Intake Of Sugar-containing Beverages Research Articles

Validation of a parent proxy-reported beverage screener compared to a 24-hour dietary recall for the measurement of sugar-containing beverage intake among young children.

Measures that can provide reasonably accurate estimates of sugar-containing beverage (SCB) intake among children are needed. The primary objective of this study was to evaluate the relative validity of a short beverage screener (Nutrition and Health Questionnaire, NHQ) compared to a 24-hour recall (Automated Self-Administered 24-h (ASA24) Dietary Assessment Tool-Canada) for assessing parent proxy-reported daily SCB intake among children aged 4-14 years from the TARGet Kids! research network in Toronto, Canada. Children for whom a NHQ completed between March 2018 and June 2019 and an ASA24 completed within one year were included. A total of 471 parents who completed the NHQ beverage screener were also asked to complete the ASA24. One-hundred sixty-three completed the ASA24 and of this group, 109 were analyzed. Estimates of daily intake of 100% juices, sweetened drinks and soda, and total SCBs from the two measures were compared. The mean difference in beverage intake, Spearman correlations, and Bland-Altman plots were estimated for continuous measures. The kappa coefficient, sensitivity, and specificity were calculated for dichotomous measures of any daily intake versus none. The mean difference in total SCB intake between the NHQ and ASA24 was 0.14 cups/day (95% CI 0.01, 0.29) and the correlation was 0.43 (95% CI 0.26, 0.57). Sensitivity and specificity for any daily SCB intake were 0.63 and 0.76, respectively. Overall, parent proxy-reporting of children's total SCB intake from a beverage screener can provide reasonable estimates of SCB intake when detailed dietary assessment is not feasible.

Correlation Between BMI, Caries Prevalence, and Sugar-containing Beverage Intake in 6-10 Year Old Children.

Background:The beverages containing sugar are proven risk factors for obesity and dental caries. Therefore, owing to the shared risk factors, an interrelationship is suspected between BMI, sugar beverage consumption, and dental caries in children.Aims:The present trial was carried out to assess the interrelationship between BMI, sugar beverage consumption, and dental caries in children aged 6–10 years.Materials and Methods:Eighty-six children within the age range of 6–10 years answered the health questionnaire. The BMI was calculated, intra-oral assessment was done, the frequency of sweetened beverage consumption was recorded, and the collected data were subjected to the statistical evaluation to formulate results.Results:On evaluation, a non-significant difference was observed in BMI levels in the four groups (P = 0.12). Whole-milk intake also showed an inverse correlation with dental caries and BMI, but this correlation was statistically non-significant with the respective values of P = 0.57 and 0.55. A similar inverse relationship was seen for low-fat milk for caries and BMI with P = 0.65 and 0.45, respectively. Regarding soft drinks, 44.1% (n = 38) took soft drinks, and a non-significant relation between caries and intake as well as BMI and intake with P = 0.86 and 0.55, respectively.Conclusion:Within its limitations, the present study concludes that no correlation exists between BMI and dental caries as well as between sugar-containing beverage consumption and dental caries. Also, BMI and sugar-containing beverage consumption showed no correlation in children aged 6–10 years.

The Correlation between Demographical and Lifestyle Factors and Traditional Chinese Medicine Constitution among Macau Elderly Individuals.

