Maternal Sugar-sweetened Beverages Research Articles

Early exposure to added sugars via infant formula may explain high intakes of added sugars during complementary feeding beyond maternal modeling.

Research has shown that early exposure to added sugars from table food is related to increased intake of added sugars in later childhood. The earliest window of exposure to added sugars may be in infancy via infant formula. However, beyond the well-established factors of maternal lifestyle and modeling, there is a lack of research examining how exposure to added sugars from infant formula influences infant/toddler added sugar intakes from table foods and sugar sweetened beverages (SSB). While accounting factors previously associated with infant/toddler added sugar intakes and maternal SSB consumption (proximal measure of maternal modeling), this study aims to examine if there is an association between added sugars in infant formula and added sugar intakes from table foods and SSB during the complementary feeding period. This is a secondary, cross-sectional analysis using three-day caregiver-reported 24-h dietary recalls in a cohort of infant/toddlers (n = 95), ages 9- < 16 mos., enrolled in a music intervention trial. Hierarchical stepwise regression was used to estimate the association between exposure to added sugars from infant formula and (1) intake of added sugars from table food and (2) SSB consumption. Infant/toddler SSB consumption was transformed to account for distributional properties. We performed incremental F-tests to determine whether the addition of each step improved model fit (R2). Early exposure to added sugars via infant formula was associated with infant/toddler SSB (ΔR2 = 0.044, Finc (1, 87) =6.009, p = 0.016) beyond sociodemographic and maternal SSB consumption, but not with infant/toddler added sugar intakes from table foods (ΔR2 = 0.02, Finc (1, 87) =3.308, p = 0.072). While past studies have identified circumstantial (i.e., sociodemographic), or indirect (i.e., maternal lifestyle and modeling), mechanisms contributing to higher infant/toddler added sugar intakes, this study identifies exposure to added sugars from infant formula as a possible direct mechanism explaining why some infants/toddlers consume more added sugars.

Association between maternal sugar-sweetened beverage consumption and the social-emotional development of child before 1 year old: A prospective cohort study.

Excessive consumption of sugar-sweetened beverages (SSBs) has become an international public health issue. Adverse effects of sugary beverage consumption on both mother and child during pregnancy continue to be found. However, evidence regarding maternal SSB consumption and social-emotional development of children is lacking. Based on the Shenzhen Birth Cohort Study (loss rate: 10.97%), we included 985 mother-infant pairs from 2018 to 2022. All mothers had a singleton live birth without hypertension, diabetes, tumor, or serious immune system disease before pregnancy. We used a chart of frequency distribution to show maternal SSB consumption, including non-diet soda, tea drinks (not 100% tea), fruit drinks, Sugar-sweetened coffee, bubble tea, or cocoa drinks, and total SSBs. A multivariate logistic regression model was used to estimate the odds ratios of the potential delay on social-emotional development of each child was monitored at both 6 months and 12 months of age based on maternal SSB consumption. Among the mothers, 728 (73.91%) drank SSBs <1 time per week, 194 (19.70%) drank SSBs 1-2 times per week, 43 (4.37%) drank SSBs 3-4 times per week, and 20 (2.03%) drank SSBs 5 or more times per week. Children aged 12 months with mothers who drank SSBs five or more times per week during pregnancy had an increased risk of potential delay on social-emotional development compared to those with mothers who drank SSBs less than once per week [odds ratio: 3.08 (1.13-8.39)]. Regarding the specific kinds of SSBs, we found that tea drinks (not 100% tea) were positively associated with potential delay on social-emotional development in children aged 6 months. Nearly three-quarters of mothers consumed almost no SSBs during pregnancy. High SSB intake during pregnancy was associated with an increased risk of the potential delay on social-emotional development of a child at 6 and 12 months of age.

The Association between Maternal Sugar-Sweetened Beverage Consumption and Infant/Toddler Added Sugar Intakes.

