Health-Related Behaviors and Perceived Health Status According to Water and Sugar-Sweetened Beverage Intake in Korean Adolescents

The objective of this study was to determine the relationship between water and sugar-sweetened beverage (SSB) intake, health behaviors, and self-perceived health status using data from the 2019 Korea Youth Risk Behavior Web-based Survey (KYRBS). The subjects included in this analysis were 57,302 Korean adolescents from the 7th to 12th grades. The intake patterns of water and SSBs were categorized into four groups: Group I, adequate water intake (>= 4 cups/day) and low frequency of SSB intake (<= 1-2 times/week); Group II, adequate water intake and high frequency of SSB intake; Group III, inadequate water intake (<4 cups/day) and low frequency of SSB intake; Group IV, inadequate water intake and high frequency of SSB intake (>= 3 times/week). Complex sample analyses were used for considering strata, clusters, and weights for samples. Significant differences were observed in the distribution of sociodemographic characteristics between the water and SSB intake groups. As grade levels increased or if students were female, there was a significant increase in the proportion of students characterized by low water intake and high consumption of SSB. Adolescents with healthier beverage habits, characterized by adequate water intake and low frequency of SSB consumption (Group I), generally abstained from smoking and alcohol, were more physically active, and maintained a desirable diet, reporting a better perceived health status. In contrast, those with higher SSB consumption and inadequate water intake (Group IV) were more likely to perceive their health as poor, with higher rates of smoking and alcohol use, lower physical activity levels, and poorer dietary habits compared to Group I. In conclusion, adolescents with desirable beverage consumption habits differed by sex and grade and they reported positive health behaviors and better overall health status. This suggests that there is a need for more active education and intervention in schools and families, as well as increased efforts by adolescents to promote healthy beverage habits.