Objectives To measure the distributed characteristics of Traditional Chinese Medicine (TCM) constitutions, as well as related factors with biased TCM constitutions among the elderly individuals in Macau. Methods The elderly individuals from elderly healthcare centers located in Macao Peninsula, Taipa, and Coloane were selected as research samples. The basic information questionnaire and the Constitution in Chinese Medicine Questionnaire (CCMQ) for elderly were employed. Descriptive analysis was applied to illustrate demographical characteristics and TCM constitution distribution. Exploratory factor analysis (EFA) was conducted to explore potential factors influencing biased constitutions, and weight of each variable for constitution was further calculated. Results A total of 313 participants were recruited. Eighty-six (27.48%) elderly were identified as balanced constitution; others were biased constitutions accounting for 72.52%. Distribution differences related to gender and age were identified among participants with unbalanced constitutions. Four biased constitutions were further analyzed with EFA. For qi-stagnation and yang-deficiency constitutions, three similar factors were determined in the domains of education, sleeping habits, and lifestyle behaviors, successively. Although four factors were identified in phlegm-dampness constitution, the latter two belonged to lifestyle behaviors and the former two were education and sleeping habits. For yin-deficiency constitution, education, tobacco-alcohol consumption, sleeping habits, and exercise were four dimensions of potential influential factors. Tobacco consumption, sleep, and exercise duration weighted the most for qi-stagnation constitution; sleep duration, education level, and sugar-containing beverage intake for phlegm-dampness; length of education, alcohol consumption, and education level for yang-deficiency constitution; and weekly exercise hours, sleep duration, and education level for yin-deficiency constitution. Conclusion The prevalence rate of biased constitutions was relatively high among elderly residents in Macau. Relations between demographical and lifestyle behavioral factors and biased constitutions were identified in this study. Controlling these influential factors might be beneficial for health management of Macau elderly individuals.

Associations Between Intake of Sugar-Containing Beverages in Infancy With Liver Fat Accumulation at School Age.

Background and AimsSugar‐containing beverage intake is a major risk factor for obesity in both children and adults and appears to be associated with NAFLD in adults. The purpose of this study was to examine the associations between sugar‐containing beverage intake in infancy and liver fat accumulation and NAFLD among school‐aged children.Approach and ResultsIn a population‐based prospective cohort study of 1,940 infants, we assessed sugar‐containing beverage intake at 1 year with a validated Food Frequency Questionnaire. Liver fat fraction and NAFLD (liver fat fraction ≥5.0%) were assessed with MR. Higher sugar‐containing beverage intake in infancy was not associated with higher liver fat accumulation at 10 years of age when assessed continuously (SD, 0.03; 95% CI, ‐0.02, 0.07, per one‐serving/day increase of sugar‐containing beverage intake) or categorically (P = 0.38). However, compared to infants with <1.0 serving/day, those with >2.0 servings/day had the highest odds of NAFLD at 10 years of age (OR, 3.02; 95% CI, 1.34, 6.83). These associations remained borderline significant after additional adjustment for sugar‐containing beverage intake and body mass index at school age (P = 0.13). Stratified analyses showed stronger associations between sugar‐containing beverage intake in infancy and NAFLD at 10 years of age among children of mothers with lower educational attainment (OR, 1.48; 95% CI, 1.12, 1.97) and among children with overweight or obesity (OR, 1.47; 95% CI, 1.05, 2.07).ConclusionsHigher sugar‐containing beverage intake in infancy was associated with NAFLD in school‐aged children, independent of sugar‐containing beverage intake and body mass index at school age. Limiting the intake of sugar‐containing beverages in infancy may help prevent liver steatosis at school age.

Sugar-containing beverages and their association with risk of breast, endometrial, ovarian and colorectal cancers among Canadian women

BackgroundThe association of sugar containing beverages (SCBs) with risk of breast, endometrial, ovarian and colorectal cancers is unclear. Therefore, we investigated these associations in the Canadian Study of Diet, Lifestyle, and Health. MethodsThe study population comprised an age-stratified subcohort of 3185 women and 848, 161, 91 and 243 breast, endometrial, ovarian and colorectal cancer cases, respectively. We used Cox proportional hazards regression models modified for the case-cohort design to assess the associations of SCBs with risk of the aforementioned cancers. ResultsCompared to SCB intake in the lowest tertile, SCB intake in the highest tertile was positively associated with endometrial cancer risk (HRT3 vs T1 = 1.58, 95 % CI = 1.08−2.33 and 1.78, 95 % CI = 1.12−2.81 for overall and Type 1 endometrial cancer, respectively) and ovarian cancer (HRT3 vs T1 = 1.76, 95 % CI: 1.09−2.83). Fruit juice intake was also positively associated with risk of Type 1endometrial (HRT3 vs T1 = 1.63, 95 % CI = 1.03−2.60). After excluding women with diabetes or cardiovascular diseases, we also observed sugar-sweetened beverages (SSBs) intake in the highest tertile was associated with higher risk of Type 1 endometrial cancer (HR T3 vs T1 = 1.65; 95 % CI: 1.03−2.64). None of the beverages was associated with risk of breast or colorectal cancer. ConclusionWe conclude that, in this cohort, relatively high SCB intake was associated with higher risk of endometrial and ovarian cancers, but not of breast or colorectal cancers. Our findings also suggest that relatively high SSB and fruit juice intake are associated with higher risk of Type 1 endometrial cancer.

