Abstract
Background/Objectives: Sugar-sweetened beverage (SSB) consumption is associated with child obesity, an understudied issue in the southern United States, where obesity rates are the highest in the country. We examined the factors associated with high SSB intakes among children aged 2-12 years in two major cities in Louisiana, New Orleans and Baton Rouge. Methods: We conducted a cross-sectional study using an online survey. The sample consisted of caregivers of children aged 2-12 years who eat restaurant meals (either dine-in, delivery, or take-out) at least once a month and reside in or near New Orleans or Baton Rouge, LA. Multivariable logistic regression was used to examine factors associated with high child SSB intake frequency (≥4 times/week), including restaurant use, caregiver attitudes towards SSB, and their demographics (n = 1006). Results: Most caregivers reported weekly child SSB consumption (74.6% ≥ 1×/week; 38.1% ≥ 4+/week) and restaurant use (58.8% ≥ 1×/week). High SSB frequency (≥4+/week) was associated with a higher frequency of restaurant use, lower caregiver education, agreement with the statement that SSBs are an important part of family meals, and disagreement with the statement that restaurants should not offer SSBs with children's meals (p < 0.05). Conclusions: Our results revealed a high frequency of SSB consumption among children who dine at restaurants monthly, with significant associations observed between SSB intake, restaurant meals, and pro-SSB attitudes. These findings may support the need for regulations, such as healthy default beverage policies for children's menus, to potentially reduce SSB intake and shift social norms, particularly in regions with high childhood obesity rates like Louisiana and the southern USA.