Associations Between Sugar-Sweetened Beverage Consumption and Fast-Food Restaurant Frequency Among Adolescents and Their Friends

Meg Bruening, Richard MacLehose, Marla E. Eisenberg, Marilyn S. Nanney, Mary Story, Dianne Neumark-Sztainer

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39 Scopus citations


Objective: To assess associations between adolescents and their friends with regard to sugar-sweetened beverage (SSB)/diet soda intake and fast-food (FF) restaurant visits. Design: Population-based, cross-sectional survey study with direct measures from friends. Setting: Twenty Minneapolis/St Paul schools during 2009-2010. Participants: Adolescents (n=2,043; mean age, 14.2±1.9years; 46.2% female; 80% non-white). Main Outcome Measures: Adolescent SSB/diet soda intake and FF visits. Analysis: Generalized estimating equation logistic models were used to examine associations between adolescents' SSB/diet soda intake and FF visits and similar behaviors in nominated friends (friend groups and best friends). School-level (middle vs high school) interactions were assessed. Results: Significant associations were found between adolescents and friends behaviors for each of the beverages assessed (P<.05), but they varied by friendship type and school level. Five of 6 models of FF visits (including all FF visits) were significantly associated (P<.05) among adolescents and their friends. Significant interactions by school level were present among adolescents' and friends' FF visits, with associations generally for high school participants compared with middle school participants (P<.05). Conclusions and Implications: Findings suggest that for many beverages and FF restaurant types, friends' behaviors are associated, especially FF visits for older adolescents. Nutrition education efforts may benefit by integrating knowledge of the impact of adolescents' friends on FF visits.

Original languageEnglish (US)
Pages (from-to)277-285
Number of pages9
JournalJournal of Nutrition Education and Behavior
Issue number4
StatePublished - Jul 2014

Bibliographical note

Funding Information:
Eating and Activity among Teens–2010 was supported by Grant R01HL084064 from the National Heart, Lung, and Blood Institute (PI: Neumark-Sztainer). A portion of the first author's time was supported by Grant R01HL084064-01A2 (PI: Sirard). Methods and analysis (PI: MacLehose) was supported by National Institutes of Health Grant U01HD061940 (PI: Wall) from the Eunice Kennedy Shriver National Institute of Child Health and Human Development . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors thank the adolescents who participated in EAT-2010, and the Minneapolis and Saint Paul school districts for their support in this research. They also thank Drs Melanie Wall, David Knoke, and John Sirard for their contributions. This study was a portion of Dr Bruening's dissertation on the role of friends on adolescent eating behaviors and weight status.


  • Adolescent
  • Restaurant
  • School
  • Sugar-sweetened beverage


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