Sugar-containing beverage consumption and cardiometabolic risk in preschool children

ObjectiveSugar-containing beverages (SCBs) including 100% fruit juice, fruit drinks and soda substantially contribute to total caloric intake in young children. The objective of this study was to examine whether consumption of SCB is associated with cardiometabolic risk (CMR) in preschool children, along with whether 100% fruit juice and sugar sweetened beverage (SSB) is associated with CMR.Study DesignWe used a repeated measures study design examining SCB consumption and CMR outcomes measured concurrently in children 3–6 years of age participating in TARGet Kids!, a primary-care, practice-based research network in Canada (2008–2017). To account for within-person variability, multivariable linear regression models using generalized estimating equation was used to examine the association between SCB consumption and CMR score and the individual CMR score components including systolic blood pressure, waist circumference, high-density lipoprotein cholesterol (HDL-c), triglycerides, and glucose.ResultsAfter adjusting for sociodemographic, familial and child-related covariates, higher SCB consumption was associated with elevated CMR score [0.05 (95% CI −0.0001 to 0.09), p = 0.05], including lower HDL-c [−0.02 mmol/L (95% CI −0.03 to −0.01), p = 0.01] and higher triglycerides [0.02 mmol/L (95% CI 0.004 to 0.04), p = 0.02]. When examined separately, higher 100% fruit juice [−0.02 mmol/L (95% CI −0.03 to −0.003), p = 0.02] and SSB[-0.03 mmol/L (95% CI −0.06 to −0.001), p = 0.04] consumption were each associated with lower HDL-c.ConclusionHigher SCB consumption was associated with small elevations of CMR in preschool children. Our findings support recommendations to limit overall intake of SCBs in early childhood, in effort to reduce the potential long-term burden of CMR.

The Association between Early Childhood and Later Childhood Sugar-Containing Beverage Intake: A Prospective Cohort Study.

Sugar-containing beverages (SCBs) are a major source of sugar intake in children. Early life intake of SCBs may be a strong predictor of SCB intake later in life. The primary objective of this study was to evaluate if SCB intake (defined as 100% fruit juice, soda, and sweetened drinks) in early childhood (≤2.5 years of age) was associated with SCB intake in later childhood (5–9 years of age). A prospective cohort study was conducted using data from the TARGet Kids! primary care practice network (n = 999). Typical daily SCB intake was measured by parent-completed questionnaires. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression. A total of 43% of children consumed ≥0.5 cups/day of SCBs at ≤2.5 years and this increased to 64% by 5–9 years. Daily SCB intake, compared to no daily intake, at ≤2.5 years was significantly associated with SCB intake at 5–9 years (adjusted OR: 4.03; 95% CI: 2.92–5.55) and this association was much stronger for soda/sweetened drinks (adjusted OR: 12.83; 95% CI: 4.98, 33.0) than 100% fruit juice (OR: 3.61; 95% CI: 2.63–4.95). Other early life risk factors for SCB intake at 5–9 years were presence of older siblings, low household income, and shorter breastfeeding duration. Daily intake of SCBs in early childhood was strongly associated with greater SCB intake in later childhood. Early life may be an important period to target for population prevention strategies.

