# Sugar-Sweetened Beverage (SSB) Intake Is Associated with Non-SSB Diet Quality in Swiss Adults

## TL;DR

Swiss adults who consume more sugary drinks tend to have poorer overall diet quality, suggesting that cutting sugary drinks alone isn't enough to improve diet health.

## Contribution

This study is the first to examine how SSB intake relates to non-SSB diet quality in Swiss adults using a national dataset.

## Key findings

- Non-SSB consumers had higher non-SSB AHEI scores than low-SSB consumers.
- High-SSB consumers had significantly poorer non-SSB diet quality.
- Non-SSB AHEI scores were only moderate across all groups, indicating room for improvement.

## Abstract

Background/Objectives: More than half of Swiss adults exceed the World Health Organization’s recommended limit for free sugar intake, with sugar-sweetened beverage (SSB) as a major contributor. SSB intake may be associated with other dietary risk factors, but little is known about diet quality excluding SSB intake. Therefore, the objective of this study was to investigate the association of SSB intake with the non-SSB diet quality in Swiss adults. Methods: Data from the cross-sectional, national nutrition survey menuCH (2014–2015, n = 2057, 18–75 years) were analyzed. Dietary intake was assessed via two 24 h dietary recalls. Participants were categorized as non-, low-, or high-SSB consumers based on the Swiss dietary guideline for free sugar intake. Diet quality excluding SSB was evaluated using the Alternative Healthy Eating Index (AHEI) scoring system (non-SSB AHEI). Results: Non-SSB consumers had higher non-SSB AHEI scores compared to low-SSB consumers, indicating healthier food choices beyond SSB intake, while high-SSB consumers had substantially poorer non-SSB diet quality. Despite these differences, non-SSB AHEI scores were only moderate across all SSB consumer types, suggesting that reducing SSB alone may not suffice to achieve optimal diet quality. Conclusions: In addition to population-based strategies to reduce SSB intake, future policies should aim to improve overall diet quality, including higher consumption of vegetables, fruits, whole grains and unsaturated fats. Prospective studies are needed to clarify which alternative food choices individuals make when reducing SSB intake.