Sweetened beverages (as a percentage of total calories in 1994–1996) were consumed by children and adolescents ages 2–18 years mostly at home (3.9 percent), followed by restaurants and quick serve restaurants (QSRs) (1.7 percent), obtained from a store but not eaten at home or ever brought into the home (0.7 percent), and vending machines (0.3 percent) (Nielsen and Popkin, 2004). Using a slightly different approach to analyzing the data, French et al. (2003) also reported an increase in the prevalence of sweetened carbonated soft drinks consumption and portion size among youth—with the largest source of consumption at home, followed by restaurants and QSRs, other locations (e.g., friends’ homes and entertainment venues), school cafeterias, and vending machines. Sweetened beverages were the largest contributors to added sweeteners in the diets of children and adolescents ages 2–18 years, from 34–52 percent depending on age and sex in 1994–1996 to 35–58 percent in 1999–2000 (Guthrie and Morton, 2000; Murphy et al., 2005). Sweetened beverages represent approximately 10 percent of their total calorie intake.

Finding: Sweetened beverage consumption (e.g., carbonated soft drinks and fruit drinks) by children and adolescents has increased considerably over the past 35 years and is now a leading source of added sugars, especially in adolescents’ diets. The consumption of milk, a major source of dietary calcium, has decreased among children and adolescents over the same period, and most have calcium intakes below the recommended adequate intake level.

Breakfast Consumption

Breakfast consumption also has changed over time. In NFCS 1965, 90 percent of boys and 84 percent of girls consumed a food, beverage, or both between 5 am and 10 am compared with 75 percent and 65 percent, respectively, in CSFII 1989–1991 (Siega-Riz et al., 1998). Consumption declined approximately 5 percentage points in younger children, 9 points in older children ages 8–10 years, and 13–20 points in adolescents. The greatest decline was among adolescent girls ages 15–18 years, who dropped from 84 percent in 1965 to 65 percent in 1991. Frequency of breakfast consumption declines with age. In 1965, African Americans and whites had similar breakfast consumption patterns; however, African American adolescents were less likely to consume breakfast by 1989–1991 (Siega-Riz et al., 1998). Data from the National Heart, Lung, and Blood Institute Growth and Health Study, a 9-year longitudinal biracial cohort of 2,379 girls, found that white girls reported more frequent breakfast consumption than African American girls, but the racial differences decreased with age



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