Better diet quality relates to larger brain tissue volumes: The Rotterdam Study.

To investigate the relation of diet quality with structural brain tissue volumes and focal vascular lesions in a dementia-free population. From the population-based Rotterdam Study, 4,447 participants underwent dietary assessment and brain MRI scanning between 2005 and 2015. We excluded participants with an implausible energy intake, prevalent dementia, or cortical infarcts, leaving 4,213 participants for the current analysis. A diet quality score (0-14) was calculated reflecting adherence to Dutch dietary guidelines. Brain MRI was performed to obtain information on brain tissue volumes, white matter lesion volume, lacunes, and cerebral microbleeds. The associations of diet quality score and separate food groups with brain structures were assessed using multivariable linear and logistic regression. We found that better diet quality related to larger brain volume, gray matter volume, white matter volume, and hippocampal volume. Diet quality was not associated with white matter lesion volume, lacunes, or microbleeds. High intake of vegetables, fruit, whole grains, nuts, dairy, and fish and low intake of sugar-containing beverages were associated with larger brain volumes. A better diet quality is associated with larger brain tissue volumes. These results suggest that the effect of nutrition on neurodegeneration may act via brain structure. More research, in particular longitudinal research, is needed to unravel direct vs indirect effects between diet quality and brain health.

Diet quality in childhood: the Generation R Study

PurposeWe aimed to evaluate diet quality of 8-year-old children in the Netherlands, to identify sociodemographic and lifestyle correlates of child diet quality, and to examine tracking of diet quality from early to mid-childhood.MethodsFor 4733 children participating in a population-based cohort, we assessed dietary intake using a validated food-frequency questionnaire at a median age of 8.1 years (interquartile range 8.0–8.2) (2011–2014). Based on dietary guidelines, we developed and validated a food-based diet quality score for children consisting of ten components (score 0–10): sufficient intake of vegetables; fruit; whole grains; fish; legumes; nuts; dairy; oils and soft fats; and low intake of sugar-containing-beverages; and high-fat and processed meat.ResultsWe observed a mean (± SD) diet quality score of 4.5 (± 1.2) out of a maximum of 10. On average, intake of legumes, nuts, and oils or soft fats was below recommendations, whereas intake of sugar-containing beverages and high-fat or processed meat was higher than recommended. The main factors associated with higher diet quality were higher maternal educational level (β = 0.29, 95% CI 0.21, 0.37 versus low education), higher household income (β = 0.15, 95% CI 0.05, 0.25 versus low income), no maternal smoking (β = 0.13, 95% CI 0.02, 0.25 versus current smoking), and less screen time (β = 0.31, 95% CI 0.24, 0.38)—all independent of each other. For children with available dietary data at age 1 year (n = 2608), we observed only weak tracking of diet quality from early to mid-childhood (Pearson’s r = 0.19, k = 0.11 for extreme quartiles).ConclusionOverall diet quality of 8-year-old children did not conform to dietary guidelines, especially for children having more screen time, children of lower educated or smoking mothers, or from lower-income households.

Mothers’ intake of sugar-containing beverages during pregnancy and body composition of their children during childhood: the Generation R Study1–3

