Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jun 28:9:885704.
doi: 10.3389/fnut.2022.885704. eCollection 2022.

Sugar Is the Key Cause of Overweight/Obesity in Sugar-Sweetened Beverages (SSB)

Lianlong Yu  1 , Han Zhou  1 , Fengjia Zheng  1 , Jian Song  1 , Yutong Lu  2 , Xiao Yu  3 , Changsheng Zhao  3
Affiliations

Sugar Is the Key Cause of Overweight/Obesity in Sugar-Sweetened Beverages (SSB)

Lianlong Yu et al. Front Nutr. .

Abstract

To evaluate association between overweight/obesity and sugar-sweetened beverages (SSB) types, SSB sugar, among children and adolescents. A total of 1,068 children and 751 adolescents were identified from a provincial survey conducted in Shandong, China. χ2 tests, logistic regression, restricted cubic spline (RCS), mediation analysis, pathway analysis, and ordinary least square (OLS) regression were applied to test association among overweight/obesity, SSB sugar, SSB types, and a set of factors. The mean daily SSB intake for children and adolescents was 210.7 and 208 ml, respectively. The threshold of SSB sugar consumption causing overweight/obesity was around 25 g/day and verified by RCS based on logistic regression. Approximately, 44.8% of the study subjects consumed more than 25 g/day of SSB sugar. SSB sugar intake above 25 g/day resulted in higher risk of overweight/obesity (OR = 1.391, 95% CI, 1.115-1.734). The effects of all types of SSBs on overweight/obesity were fully mediated by SSB sugar (p < 0.05), except for milk. Consumption of any types of SSBs had a positive impact on SSB sugar intake in both children and adolescents. Any type of SSB intake was a risk factor in excessive intake of SSB sugar (OR > 1, p < 0.05). In particular, milk powder, tea, and tea-flavored drinks, and carbonated have greater ORs for excessive intake of SSB sugar (OR = 76.08, 8.879, 4.355, p < 0.05, respectively). It was found that the effect of SSB on overweight/obesity was mediated by the intake of SSB sugar, and the effects of various SSBs were different according to multiple linear regression and pathway analysis (p < 0.05, respectively).

Keywords: adolescents; children; obesity; overweight; sugar-sweetened beverages.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Sugar intake from beverages in different age and gender groups.
FIGURE 2
FIGURE 2
An adjusted odds ratio for beverage sugar intake and overweight/obesity using restricted cubic spline (RCS) analysis. The RCS model adjusted for age, gender, and region. The solid red line is the multivariate adjusted hazard ratio, and the dashed line shows the 95% confidence interval from restricted cubic spline regression. The unassociated reference line is shown in solid bold based on the basic and beverage consumption data, gathered by the Shandong Center for Disease Control and Prevention from 2013 to 2016.
FIGURE 3
FIGURE 3
Beverage sources of sugar in different age and gender groups.
FIGURE 4
FIGURE 4
Standardized estimation of the relationship of types of SSB, SSB sugar intake, and overweight/obesity.
See this image and copyright information in PMC

References

    1. Pan XF, Wang L, Pan A. Epidemiology and determinants of obesity in China. Lancet Diabetes Endocrinol. (2021) 9:373–92. 10.1016/S2213-8587(21)00045-0 - DOI - PubMed
    1. Salamonowicz MM, Zalewska A, Maciejczyk M. Oral consequences of obesity and metabolic syndrome in children and adolescents. Dent Med Probl. (2019) 56:97–104. 10.17219/dmp/102620 - DOI - PubMed
    1. Qin W, Wang L, Xu L, Sun L, Li J, Zhang J, et al. An exploratory spatial analysis of overweight and obesity among children and adolescents in Shandong, China. BMJ Open. (2019) 9:e028152. 10.1136/bmjopen-2018-028152 - DOI - PMC - PubMed
    1. Qin P, Li Q, Zhao Y, Chen Q, Sun X, Liu Y, et al. Sugar and artificially sweetened beverages and risk of obesity, type 2 diabetes mellitus, hypertension, and all-cause mortality: a dose-response meta-analysis of prospective cohort studies. Eur J Epidemiol. (2020) 35:655–71. 10.1007/s10654-020-00655-y - DOI - PubMed
    1. Ebbeling CB, Feldman HA, Steltz SK, Quinn NL, Robinson LM, Ludwig DS. Effects of sugar-sweetened, artificially sweetened, and unsweetened beverages on cardiometabolic risk factors, body composition, and sweet taste preference: a randomized controlled trial. J Am Heart Assoc. (2020) 9:e015668. 10.1161/JAHA.119.015668 - DOI - PMC - PubMed

LinkOut - more resources