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Azevedo-Martins AK, Santos MP, Abayomi J, Ferreira NJR, Evangelista FS. The Impact of Excessive Fructose Intake on Adipose Tissue and the Development of Childhood Obesity. Nutrients 2024; 16:939. [PMID: 38612973 PMCID: PMC11013923 DOI: 10.3390/nu16070939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/16/2024] [Accepted: 01/19/2024] [Indexed: 04/14/2024] Open
Abstract
Worldwide, childhood obesity cases continue to rise, and its prevalence is known to increase the risk of non-communicable diseases typically found in adults, such as cardiovascular disease and type 2 diabetes mellitus. Thus, comprehending its multiple causes to build healthier approaches and revert this scenario is urgent. Obesity development is strongly associated with high fructose intake since the excessive consumption of this highly lipogenic sugar leads to white fat accumulation and causes white adipose tissue (WAT) inflammation, oxidative stress, and dysregulated adipokine release. Unfortunately, the global consumption of fructose has increased dramatically in recent years, which is associated with the fact that fructose is not always evident to consumers, as it is commonly added as a sweetener in food and sugar-sweetened beverages (SSB). Therefore, here, we discuss the impact of excessive fructose intake on adipose tissue biology, its contribution to childhood obesity, and current strategies for reducing high fructose and/or free sugar intake. To achieve such reductions, we conclude that it is important that the population has access to reliable information about food ingredients via food labels. Consumers also need scientific education to understand potential health risks to themselves and their children.
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Affiliation(s)
- Anna Karenina Azevedo-Martins
- Group of Study in Endocrinology and Metabolism, School of Arts, Sciences and Humanities, University of São Paulo, São Paulo 03828-000, Brazil; (M.P.S.); (N.J.R.F.); (F.S.E.)
| | - Matheus Pedro Santos
- Group of Study in Endocrinology and Metabolism, School of Arts, Sciences and Humanities, University of São Paulo, São Paulo 03828-000, Brazil; (M.P.S.); (N.J.R.F.); (F.S.E.)
| | - Julie Abayomi
- School of Medicine and Nutrition, Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk L39 4QP, UK;
| | - Natália Juliana Ramos Ferreira
- Group of Study in Endocrinology and Metabolism, School of Arts, Sciences and Humanities, University of São Paulo, São Paulo 03828-000, Brazil; (M.P.S.); (N.J.R.F.); (F.S.E.)
| | - Fabiana S. Evangelista
- Group of Study in Endocrinology and Metabolism, School of Arts, Sciences and Humanities, University of São Paulo, São Paulo 03828-000, Brazil; (M.P.S.); (N.J.R.F.); (F.S.E.)
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Alhareky M, Goodson JM, Tavares M, Hartman ML. Beverage consumption and obesity in Kuwaiti school children. Front Endocrinol (Lausanne) 2024; 14:1174299. [PMID: 38529102 PMCID: PMC10961371 DOI: 10.3389/fendo.2023.1174299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 10/17/2023] [Indexed: 03/27/2024] Open
Abstract
Sweetened beverage consumption is particularly important in countries such as Kuwait, where the prevalence of obesity is high, and most children drink sweetened beverages daily. To assess the relationship between three most commonly consumed beverages, (soda, milk, and juice) and the incidence of obesity among Kuwaiti children at the critical age of 10-12 year, Longitudinal cohort data of 6,305 children on initial presentation in 2012 (age, 10 years) and follow-up in 2014 (age, 12 years) were obtained from the Kuwait Healthy Life Study. The servings for the three beverages (soda, juice, and milk) were calculated as servings per day groups (0, 1-2, and 3 servings/day or more). Multivariate logistic regression was performed to assess the relationship between developing obesity during 2012-2014 and soda, juice, and milk consumption. Model selection was based on clinically relevant covariates and potential confounders using stepwise model selection. Six percent children become obese between baseline and follow-up visits. High soda drinking showed significant association with developing obesity. High milk consumption (more than 3 servings a day) was also significantly associated with developing obesity. Potential confounders included in the final model were age, sex, governorates, and fitness level, of which none were significant confounders or effect modifiers for the association. Children with high soda consumption had significantly higher prevalence of obesity. High obesity prevalence was observed with high milk consumption at a lower significance level but not with high juice consumption.
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Affiliation(s)
- Muhanad Alhareky
- Department of Preventive Dental Sciences, Imam Abdulrahman Bin Faisal, College of Dentistry, Dammam, Saudi Arabia
| | - Jo Max Goodson
- Department of Applied Oral Sciences, the Forsyth Research Institute, Cambridge, MA, United States
| | - Mary Tavares
- The Forsyth Institute, Cambridge, MA, United States
| | - Mor-Li Hartman
- Department of Applied Oral Sciences, the Forsyth Research Institute, Cambridge, MA, United States
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Monge-Rojas R, Barboza LA, Vargas-Quesada R. Reducing dietary intake of added sugars could affect the nutritional adequacy of vitamin A in adolescents: the Costa Rica case. BMC Public Health 2023; 23:2503. [PMID: 38097973 PMCID: PMC10720178 DOI: 10.1186/s12889-023-17243-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 11/16/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND In countries where sugar fortification with vitamin A is mandatory, strategies to reduce the prevalence of overweight/obesity in adolescents that involve lowering added sugar intake could lead to vitamin A inadequate intakes, since vitamin A-fortified sugar for home consumption contributes to a high proportion of this vitamin intake in the adolescent diet. METHODS The study employed a hierarchical linear model to perform a mediation analysis on a cross-sectional sample of adolescents (13-18 years old) in the province of San José, Costa Rica. RESULTS Lowering the total energy intake derived from added sugars to less than 10% significantly increases the prevalence of vitamin A inadequate intake in adolescents by 12.1% (from 29.6% to 41.7%). This is explained by the mediation model in which, the reduced adequacy of vitamin A intake is mediated by a reduction in total energy intake derived from added sugars fortified with vitamin A. CONCLUSIONS The vitamin A fortification of sugar for household consumption should be reassessed according to the current epidemiological profile in Costa Rica to promote strategies that reduce the prevalence of overweight/obesity in adolescents by lowering the consumption of added sugars without affecting vitamin A intake.
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Affiliation(s)
- Rafael Monge-Rojas
- Nutrition and Health Unit, Researcher, Costa Rican Institute for Research and Education On Nutrition and Health (INCIENSA), 4-2250 Tres Ríos, Cartago, Costa Rica.
| | - Luis A Barboza
- Center for Pure and Applied Mathematics (CIMPA), Researcher, Department of Mathematics, Universidad de Costa Rica, San José, 2060, Costa Rica
| | - Rulamán Vargas-Quesada
- Nutrition and Health Unit, Researcher, Costa Rican Institute for Research and Education On Nutrition and Health (INCIENSA), 4-2250 Tres Ríos, Cartago, Costa Rica
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Kasman M, Hammond RA, Reader L, Purcell R, Guyer S, Ganiban JM, Mitchell DC, Dabelea DM, Bellatorre A, Bekelman TA, Cohen CC, Perng W, Grummon AH, Wu AJ, Oken E, Kleinman K. Childhood Sugar-Sweetened Beverage Consumption: an Agent-Based Model of Context-Specific Reduction Efforts. Am J Prev Med 2023; 65:1003-1014. [PMID: 37451323 PMCID: PMC10787028 DOI: 10.1016/j.amepre.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 07/07/2023] [Accepted: 07/09/2023] [Indexed: 07/18/2023]
Abstract
INTRODUCTION Despite widespread recognition among public health experts that childhood sugar-sweetened beverage consumption should be reduced, doing so has proven to be a challenge. An agent-based model of early childhood sugar-sweetened beverage consumption was applied to data from three high-quality, longitudinal cohort studies to gain insight into potentially effective intervention strategies across contexts. METHODS From 2021 to 2023, a single agent-based model design was applied to data sets derived from three separate cohorts of children followed from infancy to childhood, with very different populations and environments (participants recruited in 1999-2002; 2003-2010; and 2009-2014). After assessing its ability to reproduce observed consumption patterns across cohorts, it was used to simulate potential impacts of multiple intervention strategies across contexts. RESULTS Interventions reducing home availability of sugar-sweetened beverages consistently had the largest potential effects. Impact differed between cohort settings: a complete decrease in availability resulted in an estimated 87% decrease in overall early childhood consumption for one of the cohorts, compared with 61% and 54% in the others. Reducing availability in center-based child care resulted in substantially greater reduction in one cohort relative to the other two. CONCLUSIONS There is untapped potential for strategies targeting children's sugar-sweetened beverage consumption in the home, but in some instances, other approaches might also yield meaningful effects. Tailoring approach to setting may be important, and agent-based models can be informative for doing so. This agent-based model has broad generalizability and potential to serve as a tool for designing effective, context-specific strategies to reduce childhood sugar-sweetened beverage consumption.
