Sugary Drinks Research Articles

Higher sweet beverage consumption was associated with increased gestational weight gain and birth weight: A Chinese cohort study

Diet during pregnancy is crucial to maternal metabolism and fetal development, so exploring the most potent food risk factor could improve maternal and child health. In this study, we investigated the diet and lifestyle of 833 healthy pregnant women in the second trimester from November 2020 to August 2021. Based on the Tianjin Antenatal Care System in China, we followed up with these women and recorded their gestational weight gain (GWG) and newborn birth weight. We conducted a dietary survey through FFQ based on the food groups recommended by the Chinese Dietary Guidelines and included common ultra-processed foods. We collected 219 semi-quantitative FFQs and 614 self-reported FFQs for analysis. According to the consumption frequency of 12 food groups, 4 dietary patterns were extracted by principal component analysis. We analyzed the associations of food energy, consumption frequency, and dietary patterns with GWG and birth weight, especially GWG in the first and second trimesters (f-GWG). The results showed that f-GWG was positively correlated with food energy. Beverage consumption was associated with f-GWG (r = 0.288, P = .026) in obese pregnant women. A dietary pattern that favors high consumption of ultra-processed foods (fried foods, baked desserts, and sweet beverages) was associated with increased GWGs. Non-obesity women with high consumption of baked desserts and sweet beverages had higher GWGs (P < .05). After adjusting for confounding factors (including total energy, physical activity, and sleep quality), only sweet beverage consumption was associated with f-GWG (β 0.498, 95%CI 0.153-0.843) and birth weight (β 0.124, 95%CI 0.009-0.240). Sweet beverage consumption is a key adjustable risk factor for prenatal care.

Total sugar content of pre-packaged beverages available in Saudi Arabia

Beverages are a major source of sugar; therefore, efforts to reduce sugar consumption focus on limiting sugary drinks. This is a descriptive observational analysis study of pre-packaged beverages. The analysis covered 12 beverage categories and 28 types of commonly available sugars in beverages. The beverages' median total sugar was determined and assessed based on the World Health Organization (WHO) recommended upper limit of sugar intake and the multiple traffic light labeling (MTL) criteria. Different analyses were performed including frequencies and median to determine the categories with high sugar content and non-parametric tests to compare the median of the total sugar among categories. The median total sugar content of the 1400 analyzed beverages was 11 g 100 mL-1; fruit juices and soft drinks had the highest median of total sugar (12 – 11 g 100 mL-1). The top sugar terms found are White sugar, Sucrose, High-fructose corn syrup, and Glucose syrup. The median total sugar in our study amounts to 20 % of the WHO upper limit recommendation, and 46.22 % of the beverages received a ‘red’ label for sugar content per 100 mL based on the MTL criteria. Sugar content in the pre-packaged beverages is high compared to the recommended daily limit of sugar.

Intermittent access to sugary drinks associated with fasting induces overeating and depressive-like behavior in female C57BL/6J mice

Binge eating disorder is the most prevalent eating disorder, affecting both sexes but more commonly found in women. Given the frequent co-occurrence of psychiatric disorders, this study aimed to establish a standardized experimental intermittent protocol to investigate overeating associated with depression. A 10-day protocol induced uncontrolled eating behavior in C57BL/6J female mice. The first experiment included the following groups: naive group (chow ad libitum), control group (chow and sucrose solution ad libitum), and fasting groups (16 and 20 h) exposed to an intermittent sucrose solution (10 %) and chow regimen. Subsequently, the feeding test, open field test, elevated plus maze test, tail suspension test, and light/dark conflict test were conducted. Furthermore, monoamine oxidase (MAO) A and B activities in brain structures and plasma corticosterone levels were assessed. Food overconsumption and depressive-like behavior were observed in both sucrose fasting groups, while risk-taking behaviors were specifically observed in the 20-hour fasting sucrose group. While both fasting sucrose groups caused reduced hippocampal MAO-A activity, only the F20 sucrose group inhibited MAO-B in the cortex and hypothalamus. Moreover, both fasting sucrose groups exhibited elevated corticosterone levels. In a separate design (Experiment 2), groups with 16 and 20 h of fasting alone (without sucrose) did not show the same behavioral results as the intermittent fasting sucrose groups, thus avoiding fasting bias. Based on these results, the 20-hour sucrose fasting group was chosen as the ideal protocol for mimicking overeating behavior associated with depression to investigate future therapeutic approaches for this comorbidity.

