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Global Patterns of Adolescent Fruit, Vegetable, Carbonated Soft Drink, and Fast-Food Consumption: A Meta-Analysis of Global School-Based Student Health Surveys
Open accessAbstract
Background: Adolescence presents an opportunity to influence diet, which impacts present and future health outcomes, yet adolescent diets globally are poorly understood. Objective: We generate evidence on adolescent diets globally and explore patterns and trends by subpopulation. Methods: We estimated mean frequency of consumption and prevalence of less-than-daily fruit and vegetable consumption, at-least-daily carbonated beverage consumption, and at-least-weekly fast-food consumption among school-going adolescents aged primarily 12 to 17 years from the Global School-based Student Health Surveys in Africa, Asia, Oceania, and Latin America between 2008 and 2015. Random-effects meta-analysis was used to pool estimates globally and by subgroup. Results: On average, adolescents consumed fruit 1.43 (95% confidence interval [CI] 1.26–1.60) times per day, vegetables 1.75 (1.58–1.92) times per day, carbonated soft drinks 0.99 (0.77–1.22) times per day, and fast food 1.05 (0.78–1.32) times per week. Overall, 34.5% (95% CI 29.4–39.7) consumed fruit less than once per day, 20.6% (15.8–25.9) consumed vegetables less than once per day, 42.8% (35.2–50.7) drank carbonated soft drinks at least once per day, and 46.1% (38.6–53.7) consumed fast food at least once per week. Mean daily frequency of fruit consumption was particularly low in South and East Asia (1.30 [1.02–1.58]); carbonated soft drink consumption high in Latin America (1.54 [1.31–1.78]), high-income countries (1.66 [1.29–2.03]), and modern food system typologies (1.44 [0.75–2.12]); and mean weekly fast food consumption high in mixed food system typologies (1.29 [0.88–1.71]). Conclusions: School-going adolescents infrequently consume fruits and vegetables and frequently consume carbonated soft drinks, but there is wide variability by subpopulation.
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“A meta-analysis examining the Global School-based Student Health Surveys from 2008 to 2015 including Africa, Asia, Oceania, and Latin America revealed that 35% of adolescents do not meet the recommended intake of FV, 43% consume sugary sweetened beverages (SSBs) daily, and 46% eat processed foods at least weekly [12].”
From School-based healthy eating interventions for adolescents aged 10–19 years: an umbrella review (2024) · cites this paper as [12]
In the citing paper
“A meta-analysis examining the Global School-based Student Health Surveys from 2008 to 2015 including Africa, Asia, Oceania, and Latin America revealed that 35% of adolescents do not meet the recommended intake of FV, 43% consume sugary sweetened beverages (SSBs) daily, and 46% eat processed foods at least weekly [12].”
From School-based healthy eating interventions for adolescents aged 10–19 years: an umbrella review (2024) · cites this paper as [12]
In the citing paper
“Adolescents in both low- and middle-income countries (LMICs) and high-income countries (HICs) frequently have diets that are calorie-dense yet nutrient-deficient, marked by excessive consumption of sugar-sweetened beverage (SSB), ultra-processed foods, and insufficient intake of FV [11–13].”
From School-based healthy eating interventions for adolescents aged 10–19 years: an umbrella review (2024) · cites this paper as [12]
In the citing paper
“A meta-analysis examining the Global School-based Student Health Surveys from 2008 to 2015 including Africa, Asia, Oceania, and Latin America revealed that 35% of adolescents do not meet the recommended intake of FV, 43% consume sugary sweetened beverages (SSBs) daily, and 46% eat processed foods at least weekly [12].”
