The sweetening of the world's diet.

OBJECTIVE Using data from many countries in the world combined with in-depth U.S. dietary data, we explored trends in caloric sweetener intake, the role of urbanization and income changes in explaining these trends, and the contribution of specific foods to these changes. RESEARCH METHODS AND PROCEDURES Food disappearance data from 103 countries in 1962 and 127 in 2000 were coupled with urbanization and gross national income per capita data in pooled regression analysis to examine associations between these factors and caloric sweetener intake. Three nationally representative surveys from 1977 to 1978, 1989 to 1991, and 1994 to 1996 plus 1998 are used to examine caloric sweetener intake trends in the United States and the foods responsible for these changes. RESULTS Increased consumption of caloric sweetener is one element in the world's dietary changes, represented by a 74-kcal/d increase between 1962 and 2000. Urbanization and income growth represent 82% of the change. U.S. data show an 83-kcal/d increase of caloric sweetener consumed-a 22% increase in the proportion of energy from caloric sweetener. Of this increase, 80% comes from sugared beverages; restaurant and fast food sources are represented in greater proportions. DISCUSSION Caloric sweetener use has increased considerably around the world. Beverage intake seems to be a major contributor.