Responsiveness and Reliability of a Sipping Device to Measure Motivation in Normal-Weight Individuals and Bariatric Surgery Patients.

There is an urgent need to measure the motivation to taste a sweet fluid in order to determine the influence of sweet tastes on the potential choices and consumption of beverages in patients with obesity. Current methods utilize either survey instruments or arbitrary operant tasks. The sipometer enables the participant to utilize an actual ingestive behavioral response to measure motivation during access to beverages on either ad libitum (AL) or progressive time ratio (PR) schedules. We determined the sipometer's responsiveness and reliability as a test of change in motivation for sweet tastes after bariatric surgery. Participants (58 patients and 28 controls, BMI: 18.5-24.9 kg/m2) sham-consumed an aspartame-sweetened (S) and non-sweetened (N) beverage under AL and PR schedules at a pre-surgery/baseline and a 3-month and 24-month visit (patients only). Cumulative pressure (CumPres), a measure of effort, was the sum of the pressures exerted during sipping under each condition. Baseline CumPres for PRS was higher than ALS and ALN in patients (p < 0.03) and higher than PRN in controls (p = 0.009). At 3 months, CumPres did not differ amongst conditions in patients, but CumPres for PRS was higher than all other conditions in controls (p < 0.0005). There were no baseline group differences; however, patients' CumPres for PRS was lower than controls' at 3 months (p = 0.002). Patients' CumPres for PRS decreased non-significantly between the baseline and 3 months but increased at 24 months compared to 3 months (p = 0.025) and was no different from baseline. Controls' CumPres for PRS increased at 3 months (p = 0.0359), but CumPres for all conditions was correlated between visits (p's < 0.038). The sipometer is a reliable and sensitive measure of motivation to consume sweet beverages and may reflect changes in post-operative energy intake.

Online retail nudges to help parents with lower-income choose healthy beverages for their children: A randomized clinical trial.

Nudges offer a promising tool to reduce sugary drink intake among children who are most at risk for diet-related disease. To examine the impact of online store nudges on purchases of sugary drinks for children in lower-income households. Caregivers with lower-income were recruited to an online shopping experiment and instructed to spend $10-$30 on three beverages for their child aged 1-5 years. Participants were randomized to navigate an online supermarket in its standard version (n = 1106) or a version with nudges (n = 1135), including a product placement nudge (i.e. placing healthy beverages in prominent positions) and a swap nudge (i.e. offering a swap of water, plain milk and/or 100% fruit juice upon selection of sugary drinks). On average, participants purchased 1887 (SD = 2113) and 620 (SD = 1528) calories from sugary drinks per basket in the control and experimental conditions, respectively. Model-based results indicate that those in the experimental condition purchased 1267 (95% CI: 1419, 1114) fewer calories from sugary drinks, and fewer grams of total sugar (β = -253.5 g (95% CI: -286.3, -220.6)) and added sugar (β = -287.8 g (95% CI: -323.1, -252.5)) purchased from sugary drinks. Nudges may be an effective, acceptable, scalable strategy for leading caregivers in lower-income households to purchase fewer sugary drinks for their children.

