Public Health Nutrition: 11(1), 49–56 DOI: 10.1017/S1368980007000122 Determinants of adolescents’ soft drink consumption Elling Bere 1,2, *, Elin Sørli Glomnes 1 , Saskia J te Velde 2 and Knut-Inge Klepp 1 1 Department of Nutrition, University of Oslo, Box 1046, Blindern, N-0316 Oslo, Norway: 2 Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands Submitted 27 June 2006: Accepted 18 January 2007: First published online 21 June 2007 Abstract Objective: To identify determinants of adolescents’ consumption of carbonated soft drinks (regular and diet), both of total consumption and of consumption at school. Design/Setting/Subjects: Regular and diet soft drink consumption was measured by food frequency questions that were dichotomised. Several potential environ- mental and personal determinants of consumption were measured. A total of 2870 (participation rate: 85%) 9th and 10th graders, within 33 Norwegian schools, participated in the study. Multilevel logistic regression analyses were preformed for total soft drink consumption (twice a week or more vs. less) and for con- sumption at school (once a week or more vs. less). Results: A total of 63% and 27% of the participants reported to drink respectively regular and diet soft drinks twice a week or more, and 24% and 8%, respectively, reported to drink soft drinks once a week or more at school. Preferences, accessibility, modelling and attitudes were the strongest determinants of both regular and diet soft drink consumption. In addition, gender, educational plans and dieting were related to both total soft drink consumption and consumption at school. Pupils with longer distance from school to shop and those in schools with rules concerning soft drink consumption tended to have lower odds of drinking both regular and diet soft drinks at school. Conclusion: This study shows that gender, educational plans, dieting, accessi- bility, modelling, attitudes and preferences all seem to be strong determinants of adolescents’ soft drink consumption. Parents and the home environment appear as great potential intervention targets. Keywords Soft drinks Adolescents Determinants The World Health Organization (WHO) recommends a diet where a maximum 10% of the energy comes from refined sugar (5added sugar) 1 . A recent dietary survey reported that Norwegian children and adolescents con- sume too much added sugar 2 . On average, 18% of the energy consumption of Norwegian 8th grade pupils comes from added sugar, and 89% of the age group have a diet where more than 10% the energy comes from added sugar 2 . Soft drinks contribute 30% of the total intake of added sugar 2 . It has been speculated that soft drinks may be an important factor in the observed rise in obesity pre- valence 3,4 . Studies have found soft drink consumption to be positively associated with energy intake among children and adolescents 3–5 , probably because over- consumption is a particular problem when energy is ingested in liquid form and because these drinks to a large extent represent energy added to, not displacing, other dietary intake 6–8 . Added sugar (i.e. from soft drinks) supplies the diet only with empty calories, which means just energy and no other nutrients. A national dietary survey reported negative correlations between intake of added sugar and intake of micronutrients and fruit and vegetable consumption 2 . A diet with less added sugar/soft drinks will therefore be more nutrient-dense. Diet soft drinks contain little or no energy, and are not associated with overweight/obesity 8 . However, all types of carbo- nated soft drinks pose a risk of dental caries due to enamel erosion caused by their acidity 9,10 . Only a few studies have reported determinants of adolescents’ soft drink consumption 11 . Boys tend to drink more soft drinks than girls 4,12–14 and pupils of lower parental occupation status tend to drink more than pupils of higher parental occupation status 14 . In addition, taste preferences, soft drink consumption habits of parents and friends, availability at home and school and television viewing have been reported to be associated with soft drink consumption in one study 13 . Recently, two studies from The Netherlands also linked soft drink consumption to attitude, subjective norm and parenting practices 15 , as well as parenting style 16 . As interventions work by mediating variables 17 , a better understanding of the *Corresponding author: Email ellingb@medisin.uio.no r The Authors 2007