From School-based healthy eating interventions for adolescents aged 10–19 years: an umbrella review (2024) · cites this paper as [12]
Citations
Cites
A Simple Sequentially Rejective Multiple Test Procedure
(1979) · Scandinavian Journal of Statistics · doi:10.2307/4615733 · Cited by 21,526
Conducting Meta-Analyses in R with the metafor Package
Viechtbauer, W. (2010) · Journal of Statistical Software · doi:10.18637/jss.v036.i03 · Cited by 20,464 · cited 2×
“F tests (allowing a variable t(2)), which are similar to the Knapp and Hartung method(40) and generally result in more conservative P values than w(2) tests, were used to test for overall differences between groups (region, income, and FST) and subgroups (sex).(36,41) Any outcome variables with an F test P value below…”
MethodNg, M., Fleming, T., Robinson, M., Thomson, B., Graetz, N., Margono, C., Mullany, E. C., Biryukov, S., Abbafati, C., Abera, S. F., et al. (2014) · The Lancet · doi:10.1016/s0140-6736(14)60460-8 · Cited by 11,952
Lim, S. S., Vos, T., Flaxman, A. D., Danaei, G., Shibuya, K., Adair-Rohani, H., AlMazroa, M. A., Amann, M., Anderson, H. R., Andrews, K. G., et al. (2012) · The Lancet · doi:10.1016/s0140-6736(12)61766-8 · Cited by 11,805
Maternal and child undernutrition and overweight in low-income and middle-income countries
Black, R. E., Victora, C. G., Walker, S. P., Bhutta, Z. A., Christian, P., de Onis, M., Ezzati, M., Grantham-McGregor, S., Katz, J., Martorell, R., et al. (2013) · The Lancet · doi:10.1016/s0140-6736(13)60937-x · Cited by 8,475
Abarca-Gómez, L., Abdeen, Z. A., Hamid, Z. A., Abu-Rmeileh, N. M., Acosta-Cazares, B., Acuin, C., Adams, R. J., Aekplakorn, W., Afsana, K., Aguilar-Salinas, C. A., et al. (2017) · The Lancet · doi:10.1016/s0140-6736(17)32129-3 · Cited by 7,482
Cochrane Handbook for Systematic Reviews of Interventions
Tarsilla, M. (2010) · Journal of MultiDisciplinary Evaluation · doi:10.56645/jmde.v6i14.284 · Cited by 5,232
Our future: a Lancet commission on adolescent health and wellbeing
Patton, G. C., Sawyer, S. M., Santelli, J. S., Ross, D. A., Afifi, R., Allen, N. B., Arora, M., Azzopardi, P., Baldwin, W., Bonell, C., et al. (2016) · The Lancet · doi:10.1016/s0140-6736(16)00579-1 · Cited by 3,785 · cited 1×
“8 billion).(4,5) Adolescent diets are typically characterized by low intakes of fruits and vegetables and high intakes of energy-dense, nutrient-poor foods, including sweet and salty items, sugar-sweetened beverages, and fast foods.”
BackgroundAdolescence: A foundation for future health
Sawyer, S. M., Afifi, R. A., Bearinger, L. H., Blakemore, S.-J., Dick, B., Ezeh, A. C., & Patton, G. C. (2012) · The Lancet · doi:10.1016/s0140-6736(12)60072-5 · Cited by 2,635
Barendregt, J. J., Doi, S. A., Lee, Y. Y., Norman, R. E., & Vos, T. (2013) · Journal of Epidemiology and Community Health · doi:10.1136/jech-2013-203104 · Cited by 2,169 · cited 1×
“Variance in the raw prevalences was stabilized using a double arcsine transformation and back-transformed by the inverse of the double arcsine transformation using the harmonic mean of the sample sizes.(38,39) I(2) was calculated to present the percentage of variability due to study heterogeneity.”
MethodImproved tests for a random effects meta‐regression with a single covariate
Knapp, G., & Hartung, J. (2003) · Statistics in Medicine · doi:10.1002/sim.1482 · Cited by 2,075
Principles Of Nutritional Assessment
Gibson, R. S. (2005) · doi:10.1093/oso/9780195171693.001.0001 · Cited by 1,887
Childhood obesity: causes and consequences
Sahoo, K., Sahoo, B., Choudhury, A., Sofi, N. Y., Kumar, R., & Bhadoria, A. (2015) · Journal of Family Medicine and Primary Care · doi:10.4103/2249-4863.154628 · Cited by 1,790 · cited 1×
“Fast-food consumption among adolescents is associated with obesity and metabolic markers of diabetes and cardiovascular disease.(22,23) While there is growing global evidence for adult dietary patterns,(24) there is limited evidence on adolescent diets.”
BackgroundHealth-promoting components of fruits and vegetables in the diet.