Food Contamination with Micro-plastics: Occurrences, Bioavailability, Human Vulnerability, and Prevention

Abstract: Microplastics (MPs) are emergent environmental contaminants that are designated as either primary or secondary dependent on their origins. Formulation, morphology, dimensions, and colour scheme, along with other features, are connected with their propensity to reach the food webs and their dangers. Whilst ecological adversities of MPs have drawn considerable interest, the hazards to individuals from dietary exposure have yet to be determined. The aim of this review is to gauge existing understanding concerning MPs in foodstuffs and to explore the problems and inadequacies for threat assessment. The prevalence of MPs in foodstuffs and sugary drinks has been detected all over the world, but most researchers judged the existing information to be not only inadequate but also of dubious value, owing to the notable lack of agreement on a regulated quantification methods and a consistent appellation. Most published papers have highlighted potable water and condiments such as sugars, salts, and nectar as significant food components of MPs for humans. The threat assessment reveals significant discrepancies in our understanding of MP toxicity for human consumption, which hinders the estimate of risk-based regulations regarding food safety. The lack of comparators for evaluating MPs food consumption prohibits dietary MPs risk description and risk mitigation. Researchers and Food Safety Administrators confer various obstacles along with possibilities linked to the appearance of MPs in foodstuffs. Further investigation on the MPs categorization and exposures is essential considering that any subsequent threat evaluation record can contain a comprehensive dietary viewpoint.

A study of parental knowledge and intended behaviour regarding introduction of juices and sugar-sweetened beverages in early childhood.

Parents and families have a role to play in helping children develop healthy behaviours that will carry over into adulthood. The sugary drink and fruit juice consumption is significantly related to unhealthy weight gain in childhood. Hence, this study was planned to assess parental knowledge, attitudes, and practices about juice and sugar-sweetened beverages (SSBs) among parents of children (2-24 months) and identify factors that contribute to their early introduction. A cross-sectional study was conducted on 400 children-parent dyads (2-24 months). A questionnaire regarding the knowledge and attitudes about initiating fruit juice and SSB among children was prepared with 6 statements that were validated for contents by two subject experts. Each of the questions was designed to be answered on a Five-point Likert-type scale. STATA 14.2 version was used to analyse data. Out of 400, 14 (26.9%) and 125 (68%) parents planned to introduce SSBs and juices respectively in the first year life of their child. None of the parents had an excellent knowledge score. There was no significant difference reported between parents with less than high school and those with high school/graduation educated in their intention to introduce juice and SSBs (P = 0.68) to their babies in the first year of life and about its knowledge (P = 0.82). Most parents with lower socio-economic status (58.6%) showed less likeliness to introduce juices and SSBs to their child's diet as reflected by a statistically significant (P = 0.01) knowledge score. There was a knowledge gap among parent's of children irrespective of their education level and socio-economic status.

Adherence to Mediterranean diet and prevalence of differentiated thyroid cancer: a single-center Unit of Thyroid Surgery experience in a Southern-Italy cohort.

The Mediterranean diet (MD) is recognized as a cultural heritage by UNESCO, thus, is a nutritional model widely spread in all Mediterranean countries. As already demonstrated by several studies, high adherence to MD is a protective factor against many chronic diseases. Conversely, poor adherence to the diet is correlated with an increased prevalence of these pathologies. The aim of the current study was to investigate the relationship between the adherence to MD and the prevalence of benign and malignant thyroid disease. We analyzed the health status of 60 patients, referred to total thyroidectomy and histological examination, due to nodular thyroid disease. Eating habits were evaluated according to the PREDIMED questionnaire, and patients' results were evaluated according to histological findings of benign or malignant disease. PREDIMED Score was lower in patients with malignant thyroid disease (MTD) than those with benign thyroid disease (BTD) (5.27±0.87 vs. 7.00±1.23, respectively; P value <0.001). A significant correlation was found between poor adherence to MD and diagnosis of MTD (r=0.454; P<0.001). Excessive consumption of butter and sugary drinks, along with low consumption of pasta, white meat, and rice were found to be predictive factors of MTD. In our cohort, a PREDIMED Score ≤7 resulted significantly related to MTD diagnosis, while a good adherence to MD resulted associated with BTD. Moreover, high consumption of sweetened beverages seemed to predict MTD histologic diagnosis, while, conversely, low consumption resulted predictor of BTD. Nevertheless, more studies are needed to evaluate the effective impact of MD on MTD incidence on larger cohorts.