Intake of added sugars during early life is associated with poor health outcomes. Maternal dietary intake influences the intake of their children, but little research investigates the relationship between maternal sugar sweetened beverage (SSB) and infant/toddler added sugar intakes. Our objective was to explore the relationship between maternal total sugars and SSB intakes and infant/toddler added sugar intakes. This cross-sectional study (n = 101) of mother-infant dyads measured maternal dietary intake by food frequency questionnaire and infant intake by three 24-h dietary recalls. Pearson’s correlations explored the relations between maternal total sugars and SSB intakes and infant added sugar intakes. Hierarchical stepwise regressions determined if maternal total sugars and SSB intakes explained the variation in infant added sugar intakes after accounting for known risk factors for early introduction of added sugars. Maternal total sugars (r = 0.202, p = 0.043) and SSB (r = 0.352, p < 0.001) intakes were positively correlated with infant/toddler added sugar intakes. In the hierarchical models, maternal total sugar intakes did not account for more variance in infant added sugar intakes (β = 0.046, p = 0.060), but maternal SSB intake was a significant contributor of infant added sugar intakes (β = 0.010, p = 0.006) after accounting for confounders. Interventions to reduced maternal SSB consumption may help reduce infant/toddler added sugar intakes.

Maternal Sugar-Sweetened Beverage Intakes Are Predictive of Infant Added Sugar Intakes

ObjectivesTo understand how a mother's dietary intakes are related to an infant's added sugar intakes.MethodsA cross-sectional analysis on data obtained from food frequency questionnaires and three 24-h dietary recalls, respectively, pertaining to the dietary intakes of 101 mothers (age 32.6 ± 4.3 years) and their infants (age 11.8 ± 1.8 years, 44.6% male) was conducted. Pearson correlations were used to evaluate associations between a mother's total energy, macronutrient, and sugar intakes, and infant added sugar intakes. Hierarchical stepwise regressions evaluated whether maternal intakes accounted for additional variance in predicting infant added sugar intakes beyond an infant's gestational age, birthweight, breastfeeding duration, and introduction of solid foods, and a mother's education, income, BMI, parity, and age.ResultsPositive correlations were observed between infant added sugar intakes and maternal total sugar intakes (r = 0.276, p = 0.005) and sugar-sweetened beverage (SSB) intakes (r = 0.352, p < 0.001). The association between infant added sugar intakes and maternal SSB intakes remained significant after accounting for known obesity-related covariates (p = 0.005). The model with all covariates accounted for 39% of the variance in predicting infant added sugar intakes. When maternal SSB intakes were added to the model, the association remained significant and accounted for an additional 5% of variance in predicting infant added sugar intakes (Finc (1,90) = 8.23, p = 0.01). Maternal total sugar intakes lost significance when added to the model (p = 0.06) and only accounted for 2% of additional variance.ConclusionsWomen who consume high amounts of sugar, especially from SSBs, might feed their children more added sugars during infancy.Funding SourcesNational Institute on Child Health and Human Development of the National Institutes of Health.

Group-based trajectories of maternal intake of sugar-sweetened beverage and offspring oral health from a prospective birth cohort study

ObjectivesTo investigate the trajectory of maternal intake of sugar-sweetened beverages (SSB) during the first five years of their child's life and its effect on the child's dental caries at five years-of-age. MethodsThis is an ongoing prospective population-based birth cohort study in Adelaide, Australia. Mothers completed questionnaires on their SSB intake, socioeconomic factors and health behaviors at the birth of their child and at the ages of one, two and five years. Child dental caries measured as decayed, missing, or filled tooth surfaces was collected by oral examination. Maternal SSB intake was used to estimate the trajectory of SSB intake. The trajectories then became the main exposure of the study. Dental caries at age five years were the primary outcomes. Adjusted mean- and prevalence-ratios were estimated for dental caries, controlling for confounders. Results879 children had dental examinations at five years-of-age. Group-based trajectory modeling identified three trajectories of maternal SSB intake: ‘Stable low’ (40.8%), ‘Moderate but increasing’ (13.6%), and ‘High early’ trajectory (45.6%). Multivariable regression analysis found children of mothers in the ‘High early’ and ‘Moderate but increasing’ groups to have greater experience of dental caries (MR: 1.37 (95%CI 1.01–1.67), and 1.24 (95%CI 0.96–1.60) than those in the ‘Stable low’ trajectory, respectively. ConclusionMaternal consumption of SSB during pregnancy and in the early postnatal period influenced their offspring's oral health. It is important to create a low-sugar environment from early childhood. The results suggest that health promotion activities need to be delivered to expecting women or soon after childbirth.

Text Messages to Curb Sugar-Sweetened Beverage Consumption among Pregnant Women and Mothers: A Mobile Health Randomized Controlled Trial.