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Affiliation(s)
- Matt Kasman
- Center on Social Dynamics and Policy, Brookings Institution, Washington, District of Columbia.
| | - Ross A Hammond
- Center on Social Dynamics and Policy, Brookings Institution, Washington, District of Columbia; Center for Public Health Systems Science, Brown School at Washington University, St Louis, Missouri; The Santa Fe Institute, Santa Fe, New Mexico
| | - Lydia Reader
- Center for Public Health Systems Science, Brown School at Washington University, St Louis, Missouri
| | - Rob Purcell
- Center on Social Dynamics and Policy, Brookings Institution, Washington, District of Columbia
| | - Sally Guyer
- Leve Lab, University of Oregon, Eugene, Oregon
| | - Jody M Ganiban
- Department of Psychology, The George Washington University, Washington, District of Columbia
| | - Diane C Mitchell
- Department of Nutritional Sciences, Pennsylvania State University, University Park, Pennsylvania
| | - Dana M Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Anna Bellatorre
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Traci A Bekelman
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Catherine C Cohen
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Wei Perng
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Anna H Grummon
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California
| | - Allison J Wu
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Emily Oken
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts; Department of Nutrition, Harvard TH Chan School of Public Health, Boston, Massachusetts
| | - Ken Kleinman
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts-Amherst, Amherst, Massachusetts
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Mohseni Z, Tumin D, Collier DN, Taft N, Lazorick S. Longitudinal Patterns of Beverage Intake in Treatment-Seeking Children with Obesity in Eastern NC Using the Validated BEVQ-15. Nutrients 2023; 15:4171. [PMID: 37836455 PMCID: PMC10648911 DOI: 10.3390/nu15194171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/19/2023] [Accepted: 09/21/2023] [Indexed: 10/15/2023] Open
Abstract
Sugar-sweetened beverage (SSB) consumption remains a major target for interventions to treat severe obesity in children. Understanding how total energy consumption is divided among different types of beverages remains unclear. This study retrospectively examined how the consumption of beverage calories (kcal) from 100% fruit juice and SSBs, and body mass index, assessed as a percent of the 95th sex- and age-specific percentile (%of 95BMI), changed during the treatment of children with obesity aged 2-18 years. Treatment was provided by an integrative multi-disciplinary team, comprising a physician, a dietician/ nutritionist and a behavioralist employing motivational interviewing and a small change approach to promote improved sustainable health habits and induce a net negative energy balance. The sample included 155 patients, with 341 visits. The median age was 11 years, 60% were girls, and there was a median follow-up of 3.1 months. At baseline, the median %of 95BMI was 135 and the median kcal/day intake was 436 from juice and 263 from SSB. For each additional 100 kcal consumed/day from SSB and juice, the %of 95BMI increased by 1.4 percentage points. In the follow-up, each additional month was associated with 7 fewer kcal/day from SSB and juice combined, with a 0.5 percentage point increase in %of 95BMI. Children in this treatment program consumed fewer calories from SSB over time, although the %of 95BMI did not decrease. SSBs other than soda accounted for the majority of beverage kcal intake, therefore potentially providing a targeted direction for interventions.
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Affiliation(s)
- Zahra Mohseni
- Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA;
| | - Dmitry Tumin
- Department of Pediatrics, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA; (D.T.); (D.N.C.); (N.T.)
| | - David N. Collier
- Department of Pediatrics, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA; (D.T.); (D.N.C.); (N.T.)
| | - Natalie Taft
- Department of Pediatrics, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA; (D.T.); (D.N.C.); (N.T.)
| | - Suzanne Lazorick
- Department of Pediatrics, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA; (D.T.); (D.N.C.); (N.T.)
- Department of Public Health, Brody School of Medicine, East Carolina University, 115 Heart Dr, Mailstop 660, Greenville, NC 27834, USA
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Liu S, Ohinmaa A, Maximova K, Veugelers PJ. The health and economic benefits of sugar taxation and vegetables and fruit subsidy scenarios in Canada. Soc Sci Med 2023; 329:116012. [PMID: 37331286 DOI: 10.1016/j.socscimed.2023.116012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 06/05/2023] [Accepted: 06/07/2023] [Indexed: 06/20/2023]
Abstract
A tax on sugar-sweetened beverages (SSB) has been implemented in various jurisdictions. Though research confirmed this tax to reduce sugar consumption and to prevent chronic diseases, it also revealed concerns: one concern relates to the small proportion of sugar in the diet coming from SSBs; and another concern relates to the disproportional tax burden to low-income groups. To inform public health decision makers on alternatives, we examined three 'real world' taxation and subsidy scenarios in Canada: 1) a CAD$0.75/100 g tax on SSBs; 2) a CAD$0.75/100 g tax on free sugar in all foods; and 3) a 20% subsidy on vegetables and fruit (V&F). Using national survey data and a proportional multi-state life table-based Markov model, we simulated the changes in disability-adjusted life years, healthcare costs, tax revenue, intervention costs, and incremental cost-effectiveness ratio for five income quintiles after implementing the three scenarios, over a lifetime of the 2015 Canadian adult population. The first, second and third scenario would prevent 28,921, 262,348 and 551 cases of type 2 diabetes, respectively. They would avert 752,353, 12,167,113, and 29,447 disability-adjusted life years and save CAD$12,942 million, 149,927 million, and 442 million in health care costs, respectively, over a lifetime. Combining the second and third scenarios would lead to the largest health and economic benefits. Although the lowest income quintile would bear a higher sugar tax burden (0.81% of income, CAD$120/person/year), this would be compensated by a coinciding subsidy on V&F (1.30% of income, CAD$194/person/year). These findings support policies that include a tax on all free sugar in foods and a subsidy on V&F as an effective means to reduce chronic diseases and health care costs. Although the sugar tax was financially regressive, the V&F subsidy could compensate for the tax burden of the disadvantaged groups and improve health and economic equity.
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Affiliation(s)
- Siyuan Liu
- Population Development Studies Center, Institute of Health Science, School of Sociology and Population Studies, Renmin University of China, Beijing, China; Population Health Intervention Research Unit, School of Public Health, University of Alberta, Edmonton, Alberta, T6G 2T4, Canada
| | - Arto Ohinmaa
- Population Health Intervention Research Unit, School of Public Health, University of Alberta, Edmonton, Alberta, T6G 2T4, Canada.
| | - Katerina Maximova
- Population Health Intervention Research Unit, School of Public Health, University of Alberta, Edmonton, Alberta, T6G 2T4, Canada; MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Paul J Veugelers
- Population Health Intervention Research Unit, School of Public Health, University of Alberta, Edmonton, Alberta, T6G 2T4, Canada
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Chien YH, Lin CY, Hsu SY, Chen YH, Wu HT, Huang SW, Chen YC. Effects of Nonnutritive Sweeteners on Body Composition Changes during Pubertal Growth. Nutrients 2023; 15:nu15102319. [PMID: 37242202 DOI: 10.3390/nu15102319] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/01/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023] Open
Abstract
The effects of consuming specific types of nonnutritive sweeteners (NNSs) on adiposity changes in children have remained inconsistent. In this study, we aimed to investigate the effects of the intake of different kinds of NNSs on long-term adiposity changes during pubertal growth. Furthermore, we examined the above relationships among different sexes, pubertal stages, and levels of obesity. A total of 1893 6-15-year-old adults were recruited and followed-up every 3 months. The NNS-FFQ (Food Frequency Questionnaire) was conducted and urine samples were collected to investigate the effects of the selected sweeteners, which included acesulfame potassium, aspartame, sucralose, glycyrrhizin, steviol glycosides, and sorbitol. Multivariate linear mixed-effects models were used to examine the relationship between NNS intake and body composition. The consumption of aspartame, sucralose, glycyrrhizin, stevioside, and sorbitol was associated with decreased fat mass and increased fat-free mass. In the highest tertile group, the effects of NNS consumption on fat mass corresponded to values of -1.21 (95% CI: -2.04 to -0.38) for aspartame, -0.62 (95% CI: -1.42 to 0.19) for sucralose, -1.26 (95% CI: -2.05 to -0.47) for glycyrrhizin, -0.90 (95% CI: -2.28 to 0.48) for stevioside, and -0.87 (95% CI: -1.67 to -0.08) for sorbitol, while the effects on fat-free mass corresponded to values of 1.20 (95% CI: 0.36 to -0.38) for aspartame, 0.62 (95% CI: -0.19 to 1.43) for sucralose, 1.27 (95% CI: 0.48 to 2.06) for glycyrrhizin, 0.85 (95% CI: -0.53 to 2.23) for stevioside, and 0.87 (95% CI: 0.08 to 1.67) for sorbitol. Particularly, aspartame and sorbitol revealed a dose-responsiveness effect. The above finding was more prominent among girls than boys. Moreover, fat mass was significantly reduced in normal-weight children who consumed a moderate amount of aspartame and a large amount of glycyrrhizin and sorbitol compared with obese children. In conclusion, the NNS-specific and sex-specific effects of long-term NNS consumption revealed associations of decreasing fat mass and increasing fat-free mass for children undergoing pubertal growth.