79 - Parent and child choice of sugary drinks under four labelling conditions

79 - Parent and child choice of sugary drinks under four labelling conditions

Water Is K’é: Learning from the Navajo Community to Promote Early Child Health

Abstract: Background: Drinking water instead of sugary drinks is key to reducing health disparities. Since beverage habits are shaped by complex personal, community, and environmental factors, community input is critical to design any intervention promoting water. Objectives: We worked with community partners to design a program to promote healthy beverage habits among young Navajo children. Methods: The socioecological model, community-based participatory methods, and strengths-based principles shaped our process. In Phase 1, multigenerational feedback taught us about the cultural importance of water and how water quality concerns influence beverage choices. In Phase 2, our Water is K’é Community Advisory Group played a leading role to design the intervention centered around cultural connection, health literacy, and water access. Lessons Learned: Water is K’é was created through community partnership. Community listening and mini-pilots take time but allows the program to meet community’s needs and interests. Conclusions: The solutions to health disparities lie within the community itself.

Socioeconomic position during pregnancy and pre-school exposome in children from eight European birth cohort studies

Distribution of environmental hazards and vulnerability to their effects vary across socioeconomic groups. Our objective was to analyse the relationship between child socioeconomic position (SEP) at birth and the external exposome at pre-school age (0–4 years).This study included more than 60,000 children from eight cohorts in eleven European cities (Oslo, Copenhagen, Bristol, Bradford, Rotterdam, Nancy, Poitiers, Gipuzkoa, Sabadell, Valencia and Turin). SEP was measured through maternal education and a standardised indicator of household income. Three child exposome domains were investigated: behavioral, diet and urban environment. We fitted separate logistic regression model for each exposome variable - dichotomised using the city-specific median - on SEP (medium/low vs high) adjusting for maternal age, country of birth and parity. Analyses were carried out separately in each study-area.Low-SEP children had, consistently across study-areas, lower Odds Ratios (ORs) of breastfeeding, consumption of eggs, fish, fruit, vegetables and higher ORs of TV screen time, pet ownership, exposure to second-hand smoke, consumption of dairy, potatoes, sweet beverages, savory biscuits and crisps, fats and carbohydrates. For example, maternal education-breastfeeding OR (95% Confidence Interval (CI)) ranged from 0.18 (0.14–0.24) in Bristol to 0.73 (0.58–0.90) in Oslo. SEP was also strongly associated with the urban environment with marked between-city heterogeneity. For example, income-PM2.5 OR (95%CI) ranged from 0.69 (0.47–1.02) in Sabadell to 2.44 (2.16–2.72) in Oslo.Already at pre-school age, children with lower SEP have consistently poorer diets and behaviours, which might influence their future health and wellbeing. SEP-urban environment relationships are strongly context-dependent.

Trends of high fat, salt and sugar food consumption and its impact on nutritional status of school children

Background: India is currently in a phase of nutrition transition. Increased consumption of food high in fat, sugar and salt (HFSS) is contributing significantly to prevalence of triple burden of malnutrition among children. Methods: In this study, the nutritional status and frequency of HFSS food consumption were assessed in 360 school children (boys n=171, girls n=189) aged between 6-16 years using standard tools and techniques. Results: From the results, it was evident that the frequency of consumption of HFSS food among children of both the age group 6-10 years and 11-16 years was significantly high (p≤0.05). Children aged between 6-10 years were more prone to under nutrition (38%) and they were consuming more snacks such as chips, biscuits, packaged fruit juices high in sodium, saturated fat and sugar. On the other hand, adolescents aged between 11-16 years show a higher prevalence of both under nutrition and overweight (10%), potentially linked to their consumption of bakery products, street foods, sugary drinks and carbonated beverages. Conclusions: The nutrition transition shift is towards consumption of refined, ultra processed, high sodium and fat foods. The age-based trend is a nutritional challenge among children and adolescents. The findings of this study emphasized the urgent need for early screening of nutrient deficiencies, comprehensive interventions to address the triple burden of malnutrition among school children. Efforts should focus on promoting healthy dietary behaviours, enhancing nutritional literacy among children, parents and care givers, improving access to nutritious foods, and regulating the marketing and availability of HFSS foods.