Background: High intake of sugar-containing beverages (SCBs) has been linked to increased risk of obesity. However, associations of SCB intake during pregnancy with child body composition have been unclear.Objectives: We explored whether SCB intake during pregnancy was associated with children’s body mass index (BMI) and detailed measures of body composition. In addition, we examined different types of SCBs (i.e., fruit juice, soda, and concentrate).Design: We included 3312 mother-child pairs of the Generation R Study, a prospective cohort from fetal life onward in the Netherlands. Energy-adjusted SCB intake was assessed in the first trimester with a food-frequency questionnaire. Anthropometric data of the children were collected repeatedly ≤6 y of age, and BMI was calculated. At 6 y of age, we further measured fat mass index (FMI) and fat-free mass index with dual-energy X-ray absorptiometry. All outcomes were sex- and age-standardized. Associations of SCB intake with children’s BMI trajectories and body composition were analyzed with multivariable linear mixed and regression models.Results: Results from linear mixed models showed that, after adjustment for confounders including the SCB intake of the child itself, mothers’ total SCB intake was positively associated with children’s BMI ≤6 y of age [per serving per day: 0.04 SD score (SDS); 95% CI: 0.00, 0.07 SDS]. In addition, intakes of total SCBs and fruit juice, but not of soda or concentrate, were associated with a higher FMI [total SCBs: 0.05 SDS (95% CI: 0.01, 0.08 SDS); fruit juice: 0.04 SDS (95% CI: 0.01, 0.06 SDS)] of the 6-y-old children. These associations remained significant (P < 0.05) after additional adjustment for gestational weight gain, birth weight, and children’s insulin concentrations.Conclusion: Our study suggests that maternal SCB intake during pregnancy is positively associated with children’s BMI during early childhood and particularly with higher fat mass.

Elementary School-Based Obesity Intervention Using an Educational Curriculum.

Pediatric obesity is a significant public health problem with a prevalence of 16.9% among US children. School-based obesity interventions show promise for reducing adiposity in elementary age children. This pilot study evaluated the impact of the Let's Go! 5-2-1-0 pediatric obesity intervention program in an elementary school setting. This was a cluster randomized controlled field trial comprising 8 classrooms of second- and third-grade children. The impact of implementation of a standardized 5-2-1-0 curriculum was evaluated in the classrooms by looking at health behavior (self-reported fruit and vegetable and sugar-containing beverage intake, and screen time), physical activity (steps measured by pedometer), and body mass index (BMI). Half of the classrooms were given 5-2-1-0 teaching over a 4-month period. There was no statistical difference in improvement of healthy habits, BMI, or physical activity in the intervention group compared with the control group. The 5-2-1-0 intervention used in this study was feasible. There was no significant change in healthy habits, likely due to the small number of participants in the study. The intervention and control sites were in different classrooms and there could be factors such as teacher enthusiasm, socioeconomic factors, and individual traits affecting habits. Future studies could use pre- and post-intervention quizzes to assess healthy habits knowledge retention, involving the environments the child participates in outside of school, using research-grade pedometers or accelerometers for measuring activity data collection, and recruiting larger samples to ensure adequate statistical power.

Question 1: What is the best strategy to promote water consumption in children?

Mario is obese and drinks over 1 L of sweetened beverages a day. His mother is worried about her son because she is obese as well and was just diagnosed with type 2 diabetes. She has read that sugar-containing beverage intake is linked to obesity in childhood. She wonders if there is a way to get Mario to drink water instead of sweetened beverages and asks your opinion. ### Structured clinical question In children and adolescents (0–18 years) (patient), how should we promote water drinking (intervention) to increase water intake (outcome)? Secondary sources (Cochrane Library): nil. Search strategy MEDLINE (to October 2015) ‘water’ and ‘drink’ and ‘children’ yielded 292 hits, of which 7 were relevant; ‘water’ and ‘encourage*’ and ‘children’ with limit ‘clinical study’ produced 274 hits and revealed two additional studies; ‘water’ and ‘promot*’ with limit ‘clinical study’ produced 126 hits …

Sugar-containing beverage intake at the age of 1 year and cardiometabolic health at the age of 6 years: the Generation R Study.