Racial, ethnic, and socioeconomic disparities in childhood obesity in the United States (U.S.) originate in early life. Maternal sugar-sweetened beverage (SSB) consumption is an early life risk factor for later offspring obesity. The goal of this study was to test the effects of policy-relevant messages delivered by text messages mobile devices (mHealth) on maternal SSB consumption. In this three-arm 1-month randomized controlled trial (RCT), pregnant women or mothers of infants in predominantly Hispanic/Latino New York City neighborhoods were randomized to receive one of three text message sets: graphic beverage health warning labels, beverage sugar content information, or attention control. The main outcome was change in maternal self-reporting of average daily SSB consumption from baseline to one month. Among 262 participants, maternal SSB consumption declined over the 1-month period in all three arms. No intervention effect was detected in primary analyses. In sensitivity analyses accounting for outliers, graphic health warning labels reduced maternal SSB consumption by 28 kcal daily (95% CI: −56, −1). In this mHealth RCT among pregnant women and mothers of infants, graphic health warning labels and beverage sugar content information did not reduce maternal SSB consumption.

Associations of maternal fructose and sugar-sweetened beverage and juice intake during lactation with infant neurodevelopmental outcomes at 24 months

Our prior studies revealed that infant somatic growth is influenced by fructose in breast milk, and fructose in breast milk is increased in response to maternal sugar-sweetened beverage (SSB) intake in lactation. It is unknown whether infant neurodevelopmental outcomes are also influenced by maternal SSBs in lactation. To determine whether infant cognitive development at 24 postnatal months was influenced by maternal fructose consumption during lactation, and whether this relation persisted after accounting for maternal SSB and juice (SSB+J) intake. Hispanic mother-infant pairs (n=88) were recruited across the spectrum of prepregnancy BMI. Mothers completed two 24-h dietary recalls at 1 and 6 postnatal months, and reported breastfeedings per day. The Bayley-III Scales of Infant Development were administered at 24 postnatal months to assess infant cognition. Linear regressions were used to examine associations, reported as unstandardized (B) coefficients, 95% CIs, and P values. Mothers consumed 1656±470 kcal, 21.8±12 g fructose, and 2.5±2.6 servings SSBs+J, and reported 6.9±2.1 breastfeedings per day at 1 postnatal month. Controlling for maternal age, prepregnancy BMI, education level, kilocalories, infant age, sex, and birthweight revealed that infant cognitive development scores at 24 postnatal months correlated inversely with maternal fructose consumption at 1 postnatal month (B = -0.08; 95% CI = -0.13, -0.03; P<0.01). The association of infant cognitive development scores with maternal fructose consumption was no longer significant after adjustment for maternal SSB+J intake (B = -0.05; 95% CI = -0.10, 0.00; P=0.07), whereas maternal SSB+J intake was significant in the same model (B = -0.29; 95% CI = -0.52, -0.05; P=0.02). Infant cognitive development scores were not associated with maternal fructose and SSB+J consumption at 6 postnatal months. Our findings suggest that infant neurodevelopmental outcomes at 24 postnatal months can be adversely influenced by maternal fructose intake in early lactation, and this could be attributed to maternal SSB+J intake.

The effect of sugar-sweetened beverages at 4 years of age on appetitive behaviours of 7-year-olds from the Generation XXI birth cohort.

The consumption of energy-dense sugar-sweetened beverages (SSB) and its low satiating effects may influence the development of child eating behaviours. We aimed to investigate the association of SSB consumption at 4 years on appetitive behaviours at age 7 years. Children from the Generation XXI birth cohort were included (n 3880). SSB consumption was evaluated through a FFQ and appetitive behaviours were evaluated through the Children's Eating Behaviour Questionnaire, which includes eight subscales. Two composite factors, derived by principal component analysis (Appetite Restraint - related to Food Fussiness, Enjoyment of Food, Slowness in Eating and Satiety Responsiveness - and Appetite Disinhibition - related to Food Responsiveness, Emotional Under- and Overeating and Desire to Drink), were also investigated. The dose-response relationship between SSB consumption and appetitive behaviours was examined using multivariable linear regression (continuous eating behaviour scores) and multinomial logistic regression (tertile categories of eating behaviour scores). Child SSB consumption at 4 years was associated with higher Appetite Disinhibition and Desire to Drink and lower Food Fussiness and Slowness in Eating at 7 years. Consuming SSB ≥1 times/d (compared with a lower intake) was associated with 29 % increase in the odds of Desire to Drink (3rd v. 1st tertile). Pre-schoolers' SSB consumption was associated with higher food approach and less food avoidant behaviours later in childhood. Family characteristics, particularly maternal SSB consumption, explained part of these associations. It is essential to promote the intake of water, instead of sugary drinks, and make parents and caregivers aware of the importance of this exposure, since they have a pivotal role in shaping children's eating behaviours.