The Effect of Nutrition and Diet on the Causes of Kidney Failure in Minors in Indonesia

Renal failure among minors in Indonesia has become a growing public health concern, with increasing evidence suggesting that dietary habits play a significant role in its development. This study investigates the influence of nutrition and diet on the causes of renal failure in minors, utilizing a quantitative analysis of 80 samples. Data were collected using a Likert scale (1 to 5) and analyzed with SPSS version 26. The results indicate significant positive correlations between the consumption of processed foods, sugary drinks, and the incidence of renal failure. Conversely, higher intake of fruits and vegetables was associated with a reduced risk of renal failure. Multiple regression analysis further confirmed the predictive power of these dietary factors, with processed foods and sugary drinks emerging as significant contributors to renal failure. The findings emphasize the need for targeted nutritional interventions and public health strategies to promote healthier eating habits among minors in Indonesia, aiming to reduce the incidence of renal failure and improve long-term health outcomes.

Production of sweet potato distilled beverage: Economic evaluation via enzymatic and acid hydrolysis

AbstractThis study aimed to assess the feasibility of utilizing sweet potato waste for distilled beverage production in two process scenarios: (i) acid hydrolysis and (ii) enzymatic hydrolysis. Laboratory experiments were conducted using in natura sweet potato waste and the data obtained were used to design a production system capable of producing 1000 L of distillate per day. Net present value (NPV), internal rate of return (IRR), and discounted payback indicators were used for economic analysis, with a minimum attractiveness rate (MARR) of 15%. The initial investment for the projects was BRL 1 139 610.86 (USD 223 146.80) for enzymatic hydrolysis and BRL 1 314 824.54 (USD 257 455.36) for acid hydrolysis. Packaging costs were identified as the greatest expenses in the process. Assuming a selling price of BRL 14.50 (USD 2.84), the enzymatic hydrolysis process demonstrated an NPV of BRL 4 792 520.77 (USD 938 421.92) and IRR of 83.39%, and the acid hydrolysis process showed an NPV of BRL 2 191 636.78 (USD 429 143.68) and IRR of 42.49%. Consequently, establishing a production plant for distilled beverages proved to be more economically attractive when employing the enzymatic hydrolysis process and fermentation simultaneously, resulting in a return on investment within 1.46 years of operation. Upon scrutinizing the gain matrix, it became apparent that critical factors with the potential to affect the project's feasibility detrimentally, if increased, included the cost of acquiring packaging, the final volumetric fraction of the distilled beverage, and the tax rate. Nevertheless, an upturn in the selling price of the beverage and a process improvement yield both have the potential to underpin the project effectively.

Sugar-Sweetened Beverages and Adverse Human Health Outcomes: An Umbrella Review of Meta-Analyses of Observational Studies.

Our aim was to conduct an umbrella review of evidence from meta-analyses of observational studies investigating the link between sugar-sweetened beverage consumption and human health outcomes. Using predefined evidence classification criteria, we evaluated evidence from 47 meta-analyses encompassing 22,055,269 individuals. Overall, 79% of these analyses indicated direct associations between greater sugar-sweetened beverage consumption and higher risks of adverse health outcomes. Convincing evidence (classI) supported direct associations between sugar-sweetened beverage consumption and risks of depression, cardiovascular disease, nephrolithiasis, type2 diabetes mellitus, and higher uric acid concentrations. Highly suggestive evidence (classII) supported associations with risks of nonalcoholic fatty liver disease and dental caries. Out of the remaining 40meta-analyses, 29 were graded as suggestive or weak in the strength of evidence (classesIII and IV), and 11 showed no evidence (classV). These findings inform and provide support for population-based and public health strategies aimed at reducing sugary drink consumption for improved health.

