Combined intake of sugar‐sweetened beverages and sugar‐containing ultra‐processed foods is associated with an increase in body mass index during early childhood

Abstract

Sugar-containing ultra-processed (SUP) foods and beverages consumption has increased globally in recent years and contributes to the rising global trends of obesity and diet-related chronic non-communicable diseases. However, there are limited longitudinal studies of SUP foods and beverages intake and weight gain in children. To examine associations between intake of sugar-sweetened beverages (SSB) and SUP foods and changes in body mass index during early childhood. Multistage sampling was used to select a nationally representative sample of Uruguayan children living in urban areas from the 2012-2013 Continuous Household Survey. The sample for this analysis included all children aged 0-3 years 11 months with dietary data in 2013-2014 (wave 1; n=2611) and in 2015-2016 (wave 2; n=2383). Multilevel regression modelling tested the association between children's consumption of SSB and SUP foods and change in BMI z-score (BMIz). In multivariable-adjusted models, intake of SSB and SUP foods (in combination but not individually) in both waves was positively associated with change in BMIz over 2 years β coefficient: 0.13 (95% confidence interval [CI]: 0.02, 0.23). BMIz decreased among non-consumers (β: -0.12, 95% CI: -0.24, -0.00, p=0.048). Associations were significant for SUP foods but not SSB foods individually. Children consuming ≥2 SSB and SUP foods (vs. <2) at baseline had increased BMIz (p for trend=0.02). Early and current intake of SSB and SUP foods and beverages was associated with increases in BMIz in children over 2 years.