Abstract
Sugar-sweetened beverages (SSBs) are an already known risk factor for weight gain in childhood. To identify windows of opportunity for public health interventions, insight into the consumption behavior of SSBs is needed. We investigated whether total SSB consumption was related to body mass index (BMI) change and overweight and compared whether the timing of consumption over the day differed between low and high consumers. In the Dutch GECKO Drenthe birth cohort, a cohort embedded within the Groningen Expert Center for Kids with Obesity (GECKO), height and weight were measured by trained nurses at age 5/6 years (y) and 10/11 y (N = 1257). BMI was standardized for age and sex (BMI-z). In the food pattern questionnaire completed by parents at age 5/6 y, beverages were assessed for seven time segments (breakfast, morning, lunch at school, lunch at home, afternoon, dinner, and evening). Linear and logistic regression analyses were adjusted for potential confounders (sex, baseline BMI-z, parental BMI, parental education level, maternal age at birth, maternal smoking during pregnancy). The median daily SSB consumption frequency ranged from 1.9 times per day (1.5–2.0, 25th–75th percentile) in the lowest quartile to 4.9 times per day (4.6–5.5) in the highest quartile. In the highest compared to the lowest quartile of SSB consumption frequency, the confounder-adjusted odds ratio for overweight incidence was 3.12 (95% CI, 1.60–6.07). The difference in consumption between quartile 1 and quartile 4 occurred mainly during main meals and in the evening, e.g., at breakfast (31% vs. 98%, p < 0.001), lunch at home (32% vs. 98%, p < 0.001), and dinner (17% vs. 72%, p < 0.001). These drinking occasions characterizing high SSB consumers mostly occurred in the home environment, where parental influence on dietary behaviors is profound. Therefore, these results exposed a window of opportunity, leading to the advice for parents to offer their children sugar-free drinks to quench thirst with main meals.
Highlights
Over the past decades, the global prevalence of overweight and obesity in children has increased dramatically [1]
Pattern Questionnaire; BMI: body mass index; BMI was standardized for age and sex (BMI-z): body mass index standardized for age and sex. * Represents overweight and obesity combined
In a linear regression analysis adjusting for potential confounders, BMI-z change between age 5/6 and 10/11 years was between 0.066 and 0.160 SD greater in higher quartiles of daily Sugar-sweetened beverages (SSBs) consumption frequency than in the quartile with the lowest intake (Q1) (Table 2)
Summary
The global prevalence of overweight and obesity in children has increased dramatically [1]. Sugar-sweetened beverages (SSBs) are a well-known nutritional risk factor for excess weight gain in children [4], and have, frequently been targeted in intervention studies. A positive energy balance is a key factor in excess weight gain. Sugar-sweetened beverages contribute to a positive energy balance and subsequent weight gain because of their high energy density just like other sugar-rich food items and due to their low satiating capacity. As SSBs are already consumed at a young age [9,10], they became a frequently studied target for early life prevention of overweight
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