Maternal Consumption of Sugar-Sweetened Beverages and Juices in Lactation Predicts Poorer Infant Neurodevelopment at 24 Postnatal Months

Abstract Objectives Our prior studies have shown that maternal sugar-sweetened beverage and juice (SSBJ) consumption influenced breast milk fructose, and higher breast milk fructose was associated with greater infant growth. It is unknown whether maternal SSBJ consumption in lactation also influences infant neurodevelopment. The aim of this study was to determine whether maternal SSBJ consumption in lactation was associated with infant cognitive, language, and motor development at 24 postnatal months. Associations of maternal fructose, added, and total sugar consumption with infant neurodevelopmental outcomes were also examined. Methods Hispanic mother-infant pairs (N = 89) were recruited across the spectrum of pre-pregnancy BMI. Mothers completed two 24-hour dietary recalls at 1 and 6 postnatal months. The Bayley-III Scales were administered to all infants at 24 postnatal months to assess cognitive, language, and motor development. Multiple linear regressions were used to assess the correlations of maternal diet with infant Bayley-III outcomes, adjusting for maternal age, BMI, education level, energy intake, infant age, sex, and birthweight. Results At 1 postnatal month, mothers consumed 2.7 ± 3.1 servings SSBJ, 22 ± 12 g fructose, 59 ± 35 g added sugar, and 98 ± 47 g total sugar per day, and all were inversely associated with infant Bayley-III outcomes. Every 1 serving increase in SSBJs was associated with a 0.24 decrease in cognitive, 0.50 decrease in language, and 0.43 decrease in motor development scores (all P's ≤0.01). At 6 postnatal months, maternal SSBJ consumption remained inversely associated with infant motor development scores (B = −0.24, P = 0.03), but maternal fructose, added, and total sugar consumption were not associated with infant Bayley-III outcomes. Conclusions Our findings suggest that maternal SSBJ consumption in early lactation is an adverse influence of infant neurodevelopmental outcomes at 24 postnatal months. Funding Sources National Institute of Diabetes and Digestive and Kidney Diseases (NIH R01 DK110793); The Gerber Foundation (15PN-013).

Associations of Prenatal and Child Sugar Intake With Child Cognition

Sugar consumption among Americans is above recommended limits, and excess sugar intake may influence cognition. The aim of this study was to examine associations of pregnancy and offspring sugar consumption (sucrose, fructose) with child cognition. Additionally, associations of maternal and child consumption of sugar-sweetened beverages (SSBs), other beverages (diet soda, juice), and fruit with child cognition were examined. Among 1,234 mother-child pairs enrolled 1999-2002 in Project Viva, a pre-birth cohort, in 2017 diet was assessed during pregnancy and early childhood, and cognitive outcomes in early and mid-childhood (median ages 3.3 and 7.7 years). Analyses used linear regression models adjusted for maternal and child characteristics. Maternal sucrose consumption (mean 49.8 grams/day [SD=12.9]) was inversely associated with mid-childhood Kaufman Brief Intelligence Test (KBIT-II) non-verbal scores (-1.5 points per 15 grams/day, 95% CI= -2.8, -0.2). Additionally, maternal SSB consumption was inversely associated with mid-childhood cognition, and diet soda was inversely associated with early and mid-childhood cognition scores. Early childhood consumption of SSBs was inversely associated with mid-childhood KBIT-II verbal scores (-2.4 points per serving/day, 95% CI= -4.3, -0.5) while fruit consumption was associated with higher cognitive scores in early and mid-childhood. Maternal and child fructose and juice consumption were not associated with cognition. After adjusting for multiple comparisons, the association between maternal diet soda consumption and mid-childhood KBIT-II verbal scores remained significant. Sugar consumption, especially from SSBs, during pregnancy and childhood, and maternal diet soda consumption may adversely impact child cognition, while child fruit consumption may lead to improvements. Interventions and policies that promote healthier diets may prevent adverse effects on childhood cognition.

Factors Influencing Early Feeding of Foods and Drinks Containing Free Sugars-A Birth Cohort Study.

