Global consumption of added sugars are the main source of empty calories contributing to daily energy intake, obesity, and diabetes,1–9 which is alarmingly prevalent in children’s and youth’ diets.10 A popular form of added sugar intake in this age group, sugar-sweetened beverages (SSB), substantially contributes to daily energy intake.10 SSB include soft drinks (i.e., soda, fruit punches, lemonades), fruit juices and drinks, sports drinks, as well as energy drinks.12 The major source of added sugar from SSB is 100% fruit juice, while both 100% fruit juice and soft drinks contribute similarly to total energy intake.13 Large amounts of added sugars in SSB may also increase the risk of obesity by contributing to a high glycemic load and exacerbating insulin response.11 SSB consumption, along with the daily calories sold per capita per day from all SSB, is highest in both North and Latin America,4 and is prevalent among Hispanic/Latino children and youth in Latin America and the United States (U.S.).14,15 These numbers have pronounced implications for native and immigrant youth of Hispanic/Latino heritage living in the U.S., as they are disproportionally affected by obesity.16
Existing disparities in SSB consumption and health outcomes such as obesity among Hispanic/Latino youth and their families living in the US may be associated with adoption of US customs and behaviors, versus maintenance of Latin American customs and behaviors.17 Acculturation, broadly defined as the multidimensional process through which individuals economically, psychologically, and socio-culturally adapt from one cultural context to another due to migration or other life experiences,18, 19 has been associated with dietary behaviors and other obesity-related behaviors among Hispanic/Latino youth.20 Research suggests that greater language-based acculturation to the U.S. among Hispanic/Latino families is associated with negative health outcomes and less healthful dietary behaviors,17 including greater SSB consumption than their U.S.-born non-Hispanic white counterparts.21 Recently, Arandia et al. (2018) examined associations between a multi-dimensional measure of acculturation, the Acculturation Habits, and Interests Multicultural Scale for Adolescents (AHIMSA), and Hispanic/Latino youth’s eating behaviors.22 They found no differences in consumption of empty calories by acculturation group.22 However, the study did not specifically examine SSB consumption23.
Because acculturation tends to occur more rapidly among Hispanic/Latino youth than among their parents,24 understanding the role of acculturation on SSB consumption patterns in youth is essential. One plausible factor influencing SSB consumption through acculturation is acculturative stress. Acculturative stress can be defined as the psychological impact of adaptation to a new culture.25 For Hispanics who move to the U.S., there are a number of significant stressors (i.e., language conflict, family acculturation conflicts, perceived discrimination) that can be pervasive, intense, and lifelong due to acculturation. For example, rapid acculturation to the US among youth may lead to the adoption of unhealthy behaviors through increasing inter-generational stress within families (i.e., family acculturation conflicts), and subsequent loss of Hispanic/Latino customs and behaviors.26 Thus, acculturative stress may play a significant role influencing health outcomes among Hispanic/Latino families.
The Hispanic/Latino family is a vital source of support, comprised of interdependent relationships that may cultivate cultural values and discourage family dysfunction.27, 28 This is important as youth in more dysfunctional families engage in unhealthier behaviors.29 However, the role of family functioning in influencing SSB consumption, moderated by acculturation, remains an untested hypothesis.
This study aimed to examine the associations of acculturative stress and family functioning with SSB consumption by acculturation status among U.S. Hispanic/Latino youth. We examined such associations under the assumption that on average, youth experience more rapid acculturation attainment, as well as youth adopt certain acculturation statuses on the basis of characteristics and experiences that are heterogenous across groups. We hypothesized that Hispanic/Latino youths’ SSB consumption would differ by acculturation status and that acculturative stress and family functioning would be associated with Hispanic/Latino youth’ SSB consumption across acculturation statuses.