Sugar-Sweetened Beverage Consumption and Risks of Obesity and Hypertension in Chinese Children and Adolescents: A National Cross-Sectional Analysis

Gui, Zhilun; Zhu, Yanna; Cai, Li; Sun, Fenghua; Ma, Yong; Jin, Jing; Chen, Yajun

doi:10.3390/nu9121302

Cited by 114 publications

(100 citation statements)

References 38 publications

(53 reference statements)

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“…To our knowledge, this is the first study to examine the association of SSB consumption with adiposity using a prospective cohort of Chinese children. Cross-sectional studies in Chinese children [17,28] have shown a positive association of regular SSB consumption with obesity and abdominal obesity in 6-13-year-olds [28] and an association of SSB consumption with abdominal but not general obesity in 6-17-year-olds [17]. Our lack of association of SSB consumption frequency with subsequent BMI z-score or other measures of adiposity differs from an observational study [29] and meta-analyses of observational studies largely from Western settings [5,6,30,31].…”

Section: Discussionmentioning

confidence: 99%

“…Unlike in Western developed settings, obesity is less clearly socially patterned in Hong Kong Chinese children [15,16]. Chinese children also consume fewer SSBs than those in Western developed countries [17]. SSB consumption in Chinese children may have different socioeconomic patterns than in Western settings, where children of lower SEP tend to consume more SSB [18].…”

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confidence: 97%

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Association of Sugar-Sweetened Beverage Frequency with Adiposity: Evidence from the “Children of 1997” Birth Cohort

et al. 2020

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Background: Observationally, sugar-sweetened beverage (SSB) consumption is associated with adiposity in Western children but could be confounded. We examined the association of SSB frequency with adiposity in the non-Western setting of Hong Kong. Methods: We examined the associations of SSB consumption frequency at 11 and 13 years assessed by using a food frequency questionnaire with subsequent body mass index (BMI) z-score and overweight/obesity up to 18 years using generalized estimating equations, and with waist circumference, waist-to-hip ratio, and body fat percentage at 16-19 years using linear regression in a population-representative Chinese birth cohort "Children of 1997" (n = 3628). Results: At 11 and 13 years, 6.8% and 8.2% of children respectively consumed SSB daily. Neither SSB frequency at 11 nor at 13 years was associated with subsequent BMI z-score or overweight/obesity up to 18 years, or with waist circumference, waist-to-hip ratio, or body fat percentage at 16-19 years adjusted for age, sex, socioeconomic position, health status, physical activity and other food consumption, although bias to the null from under-reporting cannot be eliminated. Conclusion: Although we cannot definitively exclude a small association of SSB frequency with adiposity, lack of association of SSB frequency with adiposity in a non-Western setting with low SSB consumption suggests that the role of SSB in adiposity appears to be minor.Nutrients 2020, 12, 1015 2 of 13 unreliable [8]. A few randomized controlled trials (RCT) have been conducted in children [9,10], which suggested reducing SSB intake reduces weight. However, meta-analyses of RCTs have revealed mixed findings. One meta-analysis showed no overall effect of SSB intake on weight in children, possibly due to low compliance in some included trials [6]. This meta-analysis also found weight decrease for reduced sugars intake and weight increase for increased sugars intake in trials of adults with ad libitum diets [6]. However, some others showed small effects of SSB intake on weight or BMI, which may be more marked for increasing consumption of SSB on weight gain and among the overweight [5,11,12]. As a beverage containing naturally occurring sugars, 100% fruit juice was not associated with weight gain in children aged 7 to 18 years in a meta-analysis of observational studies [13], but no RCT to date has tested the effect of 100% fruit juice on adiposity in children.Given the inconclusive evidence concerning the effect of SSB on adiposity, assessing the association in settings with different confounding patterns can be helpful [14]. Unlike in Western developed settings, obesity is less clearly socially patterned in Hong Kong Chinese children [15,16]. Chinese children also consume fewer SSBs than those in Western developed countries [17]. SSB consumption in Chinese children may have different socioeconomic patterns than in Western settings, where children of lower SEP tend to consume more SSB [18]. Here, we examined the association of SSB frequency at 11 and 13 years ...