Liu, R. H. (2013) · Advances in Nutrition · doi:10.3945/an.112.003517 · Cited by 1,310 · cited 1×
“Fruits and vegetables are rich in micronutrients, fiber, and beneficial bioactive compounds.(15) High intakes of fruits and vegetables are associated with increased blood vitamin concentrations among European adolescents,(16) and low intakes are a major contributor to the global burden of disease, particularly noncomm…”
BackgroundBorenstein, M., Hedges, L. V., Higgins, J. P. T., Rothstein, H. R., & Den, A. B. V. (2020) · International Coaching Psychology Review · doi:10.53841/bpsicpr.2020.15.2.121 · Cited by 1,260
Hu, F. B. (2013) · Obesity Reviews · doi:10.1111/obr.12040 · Cited by 884
Complications of obesity in children and adolescents
Daniels, S. R. (2009) · International Journal of Obesity · doi:10.1038/ijo.2009.20 · Cited by 601
Childhood and adolescent overweight and obesity in Latin America: a systematic review
Rivera, J. Á., de Cossío, T. G., Pedraza, L. S., Aburto, T. C., Sánchez-Pimienta, T. G., & Martorell, R. (2013) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(13)70173-6 · Cited by 532 · cited 1×
“For example, taxing sugar-sweetened beverages or other unhealthy foods in Latin America and high-income countries has potential to reduce intake among adolescents.(50) Low-quality diets among adolescents, in addition to low physical activity, are likely contributing to the coexistence of undernutrition, overweight/obe…”
BackgroundThe Inverse of the Freeman – Tukey Double Arcsine Transformation
Miller, J. J. (1978) · The American Statistician · doi:10.1080/00031305.1978.10479283 · Cited by 501 · cited 1×
“Variance in the raw prevalences was stabilized using a double arcsine transformation and back-transformed by the inverse of the double arcsine transformation using the harmonic mean of the sample sizes.(38,39) I(2) was calculated to present the percentage of variability due to study heterogeneity.”
MethodMicha, R., Khatibzadeh, S., Shi, P., Andrews, K. G., Engell, R. E., & Mozaffarian, D. (2015) · BMJ Open · doi:10.1136/bmjopen-2015-008705 · Cited by 473
Adolescent Undernutrition: Global Burden, Physiology, and Nutritional Risks
Christian, P. S., & Smith, E. R. (2018) · Annals of Nutrition and Metabolism · doi:10.1159/000488865 · Cited by 444
Complications of obesity in children and adolescents
Pavlovskaya, E. V., Bagaeva, M. E., Starodubova, A. V., Surkov, A. G., & Каганов, Б. С. (2012) · Voprosy praktičeskoj pediatrii · doi:10.20953/1817-7646-2013-3-50-58 · Cited by 376
Akseer, N., Al‐Gashm, S., Mehta, S., Mokdad, A. H., & Bhutta, Z. A. (2017) · Annals of the New York Academy of Sciences · doi:10.1111/nyas.13336 · Cited by 274 · cited 2×
“8 billion).(4,5) Adolescent diets are typically characterized by low intakes of fruits and vegetables and high intakes of energy-dense, nutrient-poor foods, including sweet and salty items, sugar-sweetened beverages, and fast foods.”
BackgroundA review of sugar consumption from nationally representative dietary surveys across the world
Newens, K. J., & Walton, J. (2015) · Journal of Human Nutrition and Dietetics · doi:10.1111/jhn.12338 · Cited by 232 · cited 1×
“A recent review of sugar consumption in Europe and North America found that adolescents consumed more added sugars than any other age-group.(44) Frequency of fastfood consumption appeared to be less common, but the GSHS only asked about fast-food consumption from restaurants, and there was likely substantial consumpti…”
BackgroundKeats, E. C., Rappaport, A. I., Shah, S., Oh, C., Jain, R., & Bhutta, Z. A. (2018) · Nutrients · doi:10.3390/nu10121978 · Cited by 210
Caleyachetty, R., Thomas, G. N., Kengne, A. P., Echouffo-Tcheugui, J. B., Schilsky, S., Khodabocus, J., & Uauy, R. D. (2018) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/nqy105 · Cited by 207
Prevalence of metabolic syndrome (MS) in children and adolescents with varying degrees of obesity
Calcaterra, V., Klersy, C., Muratori, T., Telli, S., Caramagna, C., Scaglia, F., Cisternino, M., & Larizza, D. (2007) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2007.03115.x · Cited by 196
Interventions to Improve Adolescent Nutrition: A Systematic Review and Meta-Analysis
Salam, R. A., Hooda, M., Das, J. K., Arshad, A., Lassi, Z. S., Middleton, P., & Bhutta, Z. A. (2016) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2016.06.022 · Cited by 176
Fruit and vegetable consumption trends among adolescents from 2002 to 2010 in 33 countries