BackgroundConsumption of sugar-containing beverages (SCBs) in adults has been associated with an increased risk of metabolic syndrome. Although the effect of SCB on body weight in children is well established, little is known about the cardiometabolic effects in young children. We studied the associations of SCB intake at the age of 1 year with cardiometabolic health at age 6 years.MethodsThis study was performed among 2,045 Dutch children from a population based prospective birth cohort. SCB intake was assessed with a semi-quantitative food frequency questionnaire at the age of 13 months and sex-specific tertiles were created. Children visited the research center at the age of 6 years. We created a continuous cardiometabolic risk factor score including: body fat percentage, blood pressure, insulin, HDL-cholesterol and triglycerides. Age-and sex-specific standard deviation (SD) scores were created for all outcomes. Multivariable linear regression was performed with adjustment for socio-demographic and lifestyle variables of mother and child.ResultsIn the total population, we observed an association between higher SCB intake at 13 months of age and a higher cardiometabolic risk factor score at the age of 6 years (0.13SD (95 % CI 0.01; 0.25), highest vs. lowest tertile) After stratification by sex, we found that boys in the highest tertile of SCB intake had a higher cardiometabolic risk factor score (0.18 SD (95 % CI 0.01; 0.34)), as compared to boys in the lowest tertile of SCB intake. There was no significant association in girls. We did not find associations of SCB intake with the individual cardiometabolic risk factors in the total population, or in the stratified analyses.ConclusionHigher SCB intake at 1 year of age was associated with a higher cardiometabolic risk factor score at age 6 years in boys, but not in girls. Further research on sex-specific effects of SCBs is needed.

Sugar-containing beverage intake in toddlers and body composition up to age 6 years: the Generation R study.

Intake of sugar-containing beverages (SCBs) has been associated with higher body mass index (BMI) in childhood. The potential effect of SCB intake during infancy is unclear. We examined the association of SCB intake at 13 months with BMI development until 6 years and body composition at age 6 years. This study included 2371 Dutch children from a population-based prospective cohort study. SCB intake at 13 months was assessed using a Food Frequency Questionnaire with validation against 24-h recalls and was standardized for total energy. BMI was calculated from repeated weight and height measurements, and age- and sex-specific s.d. scores were calculated. Adiposity was measured using Dual-energy X-ray absorptiometry. In girls, higher SCB intake at 13 months was significantly associated with higher BMI at ages 2, 3, 4 and 6 years (at age 6 years BMI (s.d. score) increase 0.11 (95% confidence interval (CI) +0.00; 0.23), high versus low intake). We observed a tendency towards higher android/gynoid fat ratio in girls with high intake (s.d. increase 0.14 (95% CI -0.02; 0.29), versus low intake) but not with body fat percentage. In boys, there was no association with BMI or body composition, but boys with high SCB intake at 13 months were taller at age 6 years (s.d. increase 0.14 (95% CI +0.00; 0.27), versus low intake). Higher SCB intake at 13 months was associated with higher BMI up to age 6 years in girls but not in boys. Our results imply that the unfavorable effects of SCB intake start early in life and that dietary advice regarding limiting SCB intake should already be given early in life.

Is the intake of sugar-containing beverages during adolescence related to adult weight status?

To investigate the relationship between the intake of sugar-containing beverages (SCB) at the age of 13 years and adult weight status 24–30 years later. A longitudinal study with 30 years of follow-up from adolescence (age 13 years in 1976) to adulthood (up to 2000 and 2006). Dietary intake was assessed through cross-check dietary history face-to-face interviews by a dietitian. Beverages were divided into two categories: (i) total SCB and (ii) SCB excluding 100% fruit juices. Percentage of total fat (%total fat) and percentage of trunk fat (%trunk fat) were obtained through dual-energy X-ray absorptiometry measurements; body weight and height were measured by trained staff. Amsterdam Growth and Health Longitudinal Study, the Netherlands. One hundred and fourteen males and 124 females. In males, but not in females, each additional daily serving of SCB excluding 100% fruit juices at 13 years was associated with 1?14% higher %total fat (95% CI 0?04, 2?23 %; P50?04) and 1?62% higher %trunk fat (95% CI 0?14, 3?10 %; P50?03) in adulthood after correction for confounders. No statistically significant relationship was found between the intake of SCB excluding 100% fruit juices at the age of 13 and BMI in both sexes. In addition, no statistically significant relationships were found between the intake of total SCB and all measures of adult weight status in both sexes. Intake of SCB excluding 100% fruit juices at the age of 13 years was positively associated with adult %total fat and %trunk fat in males, but not in females.