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Affiliation(s)
- Yu-Hsin Chien
- Department of Education, Taipei Medical University Hospital, Taipei 110, Taiwan
| | - Chia-Yuan Lin
- Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
- Department of Food Science, National Taiwan Ocean University, Keelung City 202301, Taiwan
| | - Shih-Yuan Hsu
- Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
| | - Yue-Hwa Chen
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 110, Taiwan
| | - Hung-Tsung Wu
- Department of Internal Medicine, School of Medicine, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
| | - Shiu-Wen Huang
- Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
- Department of Pharmacology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
- Department of Medical Research, Research Center of Thoracic Medicine and Asthma, Taipei Medical University Hospital, Taipei 110, Taiwan
| | - Yang-Ching Chen
- Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 110, Taiwan
- Department of Family Medicine, Taipei Medical University Hospital, Taipei 110, Taiwan
- Graduate Institute of Metabolism and Obesity Sciences, Taipei Medical University, Taipei 110, Taiwan
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Ferguson K, Gunthert K, Kaidbey JH, Parr M, Visek AJ, Sacheck JM, Sylvetsky AC. Behavioral Patterns of Sugary Drink Consumption among African American Adolescents: A Pilot and Feasibility Study Using Ecological Momentary Assessment. Nutrients 2023; 15:2171. [PMID: 37432343 DOI: 10.3390/nu15092171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 04/25/2023] [Accepted: 04/28/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Sugary drinks (SDs) are the predominant contributors to added sugar intake among adolescents, with the highest intakes reported among African American adolescents. The objective of this pilot study was to examine the feasibility of using mobile phone-based ecological momentary assessment (EMA) to investigate, in real time, behavioral patterns of SD consumption among African American adolescents from low-income households. METHODS Adolescents (n = 39, ages 12-17) attended a virtual meeting with a trained research assistant, which involved completion of surveys and training on responding to EMA prompts using a mobile phone application. On the seven subsequent days, adolescents were instructed to respond to researcher-initiated prompts three times daily, which queried their SD intake, location, social context, activities, stress, and mood. They were also asked to complete an analogous self-initiated survey each time they consumed SDs. RESULTS SD consumption was reported on 219 of 582 (38%) researcher-initiated surveys and on 135 self-initiated SD consumption surveys, for a total of 354 instances of SD intake over the 7-day assessment period. The majority (69%) of the surveys were completed while at home. SD consumption was reported on 37%, 35%, and 41% of researcher-initiated surveys completed at their home, at the home of a friend or family member, or while in transit, respectively. CONCLUSIONS These preliminary data indicate that mobile phone-based EMA is feasible for investigating SD intake behaviors among African American youth from low-income households and support the promise of EMA for investigating SD consumption in this population in larger samples of youth.
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Affiliation(s)
- Kacey Ferguson
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA
| | - Kathleen Gunthert
- Department of Psychology, American University, Washington, DC 20016, USA
| | - Jasmine H Kaidbey
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA
| | - Meredith Parr
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA
| | - Amanda J Visek
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA
| | - Jennifer M Sacheck
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA
| | - Allison C Sylvetsky
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA
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Adedeji TG, Jeje SO, Omayone TP, Dareowolabi BO. Soda intake influences phenotype, antioxidants and inflammatory status in high protein-fed wistar rats. Heliyon 2023; 9:e15781. [PMID: 37180936 PMCID: PMC10172790 DOI: 10.1016/j.heliyon.2023.e15781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 04/13/2023] [Accepted: 04/20/2023] [Indexed: 05/16/2023] Open
Abstract
An increasing population of people, especially young adults who exercise, consume high protein diets along with carbonated drinks. While there are numerous studies on the effect of high protein diets, there is a need to understand how protein diets in combination with carbonated drinks impact physiology. In order to assess these effects on wistar rats' phenotype, antioxidants and inflammatory profiles, 64 wistar rats were divided into dietary groups of 8 male and 8 female animals each. The animals were fed standard diet as control (chow), chow and carbonated soda, a high protein diet (48.1% energy from protein) and a high protein diet with carbonated soda according to their groups. Body measurements, blood glucose levels, serum insulin levels, lipid peroxidation, antioxidant activity, adipokines and inflammatory markers concentrations were all determined. At the end of the study, body measurements, inflammatory markers and adipokine concentration were increased in animals fed the high protein diet and high protein-soda diet. There was a decrease in antioxidant and lipid peroxidation levels in protein fed male and female animals but those fed protein in combination with soda had increased lipid peroxidation levels. In conclusion, high protein diet in combination with carbonated soda impacts physiology differently from a high protein diet alone, and may stimulate weight gain, oxidative stress and HPD-related inflammation in Wistar rats.
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Joveini H, Sharifi N, Meymary BK, Mehri A, Shahrabadi R, Rahmanian V, Hashemian M. The effect of empowerment program to reduce Sugar Consumption based on the Multi-Theory Model on Body Mass Index and abdominal obesity in Iranian women. BMC Womens Health 2023; 23:207. [PMID: 37118745 PMCID: PMC10147358 DOI: 10.1186/s12905-023-02361-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 04/15/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND Considering the prevalence of overweight and abdominal obesity in middle-aged women, this study was conducted to determine the effect of empowerment program to reduce sugar consumption based on the Multi-Theory Model (MTM) on Body Mass Index (BMI) and abdominal obesity in women aged 30-60 in Joven. METHODS This quasi-experimental study (include descriptive and interventional sections) was conducted on the Joven city, Khorasan Razavi province, Iran country from October 2020 to August 2021. Sampling was performed as a multi-stage cluster. First, a descriptive study was performed among 400 women, and then 128 people who were eligible to enter the interventional phase of the study were selected. In the control group, 63 people and in the intervention group, 65 people were eligible to enter the study. The educational intervention was performed in five 60-minute sessions for groups of 12 people. The instruments included the demographic questionnaire, sugar consumption checklist and researcher-made questionnaire based on MTM constructs. Before the intervention, one, three and six months after the intervention, the questionnaire was completed by both intervention and control groups also measurement of waist circumference and BMI were performed using standard instruments. The obtained data were analyzed by SPSS 17. RESULTS After the educational intervention, there was a significant difference between the intervention and control groups in all the MTM constructs. Also, six months after the educational intervention, BMI, waist circumference and amount of consumption of sugary substances decreased significantly in the intervention group (p < 0.05). CONCLUSION Educational intervention based on the MTM can be effective in reducing the consumption of sugary substances and shaping behaviors related to healthy lifestyle in women.
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Affiliation(s)
- Hamid Joveini
- Department of Health Education and Health Promotion, Faculty of Health, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Nader Sharifi
- Department of Public Health, Khomein University of Medical Sciences, Khomein, Iran
| | - Batool Kalate Meymary
- Department of Health Education and Health Promotion, Faculty of Health, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Ali Mehri
- Department of Health Education and Health Promotion, Faculty of Health, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Reza Shahrabadi
- Department of Health Education and Health Promotion, Faculty of Health, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Vahid Rahmanian
- Department of Public Health, Torbat Jam Faculty of Medical Sciences, Torbat Jam, Iran
| | - Masoumeh Hashemian
- Department of Health Education and Health Promotion, Faculty of Health, Sabzevar University of Medical Sciences, Sabzevar, Iran.
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11
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Long-Term Cola Intake Does Not Cause Evident Pathological Alterations in the Femoral Bone Microstructure: An Animal Study in Adult Mice. Nutrients 2023; 15:nu15030583. [PMID: 36771291 PMCID: PMC9920312 DOI: 10.3390/nu15030583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/16/2023] [Accepted: 01/19/2023] [Indexed: 01/24/2023] Open
Abstract
Short-term animal experiments and association studies in humans have shown that cola intake may have a detrimental impact on bone mineral density (BMD); however, other bone parameters have not been investigated. This study examined the effects of long-term cola consumption on the femoral bone microstructure using adult mice (n = 32) as an animal model, which were divided into water and cola groups depending on whether they received water or cola along with a standard rodent diet for 6 months. Micro-computed tomography revealed that cola intake did not significantly affect all measured parameters characterizing trabecular bone mass and microarchitecture, as well as cortical microarchitecture and geometry in both sexes, although a slight deterioration of these parameters was noted. Cola consumption also resulted in a slightly, statistically insignificant worsening of bone mechanical properties. In contrast to female mice, males receiving cola had a lower area of primary osteons' vascular canals. Nevertheless, long-term cola intake did not cause evident pathological alterations in the femur of adult mice, possibly due to a balanced diet and no restriction of physical activity. Therefore, the adverse effects of cola consumption on BMD, the only bone parameter studied so far, may be caused by other risk and lifestyle factors.