The relationship between youth's exposure to unhealthy digital food marketing and their dietary intake in Canada.

There is limited evidence on how exposure to digital marketing of unhealthy foods affects youth's dietary behaviours. This study therefore aimed to examine the association between youth's self-reported digital food marketing exposure and dietary intakes, and explore predictors of frequent unhealthy food consumption. A survey was conducted among 1075 youth in Canada (aged 10-17 years) in April 2023. Proportional odds models examined associations between frequency of exposure to digital marketing of unhealthy foods and frequency of consumption of those foods, adjusted for sociodemographic characteristics and digital device usage. Compared with participants reporting no exposure to digital fast-food marketing in the past week, those exposed ≥4 times per week were more likely to consume fast food more frequently. Youth exposed to digital marketing of sugary drinks and salty/savoury snacks ≥1 time(s) in the previous week were more likely to consume these foods on a greater number of days, compared with those reporting no exposure to this marketing in the past week. Reporting exposure to digital marketing of desserts/sweet treats every day or more than once a day was associated with more frequent consumption of desserts/sweet treats. Province of residence (Ontario/Quebec) and total daily time spent online predicted more frequent consumption of fast-food, sugary drinks, salty/savoury snacks and desserts/sweet treats. Overall, more frequent self-reported exposure to digital marketing of unhealthy foods is associated with more frequent consumption of these foods by Canadian youth. Regulations are needed to help protect youth from digital food marketing, which may help reduce their unhealthy food consumption.

Pilot Study Assessing the Baseline Physical Activity and Knowledge of Heart Health of Elementary School-Aged Children in Rural South Carolina and the Impact of an Interactive Educational Program.

This study asked whether, if provided with education on heart-healthy habits, elementary school children in Abbeville, Greenwood, and Saluda counties in South Carolina would retain and desire to implement healthy nutrition and increased exercise. We hypothesized that teaching children about heart-healthy habits would increase their activity levels and improve their desire to be active. This was a longitudinal survey study. Children at local after-school programs were given a pre-survey, the Kids' Activity and Nutrition Questionnaire (KAN-Q), to assess their activity levels, diet, and knowledge of heart health. The children had a 15-minute educational period followed by an interactive program. Students completed the same survey at each of the three sessions. A total of 44 children answered the survey questions at the beginning of each session. Out of the 10 behavioral questions, six indicated a favorable shift towards adopting healthier habits. Whole grain consumption increased to 71% from 32% (p<0.01). Vegetable consumption increased from 39% to 88%, and fruit consumption increased from 68% to 92% (p<0.01). There was a 30% decrease in the consumption of sugary drinks (p<0.01), and a reduction in hours watching television (p=0.05). All four knowledge-based questions had an increase in correct responses across the three sessions (p<0.01). To augment behavior, a dual approach of education on nutrition and exercise leads to improved nutrition choices and exercise habits for primary prevention of cardiovascular risk factors in elementary school-aged children. These habits improve adherence to increased physical activity and better nutrition after school.

Choose MyPlate: Drink Water Instead of Sugary Drinks

Every cell in your body needs water to function correctly. That’s why it’s important to stay hydrated. Even though all fluids provide hydration, water is a better choice. The information in this publication can help you learn why. Written by Jeanine Beatty, Shari Bresin, Karla Shelnutt, and Gail Kauwell, and published by the UF/IFAS Department of Family, Youth and Community Sciences, revised August 2024.

