Prospective associations between sugar-sweetened beverage intakes and cardiometabolic risk factors in adolescents

Abstract

Background: High sugar-sweetened beverage (SSB) consumption is associated with cardiometabolic disturbances in adults, but this relation is relatively unexplored in children and adolescents.

Objective: We tested the hypothesis that higher SSB intakes are associated with increases in cardiometabolic risk factors between 14 and 17 y of age.

Design: Data were provided by 1433 adolescent offspring from the Western Australian Pregnancy Cohort (Raine) Study. At 14 and 17 y of age, SSB intakes were estimated by using a food-frequency questionnaire; body mass index (BMI), waist circumference, blood pressure, fasting serum lipids, glucose, and insulin were measured, and overall cardiometabolic risk was estimated. Prospective associations between cardiovascular disease risk factors and SSB intake were examined with adjustment for age, pubertal stage, physical fitness, socioeconomic status, and major dietary patterns.

Results: The average SSB intake in consumers (89%) was 335 g/d or 1.3 servings/d. Girls who moved into the top tertile of SSB consumption (>1.3 servings/d) between 14 and 17 y of age had increases in BMI (3.8%; 95% CI: 1.8%, 5.7%), increased overweight and obesity risk (OR: 4.8, 95% CI: 2.1, 11.4), and greater overall cardiometabolic risk (OR: 3.2; 95% CI: 1.6, 6.2) (all P-trend ≤ 0.001). Girls and boys who moved into the top tertile of SSB intake showed increases in triglycerides (7.0-8.4%; P-trend ≤ 0.03), and boys showed reductions in HDL cholesterol (-3.1%; 95% CI: -6.2%, 0.1%; P-trend < 0.04) independent of BMI. Some associations were attenuated after adjustment for major dietary patterns.

Conclusion: Increased SSB intake may be an important predictor of cardiometabolic risk in young people, independent of weight status.

FIGURE 1.

Mean beverage intakes (g/d) in adolescents at 14 y of age (794 girls; 837 boys) and 17 y of age (541 girls; 468 boys) in the Western Australian Pregnancy (Raine) cohort. Of all beverages, SSBs were consumed in the largest amounts (boys and girls). The mean SSB consumption increased in boys and decreased in girls between 14 and 17 y of age. SSB, sugar-sweetened beverage.

FIGURE 2.

Overweight and obesity prevalence at 14 and 17 y of age in the Western Australian Pregnancy (Raine) cohort. Proportions of overweight and obese adolescents in the Raine Study were based on International Obesity Task Force definitions (18) applied to BMI measured at 14 y of age (780 girls; 825 boys) and 17 y of age (620 girls; 631 boys). Between these ages, the prevalence of obesity increased, and overweight decreased in girls. In boys, the prevalence of obesity remained the same, and overweight decreased.