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12
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Nguyen M, Jarvis SE, Tinajero MG, Yu J, Chiavaroli L, Mejia SB, Khan TA, Tobias DK, Willett WC, Hu FB, Hanley AJ, Birken CS, Sievenpiper JL, Malik VS. Sugar-sweetened beverage consumption and weight gain in children and adults: a systematic review and meta-analysis of prospective cohort studies and randomized controlled trials. Am J Clin Nutr 2023; 117:160-174. [PMID: 36789935 DOI: 10.1016/j.ajcnut.2022.11.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 11/02/2022] [Accepted: 11/10/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Sugar-sweetened beverages (SSBs) have been implicated in fueling the obesity epidemic. OBJECTIVES This study aimed to update a synthesis of the evidence on SSBs and weight gain in children and adults. METHODS MEDLINE, Embase, and Cochrane databases were searched through September 8, 2022, for prospective cohort studies and randomized controlled trials (RCTs) that evaluated intake of SSBs in relation to BMI and body weight in children and adults, respectively. Eligible interventions were compared against a noncaloric control. Study-level estimates were pooled using random-effects meta-analysis and presented as β-coefficients with 95% CIs for cohorts and weighted mean differences (MDs) with 95% CIs for RCTs. RESULTS We identified 85 articles including 48 in children (40 cohorts, n = 91,713; 8 RCTs, n = 2783) and 37 in adults (21 cohorts, n = 448,661; 16 RCTs, n = 1343). Among cohort studies, each serving/day increase in SSB intake was associated with a 0.07-kg/m2 (95% CI: 0.04 kg/m2, 0.10 kg/m2) higher BMI in children and a 0.42-kg (95% CI: 0.26 kg, 0.58 kg) higher body weight in adults. RCTs in children indicated less BMI gain with SSB reduction interventions compared with control (MD: -0.21 kg/m2; 95% CI: -0.40 kg/m2, -0.01 kg/m2). In adults, randomization to addition of SSBs to the diet led to greater body weight gain (MD: 0.83 kg; 95% CI: 0.47 kg, 1.19 kg), and subtraction of SSBs led to weight loss (MD: -0.49 kg; 95% CI: -0.66 kg, -0.32 kg) compared with the control groups. A positive linear dose-response association between SSB consumption and weight gain was found in all outcomes assessed. CONCLUSIONS Our updated systematic review and meta-analysis expands on prior evidence to confirm that SSB consumption promotes higher BMI and body weight in both children and adults, underscoring the importance of dietary guidance and public policy strategies to limit intake. This meta-analysis was registered at the International Prospective Register of Systematic Reviews as CRD42020209915.
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Affiliation(s)
- Michelle Nguyen
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Sarah E Jarvis
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Maria G Tinajero
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jiayue Yu
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Laura Chiavaroli
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Toronto 3D Knowledge Synthesis & Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON, Canada
| | - Sonia Blanco Mejia
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Toronto 3D Knowledge Synthesis & Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON, Canada
| | - Tauseef A Khan
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Toronto 3D Knowledge Synthesis & Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON, Canada
| | - Deirdre K Tobias
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Walter C Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Frank B Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Anthony J Hanley
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Division of Endocrinology, University of Toronto, Toronto, ON, Canada; Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, ON, Canada
| | - Catherine S Birken
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Department of Paediatrics, University of Toronto, Toronto, ON, Canada; Child Health Evaluative Sciences, SickKids Research Institute, Toronto, ON, Canada
| | - John L Sievenpiper
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Toronto 3D Knowledge Synthesis & Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON, Canada; Division of Endocrinology & Metabolism, St. Michael's Hospital, Toronto, ON, Canada; Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Vasanti S Malik
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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13
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Sakaki JR, Gao S, Ha K, Chavarro JE, Chen MH, Sun Q, Hart JE, Chun OK. Childhood beverage intake and risk of hypertension and hyperlipidaemia in young adults. Int J Food Sci Nutr 2022; 73:954-964. [PMID: 35761780 PMCID: PMC9951226 DOI: 10.1080/09637486.2022.2091524] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 06/10/2022] [Accepted: 06/15/2022] [Indexed: 10/17/2022]
Abstract
An epidemiological analysis assessing beverage consumption and risk factors for cardiovascular disease was conducted. Participants were 9-16 years old at enrolment, completed food frequency questionnaires in 1996-2001 and self-reported outcomes in 2010-2014. Exclusion criteria included missing data on relevant variables and covariates, prevalent disease before 2005, and implausible/extreme weight or energy intake. Intakes of orange juice, apple/other fruit juice, sugar-sweetened beverages and diet soda were related to the risk of incident hypertension or hyperlipidaemia using Cox proportional hazards regression, adjusting for diet, energy intake, age, smoking, physical activity and body mass index. There were 9,043 participants with 618 cases of hypertension and 850 of hyperlipidaemia in 17 years of mean follow-up. Sugar-sweetened beverage intake but not fruit juice nor diet soda was associated with hypertension (hazard ratio (95% confidence interval): 1.16 (1.03, 1.31)) in males. This study can guide beverage consumption as it relates to early predictors of cardiovascular disease.
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Affiliation(s)
- Junichi R. Sakaki
- Department of Nutritional Sciences, University of Connecticut, 27 Manter Rd., Unit 4017, Storrs, CT 06269
| | - Simiao Gao
- Department of Statistics, University of Connecticut, 215 Glenbrook Rd., U-4120, Storrs, CT, 06269
| | - Kyungho Ha
- Department of Food Science and Nutrition, Jeju National University, Jeju, South Korea
| | - Jorge E. Chavarro
- Department of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave., Boston, MA.; Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, and Harvard Medical School, Boston, MA
| | - Ming-Hui Chen
- Department of Statistics, University of Connecticut, 215 Glenbrook Rd., U-4120, Storrs, CT, 06269
| | - Qi Sun
- Department of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave., Boston, MA.; Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, and Harvard Medical School, Boston, MA
| | - Jaime E. Hart
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 401 Park Drive, 3rd Fl West, Boston, MA 02215.; Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, and Harvard Medical School, Boston, MA
| | - Ock K. Chun
- Department of Nutritional Sciences, University of Connecticut, 27 Manter Rd., Unit 4017, Storrs, CT 06269
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14
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Tsan L, Chometton S, Hayes AM, Klug ME, Zuo Y, Sun S, Bridi L, Lan R, Fodor AA, Noble EE, Yang X, Kanoski SE, Schier LA. Early-life low-calorie sweetener consumption disrupts glucose regulation, sugar-motivated behavior, and memory function in rats. JCI Insight 2022; 7:e157714. [PMID: 36099052 PMCID: PMC9714783 DOI: 10.1172/jci.insight.157714] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 09/12/2022] [Indexed: 01/12/2023] Open
Abstract
Low-calorie sweetener (LCS) consumption in children has increased dramatically due to its widespread presence in the food environment and efforts to mitigate obesity through sugar replacement. However, mechanistic studies on the long-term impact of early-life LCS consumption on cognitive function and physiological processes are lacking. Here, we developed a rodent model to evaluate the effects of daily LCS consumption (acesulfame potassium, saccharin, or stevia) during adolescence on adult metabolic, behavioral, gut microbiome, and brain transcriptomic outcomes. Results reveal that habitual early-life LCS consumption impacts normal postoral glucose handling and impairs hippocampal-dependent memory in the absence of weight gain. Furthermore, adolescent LCS consumption yielded long-term reductions in lingual sweet taste receptor expression and brought about alterations in sugar-motivated appetitive and consummatory responses. While early-life LCS consumption did not produce robust changes in the gut microbiome, brain region-specific RNA-Seq analyses reveal LCS-induced changes in collagen- and synaptic signaling-related gene pathways in the hippocampus and nucleus accumbens, respectively, in a sex-dependent manner. Collectively, these results reveal that habitual early-life LCS consumption has long-lasting implications for glucoregulation, sugar-motivated behavior, and hippocampal-dependent memory in rats, which may be based in part on changes in nutrient transporter, sweet taste receptor, and central gene pathway expression.