Vereecken, C. A., Pedersen, T. P., Ojala, K., Krølner, R. F., Dzielska, A., Ahluwalia, N., Giacchi, M. V., & Kelly, C. N. M. (2015) · European Journal of Public Health · doi:10.1093/eurpub/ckv012 · Cited by 170 · cited 1×
“An analysis of the 2010 Health Behavior in School-aged Children (HBSC) study provided insight into the frequency of fruit and vegetable consumption in 33 mostly high-income countries in North America and Europe, but these findings are not generalizable to low- and middle-income countries.(26) To our knowledge, there h…”
BackgroundHarnessing adolescent values to motivate healthier eating
Bryan, C. J., Yeager, D. S., Hinojosa, C., Chabot, A., Bergen, H., Kawamura, M., & Steubing, F. (2016) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1604586113 · Cited by 150 · cited 1×
“Adolescents are unlikely to be motivated by a desire for health in the distant future, and creative interventions that harness widely shared adolescent values are needed to successfully improve diets.(51) 456 Food and Nutrition Bulletin 40(4)”
BackgroundSystematic review on evidence‐based adolescent nutrition interventions
Lassi, Z. S., Moin, A., Das, J. K., Salam, R. A., & Bhutta, Z. A. (2017) · Annals of the New York Academy of Sciences · doi:10.1111/nyas.13335 · Cited by 117
Caleyachetty, R., Echouffo-Tcheugui, J. B., Tait, C. A., Schilsky, S., Forrester, T., & Kengne, A. P. (2015) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(15)00076-5 · Cited by 97 · cited 2×
“A meta-analysis of the prevalence of risk factors for cardiovascular disease included pooled estimates of combined low fruit and vegetable intake, defined as consuming fruits or vegetables less than 5 times per day, among school-going adolescents aged 12 to 15 years between 2003 and 2011.(25) But this analysis did not…”
BackgroundMethodChild undernutrition: opportunities beyond the first 1000 days
Georgiadis, A., & Penny, M. E. (2017) · The Lancet Public Health · doi:10.1016/s2468-2667(17)30154-8 · Cited by 94
Nutrient content of products served by leading Australian fast food chains
Dunford, E., Webster, J. L., Barzi, F., & Neal, B. C. (2010) · Appetite · doi:10.1016/j.appet.2010.08.015 · Cited by 93
Fast-food menu offerings vary in dietary quality, but are consistently poor
Kirkpatrick, S. I., Reedy, J., Kahle, L. L., Harris, J. L., Ohri-Vachaspati, P., & Krebs-Smith, S. M. (2014) · Public Health Nutrition · doi:10.1017/s1368980012005563 · Cited by 90
Nutrient quality of fast food kids meals
O’Donnell, S., Hoerr, S. L., Mendoza, J. A., & Goh, E. T. (2008) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.2008.26197 · Cited by 88
Patel, V., Chisholm, D., Dua, T., Laxminarayan, R., & Medina‐Mora, M. E. (2016) · Cited by 80
Breakfast and fast food consumption are associated with selected biomarkers in adolescents
Marlatt, K. L., Farbakhsh, K., Dengel, D. R., & Lytle, L. A. (2016) · Preventive Medicine Reports · doi:10.1016/j.pmedr.2015.11.014 · Cited by 63 · cited 1×
“Fast-food consumption among adolescents is associated with obesity and metabolic markers of diabetes and cardiovascular disease.(22,23) While there is growing global evidence for adult dietary patterns,(24) there is limited evidence on adolescent diets.”
BackgroundAlimi, B. A., & Workneh, T. S. (2015) · International Journal of Consumer Studies · doi:10.1111/ijcs.12248 · Cited by 62 · cited 1×
“Street foods are increasingly common in Latin America, Asia, and Africa and makeup a significant portion of the urban food supply.(45,46) When fast foods were considered as meals purchased outside the home, 93% of adolescent girls from low- and middle-income countries globally were found to consume them at least weekl…”
BackgroundChildhood and adolescent obesity and long‐term cognitive consequences during aging
Wang, J., Freire, D., Knable, L. A., Zhao, W., Gong, B., Mazzola, P., Ho, L., Levine, S., & Pasinetti, G. M. (2014) · The Journal of Comparative Neurology · doi:10.1002/cne.23708 · Cited by 55
Golley, R. K., Bell, L., Hendrie, G. A., Rangan, A., Spence, A. C., McNaughton, S. A., Carpenter, L. M., Allman-Farinelli, M. A., de Silva, A. M., Gill, T. P., et al. (2016) · Journal of Human Nutrition and Dietetics · doi:10.1111/jhn.12399 · Cited by 49 · cited 1×
“Recall of usual frequency among adolescents is less accurate and valid than 24-hour recall, particularly for foods uncommonly consumed and among younger adolescents.(48,49) Finally, FSTs were not based on the year the survey was conducted, thus some countries may have been classified differently during the survey year.”