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Section: Discussionmentioning

confidence: 99%

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confidence: 97%

Association of Sugar-Sweetened Beverage Frequency with Adiposity: Evidence from the “Children of 1997” Birth Cohort

et al. 2020

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“…In China, in a sample of more than 53,000 children and adolescents aged 6-17 years, in 2013, 66.6% of participants consumed SSBs, and 9.6% reported a consumption of more than 7 servings of SSBs per week [4]. In Italy, 36% of children aged 8-9 years participating in Okkio alla Salute, the Italian arm of Childhood Obesity Survey Initiative, consume sweetened and carbonated beverages at least once a day [5].…”

Section: Introductionmentioning

confidence: 99%

Consumption of Sugar-Sweetened Beverages in Paediatric Age: A Position Paper of the European Academy of Paediatrics and the European Childhood Obesity Group

Dereń

Weghuber

Caroli³

et al. 2019

Ann Nutr Metab

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Background: Health risks associated with the high consumption of sugar-sweetened beverages (SSBs) include overweight or obesity and their complications such as diabetes, as well as oral and dental decay, among others. Aim: The aim of the present statement is to inform health care professionals, parents, care-givers, teachers and school head teachers, stakeholders and governing bodies about the risks associated with drinking SSBs in infants, children and adolescents. Methods: We searched PubMed and the Cochrane databases for English language studies published from 2010 through October 1, 2018, for randomized clinical trials, meta-analyses, systematic reviews and observational studies (search terms are reported in eAppendix in the Supplement). We also manually searched the references of selected articles, reviews, meta-analyses and practice guidelines. Recommendations: Consumption of SSB by children and adolescents should be limited, and the consumption of water and other non-sweetened beverages should be promoted. Educational institutions such as nurseries, pre-schools and schools should offer unlimited access to drinking water, whereas the sale of SSBs should be banned.

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“…5 Many Asian countries are following this global nutrition transition toward greater consumption of sugar and SSBs. [6][7][8] (T2DM), and obesity. 11 A recent meta-analysis of seven prospective cohort studies (n = 308,420 participants; age range, years) reported 13% greater risk of stroke and 22% greater risk of myocardial infarction associated with SSB consumption.…”

Section: Introductionmentioning

confidence: 99%

Three-Month Daily Consumption of Sugar-Sweetened Beverages Affects the Liver, Adipose Tissue, and Glucose Metabolism

Lee

Han

Maeng

et al. 2020

JOMES

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Background: Growing evidence suggests links between sugar-sweetened beverages (SSBs) and metabolic disorders. We investigated the effects of SSBs commonly consumed by adolescents and their relationships to glucose metabolism and fatty liver. Methods: We treated 7-week old male C57BL/6 mice with water (control) or one of three different SSBs, carbonated soda (Coca-Cola), sweetened milk coffee (Maxwell), or chocolate-added cocoa (Choco-Latte), for 13 weeks (n=10 in each group). Half of the animals were fed a regular chow diet and the other half a high-fat diet (40% fat). Body composition and biochemical variables were investigated at the end of treatment. Histology of the liver and adipose tissue, as well as molecular signaling related to glucose and lipid metabolism, were also evaluated. Results: During the 13-week treatment, mice treated with chocolate-added cocoa or sweetened milk coffee showed significantly greater increases in body weight compared with controls, especially when fed a high-fat diet. Fasting glucose level was higher in the three SSB-treated groups compared with the control group. Lipid droplets in the liver, fat cell size, and number of CD68-positive cells in adipose tissue were greater in the SSBtreated groups than in the control group. SSB treatments increased the expression of genes related to inflammatory processes in the liver and adipose tissue. Phosphorylation of AKT and glycogen synthase kinase in muscle was significantly reduced in SSB-treated groups. Conclusion: Daily consumption of SSBs over 3 months lead to metabolic impairment and weight gain and may contribute to development of metabolic diseases.

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Sugar-Sweetened Beverage Consumption and Risks of Obesity and Hypertension in Chinese Children and Adolescents: A National Cross-Sectional Analysis

Cited by 114 publications

References 38 publications

Association of Sugar-Sweetened Beverage Frequency with Adiposity: Evidence from the “Children of 1997” Birth Cohort

Association of Sugar-Sweetened Beverage Frequency with Adiposity: Evidence from the “Children of 1997” Birth Cohort

Consumption of Sugar-Sweetened Beverages in Paediatric Age: A Position Paper of the European Academy of Paediatrics and the European Childhood Obesity Group

Three-Month Daily Consumption of Sugar-Sweetened Beverages Affects the Liver, Adipose Tissue, and Glucose Metabolism

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