The Gut Microbiome in Early Childhood Obesity: Exploring the Role of Diet and Probiotics - An Observational Study in Palembang, Indonesia

Introduction: Early childhood obesity is a growing public health concern, with the gut microbiome emerging as a potential contributing factor. Diet and probiotics hold promise in modulating the gut microbiome and potentially influencing obesity risk. This study investigated the associations between dietary patterns, gut microbiome composition, and the use of probiotics in early childhood obesity in Palembang, Indonesia. Methods: An observational study was conducted in Palembang, involving 150 children aged 2-5 years, categorized into obese and non-obese groups based on WHO growth standards. Dietary intake was assessed using a 3-day food record, gut microbiome composition was analyzed via 16S rRNA sequencing of fecal samples, and probiotic use was documented through questionnaires. Statistical analyses, including multivariate regression and microbiome diversity metrics, were employed to explore associations. Results: Obese children displayed significantly lower gut microbiome diversity compared to non-obese children (p &lt; 0.05). Dietary patterns rich in processed foods and sugary drinks were associated with altered gut microbiome composition, characterized by increased abundance of Firmicutes and decreased Bacteroidetes (p &lt; 0.01). Probiotic use was associated with improved gut microbiome diversity and a trend towards reduced obesity risk (p = 0.07). Conclusion: This study provides evidence linking dietary patterns, gut microbiome composition, and probiotic use to early childhood obesity in Palembang, Indonesia. Promoting healthy dietary choices and considering probiotic supplementation may offer potential strategies for obesity prevention in this population. Further research is warranted to establish causality and explore the long-term impact of interventions targeting the gut microbiome in early childhood obesity.

Exploring the state and influential factors of dental caries in preschool children aged 3–6 years in Xingtai City

ObjectiveTo explore the main factors affecting early dental caries among preschool children aged 3–6 years in Xingtai City to formulate effective preventive measures.MethodsA cross-sectional study was conducted on 570 preschool children aged 3–6 years in Xingtai City through questionnaire surveys and oral examinations to understand their dental caries situation. Multifactorial logistic regression analysis was used to analyse the main influencing factors for the occurrence of dental caries in preschool children.ResultsUnivariate analysis showed statistically significant differences in age (χ2 = 2.636, p = 0.008), father’s education level (χ2 = 4.207, p < 0.001), mother’s education level (χ2 = 4.217, p < 0.001), daily tooth brushing frequency (χ2 = 3.160, p = 0.002), age of starting tooth brushing (χ2 = 8.756, p < 0.001), mouth rinsing after meals (χ2 = 89.401, p < 0.001), Streptococcus mutans positivity (χ2 = 133.503, p < 0.001), non-sweet snack consumption frequency (χ2 = 5.962, p < 0.001), snack flavour preference (χ2 = 116.119, p < 0.001), use of fluoridated toothpaste (χ2 = 75.639, p < 0.001), regular oral examinations (χ2 = 98.711, p < 0.001), sugary drink consumption frequency (χ2 = 10.370, p < 0.001) and sweet food consumption frequency (χ2 = 9.261, p < 0.001) between the caries and non-caries groups. Multifactorial analysis revealed that older age (odds ratio [OR] = 5.342, 95% confidence interval [CI]: 1.434–6.631), later initiation of tooth brushing (OR = 3.244, 95% CI: 2.413–5.424), S. mutans positivity (OR = 5.357, 95% CI: 4.529–8.563), high snack consumption frequency (OR = 3.452, 95% CI: 2.634–5.442), high sugary drink consumption frequency (OR = 4.414, 95% CI: 2.534–6.451) and high sweet food consumption frequency (OR = 4.531, 95% CI: 3.421–6.354) were risk factors for dental caries. Higher father’s educational level (OR = 0.724, 95% CI: 0.564–0.891), higher mother’s educational level (OR = 0.641, 95% CI: 0.601–0.813), high daily tooth brushing frequency (OR = 0.572, 95% CI: 0.423–0.864), mouth rinsing after meals (OR = 0.743, 95% CI: 0.643–0.813), use of fluoridated toothpaste (OR = 0.657, 95% CI: 0.553–0.931) and regular oral examinations (OR = 0.443, 95% CI: 0.352–0.747) were protective factors against dental caries (all p < 0.05).ConclusionMultiple factors result in early dental caries in preschool children aged 3–6 years; however, the most influential factors are older age and high snack consumption, as well as high sugary and sweet food/drink consumption.