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Affiliation(s)
- Linda Tsan
- Neuroscience Graduate Program and
- Department of Biological Sciences, Human and Evolutionary Biology Section, University of Southern California, Los Angeles, California, USA
| | - Sandrine Chometton
- Department of Biological Sciences, Human and Evolutionary Biology Section, University of Southern California, Los Angeles, California, USA
| | - Anna M.R. Hayes
- Department of Biological Sciences, Human and Evolutionary Biology Section, University of Southern California, Los Angeles, California, USA
| | - Molly E. Klug
- Department of Biological Sciences, Human and Evolutionary Biology Section, University of Southern California, Los Angeles, California, USA
| | - Yanning Zuo
- Department of Integrative Biology and Physiology, University of California at Los Angeles, Los Angeles, California, USA
| | - Shan Sun
- Department of Bioinformatics and Genomics at the University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Lana Bridi
- Department of Biological Sciences, Human and Evolutionary Biology Section, University of Southern California, Los Angeles, California, USA
| | - Rae Lan
- Department of Biological Sciences, Human and Evolutionary Biology Section, University of Southern California, Los Angeles, California, USA
| | - Anthony A. Fodor
- Department of Bioinformatics and Genomics at the University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Emily E. Noble
- Department of Nutritional Sciences, University of Georgia, Athens, Georgia, USA
| | - Xia Yang
- Department of Integrative Biology and Physiology, University of California at Los Angeles, Los Angeles, California, USA
| | - Scott E. Kanoski
- Neuroscience Graduate Program and
- Department of Biological Sciences, Human and Evolutionary Biology Section, University of Southern California, Los Angeles, California, USA
| | - Lindsey A. Schier
- Neuroscience Graduate Program and
- Department of Biological Sciences, Human and Evolutionary Biology Section, University of Southern California, Los Angeles, California, USA
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15
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Kasman M, Hammond RA, Purcell R, Heuberger B, Moore TR, Grummon AH, Wu AJ, Block JP, Hivert MF, Oken E, Kleinman K. An agent-based model of child sugar-sweetened beverage consumption: implications for policies and practices. Am J Clin Nutr 2022; 116:1019-1029. [PMID: 36041179 PMCID: PMC9535525 DOI: 10.1093/ajcn/nqac194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 07/08/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND A strong body of evidence links young children's intake of sugar-sweetened beverages (SSBs) with myriad negative outcomes. OBJECTIVES Our research provides insight into whether and to what extent potential intervention strategies can reduce young children's consumption of SSBs. METHODS We built an agent-based model (ABM) of SSB consumption representing participants in the Project Viva longitudinal study between ages 2 and 7 y. In addition to extensive data from Project Viva, our model used nationally representative data as well as recent, high-quality literature. We tested the explanatory power of the model through comparison to consumption patterns observed in the Project Viva cohort. Then, we applied the model to simulate the potential impact of interventions that would reduce SSB availability in 1 or more settings or affect how families receive and respond to pediatrician advice. RESULTS Our model produced age-stratified trends in beverage consumption that closely match those observed in Project Viva cohort data. Among the potential interventions we simulated, reducing availability in the home-where young children spend the greatest amount of time-resulted in the largest consumption decrease. Removing access to all SSBs in the home resulted in them consuming 1.23 (95% CI: 1.21, 1.24) fewer servings of SSBs per week on average between the ages of 2 and 7 y, a reduction of ∼60%. By comparison, removing all SSB availability outside of the home (i.e., in schools and childcare) had a smaller impact (0.77; CI: 0.75, 0.78), a reduction of ∼40%. CONCLUSIONS These results suggest that interventions reducing SSB availability in the home would have the strongest effects on SSB consumption.
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Affiliation(s)
- Matt Kasman
- Center on Social Dynamics and Policy, Brookings Institution, Washington, DC, USA
| | - Ross A Hammond
- Center on Social Dynamics and Policy, Brookings Institution, Washington, DC, USA
- Brown School at Washington University in St. Louis, St. Louis, MO, USA
- The Santa Fe Institute, Santa Fe, NM, USA
| | - Rob Purcell
- Center on Social Dynamics and Policy, Brookings Institution, Washington, DC, USA
| | - Benjamin Heuberger
- Center on Social Dynamics and Policy, Brookings Institution, Washington, DC, USA
| | - Travis R Moore
- ChildObesity180, Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
- Department of Community Health, School of Arts and Sciences, Tufts University, Medford, MA, USA
| | - Anna H Grummon
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Allison J Wu
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
- Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, MA, USA
| | - Jason P Block
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
- Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Ken Kleinman
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts–Amherst, Amherst, MA, USA
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16
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Rousham EK, Goudet S, Markey O, Griffiths P, Boxer B, Carroll C, Petherick ES, Pradeilles R. Unhealthy Food and Beverage Consumption in Children and Risk of Overweight and Obesity: A Systematic Review and Meta-Analysis. Adv Nutr 2022; 13:1669-1696. [PMID: 35362512 PMCID: PMC9526862 DOI: 10.1093/advances/nmac032] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/25/2022] [Accepted: 03/25/2022] [Indexed: 01/28/2023] Open
Abstract
This WHO-commissioned review contributed to the update of complementary feeding recommendations, synthesizing evidence on effects of unhealthy food and beverage consumption in children on overweight and obesity. We searched PubMed (Medline), Cochrane CENTRAL, and Embase for articles, irrespective of language or geography. Inclusion criteria were: 1) randomized controlled trials (RCTs), non-RCTs, cohort studies, and pre/post studies with control; 2) participants aged ≤10.9 y at exposure; 3) studies reporting greater consumption of unhealthy foods/beverages compared with no or low consumption; 4) studies assessing anthropometric and/or body composition; and 5) publication date ≥1971. Unhealthy foods and beverages were defined using nutrient- and food-based approaches. Risk of bias was assessed using the ROBINS-I (risk of bias in nonrandomized studies of interventions version I) and RoB2 [Cochrane RoB (version 2)] tools for nonrandomized and randomized studies, respectively. Narrative synthesis was complemented by meta-analyses where appropriate. Certainty of evidence was assessed using Grading of Recommendations Assessment, Development, and Evaluation. Of 26,542 identified citations, 60 studies from 71 articles were included. Most studies were observational (59/60), and no included studies were from low-income countries. The evidence base was low quality, as assessed by ROBINS-I and RoB2 tools. Evidence synthesis was limited by the different interventions and comparators across studies. Evidence indicated that consumption of sugar-sweetened beverages (SSBs) and unhealthy foods in childhood may increase BMI/BMI z-score, percentage body fat, or odds of overweight/obesity (low certainty of evidence). Artificially sweetened beverages and 100% fruit juice consumption make little/no difference to BMI, percentage body fat, or overweight/obesity outcomes (low certainty of evidence). Meta-analyses of a subset of studies indicated a positive association between SSB intake and percentage body fat, but no association with change in BMI and BMI z-score. High-quality epidemiological studies that are designed to assess the effects of unhealthy food consumption during childhood on risk of overweight/obesity are needed to contribute to a more robust evidence base upon which to design policy recommendations. This protocol was registered at https://www.crd.york.ac.uk/PROSPERO as CRD42020218109.
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Affiliation(s)
- E K Rousham
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - S Goudet
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - O Markey
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - P Griffiths
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - B Boxer
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - C Carroll
- School of Health and Related Research, The University of Sheffield, Sheffield, United Kingdom
| | - E S Petherick
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester, United Kingdom
| | - R Pradeilles
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
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17
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Andrade EDDO, Rebouças ADS, Filho JQ, Ambikapathi R, Caulfield LE, Lima AÂM, Maciel BLL. Evolution of infant feeding practices in children from 9 to 24 months, considering complementary feeding indicators and food processing: Results from the Brazilian cohort of the MAL‐ED study. MATERNAL & CHILD NUTRITION 2022; 18:e13413. [PMID: 35971636 PMCID: PMC9480934 DOI: 10.1111/mcn.13413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 07/11/2022] [Accepted: 07/13/2022] [Indexed: 11/28/2022]
Abstract
Infant feeding practices impact children's nutritional and health status, influencing growth and development. This study aimed to analyse the evolution of infant feeding practices from 9 to 24 months of age, considering infant and young child feeding (IYCF) indicators and food processing. The infant feeding practices in children from the Brazilian site of the MAL‐ED study were evaluated at 9 (n = 193), 15 (n = 182) and 24 months (n = 164) using 24‐h dietary recalls. IYCF indicators were evaluated, and the extent of food processing was evaluated, using the NOVA classification. Breastfeeding declined significantly over time, from 77.6% at 9 months to 45.1% at 24 months. Although dietary diversity did not significantly change during the study period (80.5% at 24 months), the minimum acceptable diet significantly increased from 67.9% to 76.1% at 24 months (p < 0.0005). All the studied children consumed sweetened beverages from 9 months. Unhealthy food consumption and zero vegetable or fruit consumption significantly increased over time (p < 0.0005). Unprocessed food consumption decreased from 9 to 24 months of age (p < 0.0005), while ultra‐processed food consumption increased (p < 0.0005) during the study period. Logistic regressions showed that, at 9 months, breastfed children presented a lower risk for ultra‐processed food consumption (odds ratio [OR] = 0.31; 95% confidence interval [CI] = 0.13–0.77); and children reaching the minimum acceptable diet presented more risk for ultra‐processed food consumption (OR = 2.31; 95% CI = 1.01–5.27). In conclusion, data showed a reduction in the quality of infant feeding practices over the first 2 years of life, with a decrease in breastfeeding and an increase in the consumption of unhealthy and ultra‐processed foods. Data showed a reduction in the quality of infant feeding practices over the first 2 years of life. Breastfeeding decreased over the studied period. There was an increase in the consumption of ultra‐processed and unhealthy foods, which occurred concomitantly to the increase of no consumption of fruits/vegetables. Breastfeeding was an important protective factor against a greater consumption of ultra‐processed food. National nutrition policy should consider promoting breastfeeding and increasing fresh and minimally processed food consumption in children under 2 years.