BackgroundMielgo‐Ayuso, J., Valtueña, J., Huybrechts, I., Breidenassel, C., Cuenca‐García, M., Henauw, S. D., Stehle, P., Kafatos, A., Kersting, M., Widhalm, K., et al. (2017) · European Journal of Clinical Nutrition · doi:10.1038/ejcn.2016.232 · Cited by 44
Candler, T. P., Costa, S., Heys, M., Costello, A. M. D. L., & Viner, R. (2017) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2016.11.003 · Cited by 37
International summit on the nutrition of adolescent girls and young women: consensus statement
Krebs, N. F., Bagby, S. P., Bhutta, Z. A., Dewey, K. G., Fall, C. H. D., Gregory, F., Hay, W. W., Rhuman, L., Caldwell, C. W., & Thornburg, K. L. R. (2017) · Annals of the New York Academy of Sciences · doi:10.1111/nyas.13417 · Cited by 24
Adolescents: agents of change for a well-nourished world
Global Alliance for Improved Nutrition (GAIN) (2019) · doi:10.36072/cp.2 · Cited by 2
Research works printed but not linked: 5
- World Health Organization, 2017, Global Accelerated Action for the Health of Adolescents (AA-HA!): Guidance to Support Country Implementation
- WHO, 2018, Guideline: Implementing Effective Actions for Improving Adolescent Nutrition
- SPRING, 2018, Report of the Stakeholders Consultation on Adolescent Girls’ Nutrition: Evidence, Guidance and Gaps
- Miller JJ, 1978, Am Stat, 32, 138
- Holm S, 1979, Scand J Stat, 6, 65
Cited by
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Self-citationLi, L., Sun, N., Zhang, L., Xu, G., Liu, J., Hu, J., Zhang, Z., Lou, J., Deng, H., Shen, Z., et al. (2020) · Global Health Action · doi:10.1080/16549716.2020.1795438 · Cited by 135
“All of the statistical analyses were performed using SAS version 9.4 (SAS Institute, Cary, NC) and STATA version 12.0 (STATA Corporation; College Station, TX).”
BackgroundMethodInfluentialHeslin, A. M., & McNulty, B. A. (2023) · Proceedings of The Nutrition Society · doi:10.1017/s0029665123002689 · Cited by 186
Calcaterra, V., Cena, H., Magenes, V. C., Vincenti, A., Comola, G., Beretta, A., Napoli, I. D., & Zuccotti, G. (2023) · Nutrients · doi:10.3390/nu15030702 · Cited by 174
The diets of children: Overview of available data for children and adolescents
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Self-citation
Metadata
- Authors
- Beal, T., Morris, S. S., & Tumilowicz, A.
- Affiliations
- Global Alliance for Improved Nutrition (CH)
- Corresponding author
- Beal, Ty
- Venue
- Food and Nutrition Bulletin
- Publisher
- SAGE Publications
- Published
- 2019-10-16
- Volume
- 40
- Issue
- 4
- Pages
- 444-459
- ISSN
- 0379-5721 (ISSN-L)
- 1564-8265
- OpenAlex
- W2981224137
- Cited by
- 174
- References
- 46
- Citations by year
- 2026: 17 · 2025: 41 · 2024: 34 · 2023: 34 · 2022: 23 · 2021: 19 · 2020: 6
- FWCI
- 1.63
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Food and Nutrition Bulletin (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Funders
- Ministry of Foreign Affairs of the Netherlands
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Keywords
- adolescent diet, fruit consumption, vegetable consumption, soft drinks, fast food consumption, dietary habits, subpopulation differences, South and East Asia, Latin America, high-income countries, low-income countries, food intake frequency, adolescent nutrition
- MeSH terms
- Adolescent, Carbonated Beverages, Child, Diet, Female, Fruit, Health Surveys, Humans, Male, Students, Vegetables, Global Health, Fast Foods
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