Age-Related Differences in Knowledge-Attitude-Practice Patterns of Nonnutritive Sweetener Consumption among Adolescents and Adults: A Cross-Sectional Survey in Southeast Nigeria.

Authors

Beulah F Ortutu, Claire C Okwunodulu, Augusta C Ameze, Joy Sopuru, Adaeze C Ukegbu, Kelechi Ikpemo, Adiah M Odu, Nancy Oriaku, Deborah S Chijioke, Patricia O Ukegbu

Published in

Current developments in nutrition. Volume 10. Issue 8. Pages 109431. Epub Jul 02, 2026.

Abstract

Nonnutritive sweeteners (NNS) are increasingly incorporated into ultraprocessed foods and beverages, yet psychosocial drivers of NNS consumption across age groups in low- and middle-income settings remain poorly characterized. Understanding how knowledge, attitudinal beliefs, and information sources shape NNS consumption is essential for designing effective nutrition interventions.
This study examined age-related patterns of NNS consumption among adolescents and adults and evaluated how knowledge, attitudes, and sources of nutrition information interact to influence consumption practices.
A cross-sectional study was conducted among 2769 adolescents (10-19 y) and adults (≥20 y) in southeast Nigeria. Data were collected using a structured questionnaire assessing sociodemographic characteristics, NNS-related knowledge, attitudinal beliefs, consumption practices, and information sources. Mediation and conditional process analyses evaluated whether attitudinal beliefs mediated the knowledge-practice relationship and whether this mediation varied by knowledge level, age group, and information source. Logistic regression identified predictors of high NNS consumption.
Adolescents (83.1%) showed a significantly higher prevalence of NNS consumption than adults (16.9%) (P < 0.001). Results from the logistic regression revealed that being an adolescent was strongly associated with higher NNS consumption [adjusted odds ratio (AOR) = 19.45; 95% confidence intervals (CI): 15.43, -24.51]. Information sources from health professionals (AOR = 0.67; 95% CI: 0.47, -0.95) and the presence of underlying disease (AOR = 0.50; 95% CI: 0.31, -0.82) were significantly associated with lower consumption. Mediation analysis indicated that positive attitudes partially mediated the relationship between knowledge and consumption practice (indirect effect P < 0.05).
NNS consumption patterns exhibited significant age-related variance and are shaped by a complex interplay between knowledge, belief-based attitudes, and the prevailing information environment. Public health nutrition interventions must evolve beyond traditional knowledge dissemination and adopt a multifaceted approach that addresses information quality, food environments, and age-targeted programs.

PMID:
42571326
Bibliographic data and abstract were imported from PubMed on 09 Aug 2026.

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