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Affiliation(s)
| | | | - José Q. Filho
- Institute of Biomedicine for Brazilian Semiarid, Faculty of Medicine Federal University of Ceará Fortaleza Brazil
| | - Ramya Ambikapathi
- Department of Public Health Purdue University West Lafayette Indiana USA
| | - Laura E. Caulfield
- Department of International Health, Center for Human Nutrition The Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA
| | - Aldo Ângelo Moreira Lima
- Institute of Biomedicine for Brazilian Semiarid, Faculty of Medicine Federal University of Ceará Fortaleza Brazil
| | - Bruna Leal Lima Maciel
- Graduate Progam in Nutrition Federal University of Rio Grande do Norte Natal Brazil
- Department of Nutrition Federal University of Rio Grande do Norte Natal Brazil
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18
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Galfo M, Censi L, D'''''Addezio L, Melini F, Martone D. Overweight/obesity and lifestyle factors among Italian adolescents: the ALIADO study. Minerva Pediatr (Torino) 2022; 74:251-258. [DOI: 10.23736/s2724-5276.16.04708-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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19
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Learning from missing data: examining nonreporting patterns of height, weight, and BMI among Canadian youth. Int J Obes (Lond) 2022; 46:1598-1607. [PMID: 35650253 DOI: 10.1038/s41366-022-01154-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 04/29/2022] [Accepted: 05/23/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND Youth body mass index (BMI), derived from self-reported height and weight, is commonly prone to nonreporting. A considerable proportion of overweight and obesity (OWOB) research relies on such self-report data, however little literature to date has examined this nonreporting and the potential impact on research conclusions. The objective of this study was to examine the characteristics and predictors of missing data in youth BMI, height, and weight. METHODS Using a sample of 74,501 Canadian secondary school students who participated in the COMPASS study in 2018/19, sex-stratified generalized linear mixed models were run to examine predictors of missing data while controlling for school-level clustering. RESULTS In this sample, 31% of BMI data were missing. A variety of diet, exercise, mental health, and substance use variables were associated with BMI, height, and weight missingness. Perceptions of being overweight (females: 95% CI (1.42,1.62), males: 95% CI (1.71,2.00)) as well as intentions to lose weight (females: 95% CI (1.17,1.33), males: 95% CI (1.13,1.32)) were positively associated with BMI missingness. CONCLUSIONS Findings from this study suggest that nonreporting in youth height and weight is likely somewhat related to the values themselves, and hint that social desirability may play a substantial role in nonreporting. The predictors of missingness identified in this study can be used to inform future studies on the potential bias stemming from missing data and identify auxiliary variables that may be used for multiple imputation approaches.
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20
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Alshammari GM, Osman MA, Alabdulkarem KB, Alsoghair SM, Mohammed MA, Al-Harbi LN, Yahya MA. The effect of dietary behaviors on the nutritional status and associated factors of Yemeni students in Saudi Arabia. PLoS One 2022; 17:e0268659. [PMID: 35604892 PMCID: PMC9126404 DOI: 10.1371/journal.pone.0268659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 05/04/2022] [Indexed: 11/18/2022] Open
Abstract
The Kingdom of Saudi Arabia has undergone a significant transformation in eating habits and the native diets have been replaced with Western diets. The present study investigated the effect of dietary behavior on nutritional status and associated factors of Yemeni students studying in Saudi Arabia. The socioeconomic characteristics, food habits, daily food intake, and anthropometric measurement (BMI) were used to assess the nutrition status of 240 adults (120 males and 120 females) Yemni students with the ages ranging from 18 to 35 years studying at King Saud University, Saudi Arabia. The majority of students were married, had higher education level and reasonable income and eat three meals a day. Higher number of female studnets skipped breakfast compared to male students. Energy intake, i.e., vitamins and minerals was lower than the dietary recommended intake (DRI) for both male and female students. The majority of males were overweight compared to females. Most of the socioeconomic characteristics and food habits had positive or negative correlation with body mass index (BMI). Overall, the results revealed that the majority of Yemeni male students had poor eating habits compared to females, resulting in obesity. High income, number of meals per day, breakfast consumption, restaurant meals, consumption of soft drinks, sweets, and potato chips were identified as factors associated with the nutritional status of male and female students included in the study.
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Affiliation(s)
- Ghedeir M. Alshammari
- Department of Food Science and Nutrition, College of Food and Agricultural Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Magdi A. Osman
- Department of Food Science and Nutrition, College of Food and Agricultural Sciences, King Saud University, Riyadh, Saudi Arabia
| | | | - Saleh M. Alsoghair
- Department of Social Studies, College of Arts, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed A. Mohammed
- Department of Food Science and Nutrition, College of Food and Agricultural Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Laila Naif Al-Harbi
- Department of Food Science and Nutrition, College of Food and Agricultural Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed Abdo Yahya
- Department of Food Science and Nutrition, College of Food and Agricultural Sciences, King Saud University, Riyadh, Saudi Arabia
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21
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Giussani M, Lieti G, Orlando A, Parati G, Genovesi S. Fructose Intake, Hypertension and Cardiometabolic Risk Factors in Children and Adolescents: From Pathophysiology to Clinical Aspects. A Narrative Review. Front Med (Lausanne) 2022; 9:792949. [PMID: 35492316 PMCID: PMC9039289 DOI: 10.3389/fmed.2022.792949] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 03/21/2022] [Indexed: 01/09/2023] Open
Abstract
Arterial hypertension, dyslipidemia, alterations in glucose metabolism and fatty liver, either alone or in association, are frequently observed in obese children and may seriously jeopardize their health. For obesity to develop, an excessive intake of energy-bearing macronutrients is required; however, ample evidence suggests that fructose may promote the development of obesity and/or metabolic alterations, independently of its energy intake. Fructose consumption is particularly high among children, because they do not have the perception, and more importantly, neither do their parents, that high fructose intake is potentially dangerous. In fact, while this sugar is erroneously viewed favorably as a natural nutrient, its excessive intake can actually cause adverse cardio-metabolic alterations. Fructose induces the release of pro-inflammatory cytokines, and reduces the production of anti-atherosclerotic cytokines, such as adiponectin. Furthermore, by interacting with hunger and satiety control systems, particularly by inducing leptin resistance, it leads to increased caloric intake. Fructose, directly or through its metabolites, promotes the development of obesity, arterial hypertension, dyslipidemia, glucose intolerance and fatty liver. This review aims to highlight the mechanisms by which the early and excessive consumption of fructose may contribute to the development of a variety of cardiometabolic risk factors in children, thus representing a potential danger to their health. It will also describe the main clinical trials performed in children and adolescents that have evaluated the clinical effects of excessive intake of fructose-containing drinks and food, with particular attention to the effects on blood pressure. Finally, we will discuss the effectiveness of measures that can be taken to reduce the intake of this sugar.
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Affiliation(s)
- Marco Giussani
- Cardiologic Unit, Istituto Auxologico Italiano, Istituto Ricovero Cura Carattere Scientifico (IRCCS), Milan, Italy
| | - Giulia Lieti
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Antonina Orlando
- Cardiologic Unit, Istituto Auxologico Italiano, Istituto Ricovero Cura Carattere Scientifico (IRCCS), Milan, Italy
| | - Gianfranco Parati
- Cardiologic Unit, Istituto Auxologico Italiano, Istituto Ricovero Cura Carattere Scientifico (IRCCS), Milan, Italy.,School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Simonetta Genovesi
- Cardiologic Unit, Istituto Auxologico Italiano, Istituto Ricovero Cura Carattere Scientifico (IRCCS), Milan, Italy.,School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
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22
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Chu YY, Chen YH, Hsieh RH, Hsia SM, Wu HT, Chen YC. Development and Validation of the Chinese Version Non-Nutritive Sweetener Food Frequency Questionnaire with Urinary Biomarker in Children and Adolescents. Public Health Nutr 2022; 25:1-23. [PMID: 35414373 PMCID: PMC9991608 DOI: 10.1017/s136898002200088x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/03/2022] [Accepted: 04/05/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The purpose of this study was to develop a validated food frequency questionnaire (FFQ) to evaluate the intake of non-nutritive sweeteners (NNSs) in child and adolescent Asian populations. DESIGN Intensive and overall market research was performed to create the applicable NNS-FFQ with 13 food categories and 305 items. Six intense sweeteners, including acesulfame potassium, aspartame, sucralose, glycyrrhizin, steviol glycosides and sorbitol, were investigated. The validity and reproducibility of the NNS-FFQ were evaluated. The validity was further assessed by examining the consistency of reported NNS intake compared with urinary biomarkers using Cohen's κ analysis. SETTINGS This work was considered to be relevant in Asian societies. PARTICIPANTS One hundred and two children and adolescents recruited from several clinics were invited to participate in this study. RESULTS High content validity indices and high content validity ratio levels were revealed for each sweetener and food category. Reproducibility among subjects was satisfactory. Significant moderate correlations between estimated steviol glycoside/sucralose consumption and sensitive urinary biomarker levels were demonstrated (κ values were 0.59 and 0.45 for steviol glycosides and sucralose, respectively), indicating that the NNS-FFQ can be used to assess an individual's NNS intake. The dietary intense sweetener consumption pattern evaluated in this measurement was similar to those observed in other Asian countries but differed from those observed in Western populations with respect to types and amounts of NNSs. CONCLUSIONS This validated NNS-FFQ can be an applicable and useful tool to evaluate NNS intake in future epidemiological and clinical studies.
