# Criterion-Related Validity of the Sugar-Sweetened Beverage (SSB) Questionnaire Among Children and Adolescents in Malaysia

## TL;DR

This study tested a questionnaire to measure sugar-sweetened beverage consumption in Malaysian children and adolescents and found it to be valid.

## Contribution

The study provides evidence for the validity of an SSB questionnaire tailored for children and adolescents in Malaysia.

## Key findings

- The SSB questionnaire showed significant differences in consumption based on age, locality, and income.
- Environmental and behavioral factors like eating out and home availability of SSBs were strongly linked to consumption patterns.
- Five out of six hypotheses were confirmed, supporting the questionnaire's ability to differentiate between groups.

## Abstract

Sugar-sweetened beverages (SSBs) are a major source of dietary sugar, and their consumption is on the rise among children and adolescents. Excessive sugar intake is a significant contributor to overweight, obesity, and non-communicable diseases (NCDs). The consumption of SSBs, particularly that of children and adolescents, has been of interest as of late, as they are implicated in affecting body weight status. Thus, the goal of this study was to determine the predictive criterion-related validity of the SSB questionnaire that was administered to children and adolescents to assess their SSB and non-SSB intake. A nationwide cross-sectional study involving 5211 respondents aged 7-17 years old and their parents was conducted. The self-administered Malay questionnaire was distributed to collect information on socioeconomic background, the frequency of eating out at restaurants or other food premises, the availability of SSBs at home, and SSB consumption patterns of children and adolescents within a week. The predictive criterion-related validity was determined by using six hypotheses that can differentiate between two independent sample means of SSB consumption based on age, gender, locality, monthly household income, frequency of eating out at restaurants or other food premises, and availability of SSBs at home. The independent samples t-test and one-way ANOVA were used to conduct the validation process. Five out of six hypotheses were accepted. Significant mean differences were observed between sociodemographic factors, such as age (t=-10.56, p<0.001), localities (t=-5.37, p<0.001), monthly household income (F=26.83, p<0.001), and SSB consumption. Behavioural factors, including eating out at restaurants or other food premises (t=9.93, p<0.001) and environmental factors such as the availability of SSBs at home (F=136.24, p<0.001) also showed a significant difference with SSB consumption. The SSB questionnaire demonstrated the ability to differentiate between groups. Thus, this SSB questionnaire appears to be valid to measure the SSB consumption of children and adolescents.