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

Lianlong Yu; Han Zhou; Fengjia Zheng; Jian Song; Yutong Lu; Xiao Yu; Changsheng Zhao

doi:10.3389/fnut.2022.885704

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

Front Nutr. 2022 Jun 28:9:885704. doi: 10.3389/fnut.2022.885704. eCollection 2022.

Authors

Lianlong Yu¹, Han Zhou¹, Fengjia Zheng¹, Jian Song¹, Yutong Lu², Xiao Yu³, Changsheng Zhao³

Affiliations

¹ Shandong Center for Disease Control and Prevention, Jinan, China.
² Queen Mary School, Nanchang University, Nanchang, China.
³ Department of Nutriology, The Second Hospital of Shandong University, Jinan, China.

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.