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Affiliation(s)
- Ying-Yueh Chu
- Department of Nutrition and Health Sciences, Chinese Culture University, Taipei, Taiwan
| | - Yue-Hwa Chen
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan
- School of Food Safety, College of Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Rong-Hong Hsieh
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Shih-Min Hsia
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Metabolism and Obesity Sciences, Taipei Medical University, Taipei, Taiwan
| | - Hung-Tsung Wu
- Department of Internal Medicine, School of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yang-Ching Chen
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Metabolism and Obesity Sciences, Taipei Medical University, Taipei, Taiwan
- Department of Family Medicine, Taipei Medical University Hospital, Taipei Medical University, No. 252, Wu-Hsing St, Xinyi District, Taipei11031, Taiwan
- Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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23
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Yan RR, Chan CB, Louie JCY. Current WHO recommendation to reduce free sugar intake from all sources to below 10% of daily energy intake for supporting overall health is not well supported by available evidence. Am J Clin Nutr 2022; 116:15-39. [PMID: 35380611 PMCID: PMC9307988 DOI: 10.1093/ajcn/nqac084] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 04/01/2022] [Indexed: 01/15/2023] Open
Abstract
Sugar is widely consumed over the world. Although the mainstream view is that high added or free sugar consumption leads to obesity and related metabolic diseases, controversies exist. This narrative review aims to highlight important findings and identify major limitations and gaps in the current body of evidence in relation to the effect of high sugar intakes on health. Previous animal studies have shown that high sucrose or fructose consumption causes insulin resistance in the liver and skeletal muscle and consequent hyperglycemia, mainly because of fructose-induced de novo hepatic lipogenesis. However, evidence from human observational studies and clinical trials has been inconsistent, where most if not all studies linking high sugar intake to obesity focused on sugar-sweetened beverages (SSBs), and studies focusing on sugars from solid foods yielded null findings. In our opinion, the substantial limitations in the current body of evidence, such as short study durations, use of supraphysiological doses of sugar or fructose alone in animal studies, and a lack of direct comparisons of the effects of solid compared with liquid sugars on health outcomes, as well as the lack of appropriate controls, seriously curtail the translatability of the findings to real-world situations. It is quite possible that "high" sugar consumption at normal dietary doses (e.g., 25% daily energy intake) per se-that is, the unique effect of sugar, especially in the solid form-may indeed not pose a health risk for individuals apart from the potential to reduce the overall dietary nutrient density, although newer evidence suggests "low" sugar intake (<5% daily energy intake) is just as likely to be associated with nutrient dilution. We argue the current public health recommendations to encourage the reduction of both solid and liquid forms of free sugar intake (e.g., sugar reformulation programs) should be revised due to the overextrapolation of results from SSBs studies.
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Affiliation(s)
- Rina Ruolin Yan
- School of Biological Sciences, Faculty of Science, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Chi Bun Chan
- School of Biological Sciences, Faculty of Science, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
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24
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Added Fructose in Non-Alcoholic Fatty Liver Disease and in Metabolic Syndrome: A Narrative Review. Nutrients 2022; 14:nu14061127. [PMID: 35334784 PMCID: PMC8950441 DOI: 10.3390/nu14061127] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/01/2022] [Accepted: 03/04/2022] [Indexed: 02/04/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) represents the most common chronic liver disease and it is considered the hepatic manifestation of metabolic syndrome (MetS). Diet represents the key element in NAFLD and MetS treatment, but some nutrients could play a role in their pathophysiology. Among these, fructose added to foods via high fructose corn syrup (HFCS) and sucrose might participate in NAFLD and MetS onset and progression. Fructose induces de novo lipogenesis (DNL), endoplasmic reticulum stress and liver inflammation, promoting insulin resistance and dyslipidemia. Fructose also reduces fatty acids oxidation through the overproduction of malonyl CoA, favoring steatosis. Furthermore, recent studies suggest changes in intestinal permeability associated with fructose consumption that contribute to the risk of NAFLD and MetS. Finally, alterations in the hunger–satiety mechanism and in the synthesis of uric acid link the fructose intake to weight gain and hypertension, respectively. However, further studies are needed to better evaluate the causal relationship between fructose and metabolic diseases and to develop new therapeutic and preventive strategies against NAFLD and MetS.
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25
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Liu S, Veugelers PJ, Liu C, Ohinmaa A. The Cost Effectiveness of Taxation of Sugary Foods and Beverages: A Systematic Review of Economic Evaluations. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2022; 20:185-198. [PMID: 34608610 DOI: 10.1007/s40258-021-00685-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/02/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND With increasing concerns about the health consequences and economic burden of excess sugar consumption, a sugar tax is increasingly considered an effective policy to curb sugar consumption. However, little is known about the cost effectiveness of sugar taxes. To inform policy decision makers, we systematically reviewed and analyzed the evidence regarding the cost effectiveness of sugar taxation. METHODS We systematically searched six databases (MEDLINE, Web of Science, EMBASE, The Cochrane Library, EconLit, and Google Scholar) to identify relevant journal articles. Two reviewers independently scanned and selected all retrieved studies. Only studies that evaluated sugar taxes and applied economic evaluation methods were included. The quality of included studies was assessed using established standards. RESULTS Fifteen good-quality studies that originated from six countries (the US, Australia, South Africa, Canada, the UK, and Mexico) were included. These studies revealed that sugar tax improved health-related quality of life. Savings from avoided health care costs and revenue from the sugar taxes (totalling US$87 to US$167,799 million) exceeded intervention costs (US$5 to US$2177 million). Each of the 15 studies concluded that sugar tax constitutes a cost-effective intervention that led to cost savings. CONCLUSIONS Sugar tax is a practical and cost-effective policy option to reduce the health and economic burden resulting from excess sugar consumption. The impact of sugar taxes depends on the target population, time horizons, and other parameters. Economic evaluations of taxation of a broader set of sugary products and economic evaluations that combine sugar taxation with other interventions are important to inform further action to curb sugar consumption.
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Affiliation(s)
- Siyuan Liu
- Population Health Intervention Research Unit, School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Paul J Veugelers
- Population Health Intervention Research Unit, School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Chunhao Liu
- School of Economics, York University, Toronto, ON, Canada
| | - Arto Ohinmaa
- Population Health Intervention Research Unit, School of Public Health, University of Alberta, Edmonton, AB, Canada.
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26
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Sakaki JR, Rodriguez NR, Fernandez ML, Puglisi MJ, Chen MH, Chun OK. Fruit juice and childhood obesity: a review of epidemiologic studies. Crit Rev Food Sci Nutr 2022; 63:6723-6737. [PMID: 35225098 DOI: 10.1080/10408398.2022.2044284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Childhood obesity is a national epidemic, and many efforts have been made to understand its risk factors. The purpose of this review was to provide an updated account of the observational studies evaluating the relationship between 100% fruit juice intake and obesity in children and adolescents, and to highlight the major risk factors that may impact this relationship. PubMed and Scopus were searched for terms related to fruit juice and childhood obesity, and studies assessing 100% fruit juice intake in participants ≤ 19 years old, with obesity-related outcomes (BMI or adiposity), and published before March 9, 2021 were included. There were 17 prospective cohort and 14 cross-sectional studies included in the analysis. Overall, the evidence does not support a relationship between 100% fruit juice intake and measures of obesity in most children. There is some evidence to suggest a minor positive association in some overweight or very young children, but due to fundamental differences and limitations in methodology, further investigation is required. Significant gaps in literature on this topic exist particularly in regards to randomized clinical trials in children, and in studies in racially diverse populations.
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Affiliation(s)
- Junichi R Sakaki
- Department of Nutritional Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Nancy R Rodriguez
- Department of Nutritional Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Maria-Luz Fernandez
- Department of Nutritional Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Michael J Puglisi
- Department of Nutritional Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Ming-Hui Chen
- Department of Statistics, University of Connecticut, Storrs, Connecticut, USA
| | - Ock K Chun
- Department of Nutritional Sciences, University of Connecticut, Storrs, Connecticut, USA
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27
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English L, Carmona YR, Peterson KE, Jansen EC, Téllez Rojo MM, Torres Olascoaga L, Cantoral A. Changes in Sugar Sweetened Beverage Intake Are Associated with Changes in Body Composition in Mexican Adolescents: Findings from the ELEMENT Cohort. Nutrients 2022; 14:719. [PMID: 35277078 PMCID: PMC8839416 DOI: 10.3390/nu14030719] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 01/31/2022] [Accepted: 02/04/2022] [Indexed: 02/04/2023] Open
Abstract
Changes in consumption of sugar sweetened beverage (SSBs) have been associated with increased body mass index (BMI), but little work has evaluated the effect on waist circumference (WC) and body fat percentage during adolescence, a period characterized by rapid growth and change in dietary behaviors. We examined the relationship of changes in SSB intake and changes in adiposity over two years in 464 Mexican adolescents. Food frequency questionnaires were used to sum intake of regular soda, coffee with sugar, tea with sugar, sweetened water with fruit, chocolate milk, corn atole, and a sweetened probiotic milk beverage. Linear regression models were used to estimate the associations of changes in SSBs with changes in BMI, body fat percentage, and WC, adjusting for sex, socioeconomic status, screen time, physical activity, age, and change in age. Adolescents who increased their daily SSB intake by >2 serving had a −2.72% higher body fat percentage (95% CI: 0.61, 4.82); a 1−2 serving increase was associated with a 2.49 cm increase (95% CI: 0.21, 4.76) in WC compared with those with no change in intake. Within an adolescent sample, changes in SSB intake were related to concomitant changes in body fat percentage and WC, but not BMI.
