Misperceptions of peer norms as a risk factor for sugar-sweetened beverage consumption among secondary school students.

Research has shown that excess calories from sugar-sweetened beverages are associated with weight gain among youth. There is limited knowledge, however, regarding perception of sugar-sweetened beverage consumption norms. This study examined the extent of misperception about peer sugar-sweetened beverage consumption norms and the association of perceived peer norms with personal self-reported consumption. Among 3,831 6th- to 12th-grade students in eight schools who completed anonymous cross-sectional surveys between November 2008 and May 2009, students' personal perception of the daily sugar-sweetened beverage consumption norm in their school within their grade (School Grade group) was compared with aggregate self-reports of daily sugar-sweetened beverage consumption for each School Grade group. The median daily sugar-sweetened beverage consumption from personal reports was one beverage in 24 of 29 School Grade groups, two beverages in four School Grade groups, and three beverages in one School Grade group. Seventy-six percent of students overestimated the daily norm in their School Grade group, with 24% perceiving the norm to be at least three beverages or more per day. Fixed-effects multiple regression analysis showed that the perceived peer sugar-sweetened beverage consumption norm was much more positively associated with personal consumption than was the estimated actual sugar-sweetened beverage consumption norm per School Grade group. Misperceptions of peer sugar-sweetened beverage consumption norms were pervasive and associated with unhealthy sugar-sweetened beverage consumption behavior. These misperceptions may contribute to intake of excess calories, potentially contributing to adolescent obesity. Future research should assess the pervasiveness of sugar-sweetened beverage consumption misperceptions in other school populations as well as causes and consequences of these misperceptions. Health professionals may wish to consider how normative feedback interventions could potentially reduce consumption.