Behavioral and psychosocial factors associated with sugar-sweetened beverage consumption among Korean adolescents: a path analysis using the 2022 Korea Youth Risk Behavior Survey

Abstract

OBJECTIVES: Rising obesity rates among adolescents are a major global health concern and are closely linked to the consumption of sugar-sweetened beverages (SSBs). This study aimed to identify key behavioral and psychosocial factors influencing SSB consumption among adolescents. METHODS: This cross-sectional study analyzed data from the 2022 Korea Youth Risk Behavior Survey, which included 49,548 participants aged 12-18 years. Information on SSB consumption frequency, socio-demographic characteristics, eating habits, sedentary behaviors, and other health-related factors was collected through self-administered questionnaires. Path analysis was used to model SSB consumption and estimate the direct and indirect effects of modifiable factors. RESULTS: Male students, current alcohol drinkers, those with higher frequencies of fast-food or late-night snack consumption, and heavy smartphone users were more likely to frequently consume SSBs. Fast-food intake had the strongest direct effect on SSB consumption (B = 0.3884), while nighttime eating showed a substantial direct effect (B = 0.1437) and mediated 21.7% of the relationship between fast-food intake and SSB consumption. Leisure sitting time exerted both direct (B = 0.0741) and indirect effects on SSB intake, mediated through watching mukbang, smartphone use, fast-food consumption, and nighttime eating. Self-perceived health status was negatively associated with SSB consumption (B = -0.0619), with indirect effects mediated by fast-food intake and nighttime eating. CONCLUSIONS: Among Korean adolescents, SSB consumption was strongly associated with unhealthy eating patterns and prolonged leisure sitting time. Increased fast-food consumption, nighttime eating, watching mukbang, smartphone use, and negative self-perceived health status not only directly influenced SSB intake, but also acted as mediating factors.