Early feeding of free sugars to young children can increase the preference for sweetness and the risk of consuming a cariogenic diet high in free sugars later in life. This study aimed to investigate early life factors influencing early introduction of foods/drinks containing free sugars. Data from an ongoing population-based birth cohort study in Australia were used. Mothers of newborn children completed questionnaires at birth and subsequently at ages 3, 6, 12, and 24 months. The outcome was reported feeding (Yes/No) at age 6–9 months of common foods/drinks sources of free sugars (hereafter referred as foods/drinks with free sugars). Household income quartiles, mother’s sugar-sweetened beverage (SSB) consumption, and other maternal factors were exposure variables. Analysis was conducted progressively from bivariate to multivariable log-binomial regression with robust standard error estimation to calculate prevalence ratios (PR) of being fed foods/drinks with free sugars at an early age (by 6–9 months). Models for both complete cases and with multiple imputations (MI) for missing data were generated. Of 1479 mother/child dyads, 21% of children had been fed foods/drinks with free sugars. There was a strong income gradient and a significant positive association with maternal SSB consumption. In the complete-case model, income Q1 and Q2 had PRs of 1.9 (1.2–3.1) and 1.8 (1.2–2.6) against Q4, respectively. The PR for mothers ingesting SSB everyday was 1.6 (1.2–2.3). The PR for children who had been breastfed to at least three months was 0.6 (0.5–0.8). Similar findings were observed in the MI model. Household income at birth and maternal behaviours were significant determinants of early feeding of foods/drinks with free sugars.

Early sugar-sweetened beverage consumption frequency is associated with poor quality of later food and nutrient intake patterns among Japanese young children: the Osaka Maternal and Child Health Study

Evidence from Western countries shows that higher consumption of sugar-sweetened beverages (SSBs) is associated with lower quality of young children’s diets, but little is known about these relations in non-Western countries with relatively low consumption levels of SSBs. We hypothesized that SSB consumption in infancy would be associated with poor quality of later food and nutrient intake patterns among Japanese young children. The study subjects were 493 Japanese mother-child pairs from a prospective birth cohort study. Dietary data on children were collected from the mothers using self-administered questionnaires when the children were aged 16-24 months and 41-49 months. Multiple linear regression analyses were used to examine the relationships between SSB consumption frequency in infancy and later intake of foods and nutrients. At 16-24 months of age, more than half of the children (56.4%) consumed SSBs less than once a week, whereas 11.6% consumed SSBs at least once daily. More frequent consumption of SSBs in infancy was associated with higher intake of confectionaries and SSBs and lower intake of fruits and vegetables at 41-49 months of age. These associations were still evident after adjustment for maternal SSB consumption and socioeconomic status. At the nutrient level, SSB consumption frequency was positively associated with energy intake and inversely associated with intake of many nutrients, such as protein, dietary fiber, and most of the micronutrients examined. In conclusion, higher consumption frequency of SSBs at an early age is associated with poor quality of overall dietary intake among young Japanese children 1.5-2.5 years later.

Pregnancy Glucose Levels in Women Without Diabetes or Gestational Diabetes and Childhood Cardiometabolic Risk at 7 Years of Age

Objective To estimate the association between pregnancy glucose values in women without recognized pregestational diabetes or gestational diabetes and cardiometabolic risk in their children. Study design This longitudinal cohort study of 211 Mexican American mother-child pairs participating in the Center for the Health Assessment of Mothers and Children of Salinas study used multiple logistic regression to estimate the children's risk of nonfasting total cholesterol, nonfasting triglycerides, blood pressure (BP), and waist circumference (WC) ≥75th percentile at 7 years of age associated with a 1-mmol/L (18-mg/dL) increase in maternal pregnancy glucose level, measured 1 hour after a 50-g oral glucose load. Results The ORs for children in the upper quartile of diastolic BP, systolic BP, and WC associated with a 1-mmol/L increase in pregnancy glucose level were 1.39 (95% CI, 1.10-1.75), 1.38 (95% CI, 1.10-1.73), and 1.25 (95% CI, 1.02-1.54), respectively. Prepregnancy obesity was independently associated with increased odds of children belonging to the upper quartile of WC; maternal sugar-sweetened beverage consumption and gestational weight gain prior to the glucose test were not independently associated with any of the cardiometabolic outcomes. Conclusion In Mexican American women without recognized pregestational diabetes or gestational diabetes, we found an association between increasing pregnancy glucose values and the children's diastolic and systolic BPs and WC at 7 years of age. Whether interventions to reduce pregnancy glucose values, even if below levels diagnostic of overt disease, will mitigate high BP and abdominal obesity in late childhood remains to be determined.