Children at age five who consume a median intake of 250ml per day of
sugar sweetened beverages (SSB) are more likely to have a higher BMI and
are at increased risk of being overweight or obese at six years of age,
compared to children with lower intakes at around 50ml each day.
Researchers from Singapore and France also found higher skinfold
thickness (adiposity) was associated with every 100ml per day
incremental increase of SSB intake.
There have been studies on SSB consumption on BMI in children aged six
to 19 years, but researchers believed this is the first study examining
SBB consumption patterns in Asian pre-schoolers or younger children and
relating them to adiposity outcomes.
The findings were published in The British Journal of Nutrition.
Dietary assessment
The study involved 767 Singaporean children aged five. Data was taken
from The Growing in Singapore Towards healthy Outcomes (GUSTO) cohort
study.
Validated food frequency questionnaires were issued to the child’s
primary caregiver (mostly mothers) to document SSB intake (frequency and
volume).
The definition of SSB included carbonated and non-carbonated drinks and
only pre-packaged fruit juices containing added sugar, as well as
commonly consumed SSBs in the Singaporean population such as malted
drinks, cultured milk drinks, soy based drinks and traditional drinks
(e.g. barley water, chrysanthemum tea, herbal tea).
Anthropometric measures were taken at aged six, and include weight,
height and four skinfold thicknesses (triceps, biceps, subscapular and
supra-iliac).
Dietary assessment
The study involved 767 Singaporean children aged five. Data was taken
from The Growing in Singapore Towards healthy Outcomes (GUSTO) cohort
study.
Validated food frequency questionnaires were issued to the child’s
primary caregiver (mostly mothers) to document SSB intake (frequency and
volume).
The definition of SSB included carbonated and non-carbonated drinks and
only pre-packaged fruit juices containing added sugar, as well as
commonly consumed SSBs in the Singaporean population such as malted
drinks, cultured milk drinks, soy based drinks and traditional drinks
(e.g. barley water, chrysanthemum tea, herbal tea).
Anthropometric measures were taken at aged six, and include weight,
height and four skinfold thicknesses (triceps, biceps, subscapular and
supra-iliac).SSB intake
The study revealed that SSB intakes at 100ml/day increments in children
aged five, were associated with higher BMI by 0.09 s.d. unit, higher SSF
thickness by 0.68mm, and increased risk for overweight/obesity by 1.2
times at aged six.
Furthermore, the researchers reported a similar trend with high SSB
intake tertile (median intake=~250ml) significantly associated
(p<0.05) with higher BMI z-scores by 0.33 s.d. unit, and higher risk
for overweight/obesity at age six years when compared to the low intake
tertile (median intake=~50ml/day).
They speculated the relationship between SSB intake and obesity may be due to a poor diet.
High intakes of SSBs in preschoolers could be just markers of poor diet
quality where these children were consuming high amounts of sweet foods,
along with high intake of sugary beverages.
High glycaemic loads from the possible high sugar diet alone could
induce hyperinsulinemia, leading to increase in fat deposition.
Another alternate mechanism linking poor diet and obesity could be
through the mediation effects of the microbiome profile in the gut.
Poorer diet quality (e.g. Western dietary patterns of high-fat food and
refined sugars) has been associated with a specific diversity of
microbiota termed the “obesogenic microbiota”, which has been shown to
display enhanced capacity for energy harvest from the diet that might
lead to weight gain.
Limitation and recommendations
The researchers acknowledged a limitation in their study: “The
relatively short follow-up (1 year) between SSB intakes at age 5 and
adiposity outcomes at age 6 might not be sufficient for us to observe
longer lasting effects of SSB on adiposity.”
However, they advised further longitudinal analyses to be conducted to
better understand the mechanisms involved and the effects of SSB intake
on long-term weight gain.
In conclusion, SSB intake in young childhood was associated with higher risks of adiposity and risk for overweight/obesity.
The researchers recommended public health policies working to reduce SSB
consumption to focus on prevention programs targeted at young children
as it acts as the foundation for future eating habits.
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