Sugar-containing beverage consumption and cardiometabolic risk in preschool children

Karen M Eny; Nivethika Jeyakumar; David W H Dai; Jonathon L Maguire; Patricia C Parkin; Catherine S Birken; TARGet Kids! Collaboration

doi:10.1016/j.pmedr.2020.101054

Sugar-containing beverage consumption and cardiometabolic risk in preschool children

Prev Med Rep. 2020 Jan 14:17:101054. doi: 10.1016/j.pmedr.2020.101054. eCollection 2020 Mar.

Authors

Karen M Eny^{1

2}, Nivethika Jeyakumar^{1

2}, David W H Dai³, Jonathon L Maguire^{4

5

6

7

8}, Patricia C Parkin^{9

6

7

10}, Catherine S Birken^{9

6

7

8

10}; TARGet Kids! Collaboration

Affiliations

¹ Nutrigenomix Inc, Toronto, Ontario, Canada.
² ICES, Ontario, Canada.
³ St. Michael's Hospital, Toronto, Ontario, Canada.
⁴ Applied Health Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.
⁵ Department of Pediatrics, St. Michael's Hospital, Toronto, Canada.
⁶ Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
⁷ Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Canada.
⁸ Department of Nutritional Sciences, University of Toronto, Toronto, Canada.
⁹ Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada.
¹⁰ Division of Pediatric Medicine and the Pediatric Outcomes Research Team, The Hospital for Sick Children, Toronto, Ontario, Canada.

Abstract

Objective: Sugar-containing beverages (SCBs) including 100% fruit juice, fruit drinks and soda substantially contribute to total caloric intake in young children. The objective of this study was to examine whether consumption of SCB is associated with cardiometabolic risk (CMR) in preschool children, along with whether 100% fruit juice and sugar sweetened beverage (SSB) is associated with CMR.

Study design: We used a repeated measures study design examining SCB consumption and CMR outcomes measured concurrently in children 3-6 years of age participating in TARGet Kids!, a primary-care, practice-based research network in Canada (2008-2017). To account for within-person variability, multivariable linear regression models using generalized estimating equation was used to examine the association between SCB consumption and CMR score and the individual CMR score components including systolic blood pressure, waist circumference, high-density lipoprotein cholesterol (HDL-c), triglycerides, and glucose.

Results: After adjusting for sociodemographic, familial and child-related covariates, higher SCB consumption was associated with elevated CMR score [0.05 (95% CI -0.0001 to 0.09), p = 0.05], including lower HDL-c [-0.02 mmol/L (95% CI -0.03 to -0.01), p = 0.01] and higher triglycerides [0.02 mmol/L (95% CI 0.004 to 0.04), p = 0.02]. When examined separately, higher 100% fruit juice [-0.02 mmol/L (95% CI -0.03 to -0.003), p = 0.02] and SSB[-0.03 mmol/L (95% CI -0.06 to -0.001), p = 0.04] consumption were each associated with lower HDL-c.

Conclusion: Higher SCB consumption was associated with small elevations of CMR in preschool children. Our findings support recommendations to limit overall intake of SCBs in early childhood, in effort to reduce the potential long-term burden of CMR.

Keywords: 100% fruit juice; AAP, American Academy of Pediatrics; CMR, cardiometabolic risk; CVD, Cardiovascular disease; GEE, Generalized estimating equations; HDL-c, high density lipoprotein-cholesterol; HDL-cholesterol; NHANES, National Health and Nutrition Examination Survey; SBP, Systolic blood pressure; SCB, Sugar-containing beverage; SSB, Sugar-sweetened beverage; Sugar-sweetened beverages; TG, triglycerides; Triglycerides; WC, waist circumference; zBMI, Body mass index z-score.