  Adjusted odds of ordering an SSB were higher for respondents aged 18-29 years (AOR=2.44 vs. age ≥50 years, P<0.001), were African American (AOR=2.50 vs. white, P<0.001), or stated that they chose their beverage based on price (AOR=2.15 for large SSB, P<0.001).

discussion: Increased understanding of factors influencing SSB purchases is an important first step to considering potential methods to limit unhealthy SSB consumption.