Consumption of sugar-sweetened beverages and its association with overweight among young children from China

Abstract

Objective: To fully understand the sugar-sweetened beverage (SSB) consumption status among Chinese young children and to explore its association with weight gain. Design: In this cross-sectional study, data on sociodemographic characteristics, SSB intake and weight/height were collected by means of face-to-face interviews. The intake of SSB among young Chinese children in relation to their age, different characteristics and types of SSB consumed is described, and the association between SSB intake and BMI-for-age Z-score and overweight is explored. Setting: Seven large cities and two villages in China. Subjects: Nine hundred and forty-six healthy children, aged 3-7 years. Results: The proportion of SSB intake among Chinese young children was 80·5 %; 3·4 % were daily consumers, 34·0 % (31·4 %) consumed at least once per week (month). The per capita and per consumer SSB intake was 63·1 9 (SD 100·8) and 78·4 (SD 106·9) ml/d. Children from rural areas consumed twice, or even triple, the amount of SSB as those from urban areas (P < 0·001) and great disparities existed between the types of SSB consumed by urban and rural children. An association was found between increased SSB intake and higher BMI-for-age Z-score (P < 0·05) after adjusting for potential confounders; there was also an association between SSB intake and increased risk of being overweight or obese. Conclusions: The consumption status of SSB in Chinese young children is of concern. There was a positive association between SSB intake and weight gain. Measures should be taken to improve the present situation of SSB consumption among Chinese young children. . This reflects the increasing trend in China; from 1981 to 2010, the prevalence of overweight and obesity among children increased from 1·8 (95 % CI 0·4, 3·1) % and 0·4 (95 % CI −0·1, −0·8) % respectively in 1981-1985, to 13·1 (95 % CI 11·2, 15·0) % and 7·5 (95 % CI 6·6, 8·4) % respectively in 2006-2010. The average annual increase was 8·3 and 12·4 %, respectively (2) . Overweight and obesity in the paediatric population has attracted much attention because of its persistence into adulthood (3) and short-and long-term adverse health consequences (4) . The reasons for overweight and obesity are complex, comprising the interplay of genetic, behavioural and environmental influences on metabolism, diet and activity. Nowadays, multiple sources have noted that the trends towards increasing overweight and obesity rates worldwide have paralleled an increase in sugar intake from food (5,6) . One common source of excess sugar consumption is sugar-sweetened beverages (SSB), such as carbonated drinks, fruit and/or vegetable drinks and tea. The relationship between SSB intake and overweight and obesity has been widely studied; however, the evidence is still insufficient to produce a definitive conclusion.

Differences in Lifestyle Behaviours of Students between Inner Urban and Peri-urban High Schools: A Cross-Sectional Study in Chongqing, China

“…A previous study demonstrated that most parents held the misconception that milk beverage had the same nutritional value as milk for children and adolescents and can be used as long-term substitutes for milk [38], thereby resulting in the high consumption of milk beverage. Moreover, the consumption proportions of ≥3 times/week among the four surveyed sugar-sweetened beverages (SSBs) was consistent with results of one previous study, which showed that vegetable/fruit-flavoured drinks and tea beverage had become the leading SSBs in China [39]. With increasing studies and rapid spread of mass media, the public has improved the awareness of the high sugar content and hazards of carbonated SSBs (CSSBs) [40,41].…”

Association of sugar-sweetened beverage intake at 18 months and 5 years of age with adiposity outcomes at 6 years of age: the Singapore GUSTO mother–offspring cohort

“…In our present findings, we found a trend of higher volumes of SSB consumption in older children of preschool age (5 years v. 18 months). In our study, 98 % of participants were consuming SSB by 5 years of age, and this percentage is higher than the 80•5 % children in China consuming SSB by 3-7 years of age (14) . This observation is in line with a survey conducted in 800 Singaporean children in 2009 examining their beverage consumption habits.…”

“…These observations concur with the few existing cross-sectional studies (34)(35)(36) and one prospective study (11) in children of a similar age range. These studies have all used body weight measures (BMI or BMI z score) as a main outcome and have defined the overweight/obesity statuses of children (11,14,34,35) , but none examined SSB intake with skinfold measures. SSF thickness (usually biceps, triceps, supra-iliac and subscapular) has been shown to be a useful supplementary measure widely used to assess body fatness in children (37) .…”

“…These limited cross-sectional studies in Asia also present conflicting findings. For example, consumption of SSB in two studies from China reported positive associations with obesity in children aged between 3 and 7 years (14) and aged 6 and 13 years (15) , but negatively associated with obesity in 9-to 14-year-old Korean boys (16) , while a study in 7-to 12-year-old Taiwanese children found no associations with BMI (17) .…”

A cross-sectional study of obesogenic behaviours and family rules according to family structure in European children

“…Obesogenic behaviours, including high screen time [1,2], consumption of sugar sweetened beverages (SSBs) [3,4] and lack of sleep [5,6] have become more prevalent in children and adolescents in recent years. In addition to age, socioeconomic status (SES), sex [7,8] and parental education [7,9], the family environment has a major influence on children's and adolescent's behaviour [10].…”