Associations Between Beverage Consumption, Cardiometabolic Risk and Adiposity in Adolescents Undergoing Universal Screening

Abstract

Background and Objective: The association between milk intake, diet soda and caffeinated drinks and cardiometabolic risk in adolescents is not well understood. We sought to evaluate this in adolescents having universal screening. Methods: Cross-sectional study of grade 9 adolescents over 4 school years who underwent universal risk factor screening through the Heart Niagara Inc. Healthy Heart Schools’ Program. Questionnaires assessing dietary intake and habits (24 hour recall and general intake habits) were completed. Height, weight, waist circumference (WC), blood pressure, and non-fasting lipids were measured. Results: Of the 10 659 (50%male, average age 14.5 years) students who participated, 17% (1769) were overweight (body mass index [BMI] 85- 95th percentile). Each additional daily intake of diet soda was associated with a 2.5-point (standard error (SE) 0.5, p< 0.001) increase in BMI percentile. Identifying skim/non-fat milk as the milk typically ingested was associated with a 7-point (SE 1.5, p<0.001) increase in BMI percentile, while no significant associations were observed with whole milk. Increased intake of caffeinated coffee/ tea-based beverages and caffeinated soda beverages was associated with a 2.1-point (SE 0.5, p<0.001) and 2.3-point (SE 0.6, p<0.001) increase in BMI percentile, respectively. Similar associations were seen with waist-to-height ratio (WC/height). No clinically significant associations with lipid or blood pressure measures were seen. Conclusions: Associationswere noted between increased intake of low/non-fat milk intake, diet sodas, and caffeinated beverages and increasing adiposity. Further studies are required to assess causality and evaluate potential mechanisms.