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Affiliation(s)
- Lindsey English
- Department of Nutrition and Dietetics, University of North Dakota, Grand Forks, ND 58202, USA;
| | - Yanelli R. Carmona
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA; (Y.R.C.); (K.E.P.); (E.C.J.)
| | - Karen E. Peterson
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA; (Y.R.C.); (K.E.P.); (E.C.J.)
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
| | - Erica C. Jansen
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA; (Y.R.C.); (K.E.P.); (E.C.J.)
| | - Martha María Téllez Rojo
- Center for Health and Nutrition Research, National Institute of Public Health in Mexico, Cuernavaca 62100, Mexico; (M.M.T.R.); (L.T.O.)
| | - Libni Torres Olascoaga
- Center for Health and Nutrition Research, National Institute of Public Health in Mexico, Cuernavaca 62100, Mexico; (M.M.T.R.); (L.T.O.)
| | - Alejandra Cantoral
- Department of Health, Universidad Iberoamericana Ciudad de México, Mexico City 01219, Mexico
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28
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Turck D, Bohn T, Castenmiller J, de Henauw S, Hirsch‐Ernst KI, Knutsen HK, Maciuk A, Mangelsdorf I, McArdle HJ, Naska A, Peláez C, Pentieva K, Siani A, Thies F, Tsabouri S, Adan R, Emmett P, Galli C, Kersting M, Moynihan P, Tappy L, Ciccolallo L, de Sesmaisons‐Lecarré A, Fabiani L, Horvath Z, Martino L, Muñoz Guajardo I, Valtueña Martínez S, Vinceti M. Tolerable upper intake level for dietary sugars. EFSA J 2022; 20:e07074. [PMID: 35251356 PMCID: PMC8884083 DOI: 10.2903/j.efsa.2022.7074] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Following a request from five European Nordic countries, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was tasked to provide scientific advice on a tolerable upper intake level (UL) or a safe level of intake for dietary (total/added/free) sugars based on available data on chronic metabolic diseases, pregnancy-related endpoints and dental caries. Specific sugar types (fructose) and sources of sugars were also addressed. The intake of dietary sugars is a well-established hazard in relation to dental caries in humans. Based on a systematic review of the literature, prospective cohort studies do not support a positive relationship between the intake of dietary sugars, in isocaloric exchange with other macronutrients, and any of the chronic metabolic diseases or pregnancy-related endpoints assessed. Based on randomised control trials on surrogate disease endpoints, there is evidence for a positive and causal relationship between the intake of added/free sugars and risk of some chronic metabolic diseases: The level of certainty is moderate for obesity and dyslipidaemia (> 50-75% probability), low for non-alcoholic fatty liver disease and type 2 diabetes (> 15-50% probability) and very low for hypertension (0-15% probability). Health effects of added vs. free sugars could not be compared. A level of sugars intake at which the risk of dental caries/chronic metabolic diseases is not increased could not be identified over the range of observed intakes, and thus, a UL or a safe level of intake could not be set. Based on available data and related uncertainties, the intake of added and free sugars should be as low as possible in the context of a nutritionally adequate diet. Decreasing the intake of added and free sugars would decrease the intake of total sugars to a similar extent. This opinion can assist EU Member States in setting national goals/recommendations.
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29
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Nguyen NM, K Tang H, Dibley MJ, Alam A. Sugar-sweetened beverage consumption and overweight and obesity in adolescents in Ho Chi Minh City, Vietnam: a population-based analysis. Pediatr Int 2022; 64:e14886. [PMID: 34118086 DOI: 10.1111/ped.14886] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 04/16/2021] [Accepted: 05/12/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND The aim of this research was to describe the patterns of consumption of multiple sugar-sweetened beverages (including modern and traditional ones) among adolescents in Ho Chi Minh City and to identify a possible relationship between this consumption and overweight, obesity, and other factors. METHODS A secondary analysis from a cross-sectional study of 11-15-year-old students from 31 junior high schools across Ho Chi Minh City was used. We measured the students' anthropometric status and assessed beverage consumption using a validated Food Frequency Questionnaire. Multivariate logistic regression models were used to identify the association between the consumption of sugar-sweetened beverages, obesity and other factors. RESULTS The sugar-sweetened beverages (SSB) ranged widely from modern soft drinks and powdered drinks to traditional sugar-added fruit and leaf juices, and milk-based drinks. These beverages were very popular among 2,660 participants with 36% consuming at least one variety daily. Factors positively associated with sugar-sweetened beverage consumption included a higher level of physical activity, higher consumption of fast foods, and daily fruit and vegetable consumption. We found a negative association between milk-based SSBs and the overweight and obesity status of the students, i.e. every kcal more of fresh milk with sugar and condensed milk can reduce an obesity odd of 0.005 (95% CI [0.002-0.008], p < 0.001) and 0.004 (95% CI [0.002-0.010], p = 0.044) consecutively. None of the other SSBs was significantly related to adolescent overweight and obesity. CONCLUSIONS Milk-based drinks potentially protect adolescents against overweight and obesity. Further research to assess this protection is needed.
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Affiliation(s)
- Ngoc-Minh Nguyen
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.,Faculty of Public Health, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Hong K Tang
- Faculty of Public Health, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Michael John Dibley
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Ashraful Alam
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
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30
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Parra KL, Alaofe HS, Ehiri JE, Nuño VL, Mazariegos M, Garcia B, Martinez E, Junkins A, Jolly P. Prevalence and Determinants of Underweight, Overweight, and Obesity: A Cross-Sectional Study of Sociodemographic, Dietary, and Lifestyle Factors Among Adolescent Girls in Jutiapa, Guatemala. Food Nutr Bull 2021; 42:502-519. [PMID: 34809474 DOI: 10.1177/03795721211019638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND As the incidence of overweight continues to increase among children and adolescents in Guatemala, underweight remains a prominent health problem. However, the prevalence of overweight or underweight and associated risk factors has not been investigated among adolescent girls. OBJECTIVE To determine the prevalence of underweight and overweight/obesity and associated sociodemographic, dietary, and lifestyle factors among adolescent girls in Jutiapa, Guatemala. METHODS A cross-sectional study of a subsample of 392 girls aged 12 to 17 years from an agriculture-nutrition trial was conducted. Anthropometric data were obtained using standard methods. Sociodemographic, dietary, and lifestyle data were collected using a structured questionnaire. Multivariable logistic regression was conducted using underweight (body mass index [BMI] for age < 5th percentile) and overweight/obesity (BMI for age ≥ 85th percentile) as outcome variables. RESULTS The prevalence of underweight and overweight/obesity was 9.9% and 15.6%, respectively. Age (15-17 years), high waist circumference, high blood pressure, father being a farmer, large family (> 5 persons), hours spent watching TV, and high red meat consumption were significantly associated with underweight. Whereas being in school, high waist circumference, high blood pressure, overweight/obese mother, unemployed father, watching TV for more than 2 hours, having soft drinks at home, and meeting fruit recommendations were significantly associated with overweight/obesity. CONCLUSIONS Our findings highlight the importance of concurrently addressing underweight and overweight/obesity among adolescent girls in rural Guatemala. Studies in various parts of the country are needed to confirm the results of the present study and for appropriate strategies to be implemented to reduce both underweight and overweight.
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Affiliation(s)
- Kimberly L Parra
- Department of Health Promotion Sciences, 48710University of Arizona, Mel and Enid Zuckerman College of Public Health, Tucson, AZ, USA
| | - Halimatou S Alaofe
- Department of Health Promotion Sciences, 48710University of Arizona, Mel and Enid Zuckerman College of Public Health, Tucson, AZ, USA
| | - John E Ehiri
- Department of Health Promotion Sciences, 48710University of Arizona, Mel and Enid Zuckerman College of Public Health, Tucson, AZ, USA
| | - Velia Leybas Nuño
- Department of Health Promotion Sciences, 48710University of Arizona, Mel and Enid Zuckerman College of Public Health, Tucson, AZ, USA
| | - Manolo Mazariegos
- 119961Institute of Nutrition of Central America and Panama, Guatemala
| | - Brenda Garcia
- 119961Institute of Nutrition of Central America and Panama, Guatemala
| | - Estefania Martinez
- 48653University of Alabama at Birmingham, School of Public Health Birmingham, AL, USA
| | - Anna Junkins
- 48653University of Alabama at Birmingham, School of Public Health Birmingham, AL, USA
| | - Pauline Jolly
- 48653University of Alabama at Birmingham, School of Public Health Birmingham, AL, USA
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31
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Parker MK, Davy BM, Hedrick VE. Current Knowledge Base of Beverage Health Impacts, Trends, and Intake Recommendations for Children and Adolescents: Implications for Public Health. Curr Nutr Rep 2021; 10:427-434. [PMID: 34797556 DOI: 10.1007/s13668-021-00376-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2021] [Indexed: 01/18/2023]
Abstract
PURPOSE OF REVIEW Improving beverage patterns is important for promoting the health of children and adolescents. Food preferences can begin developing at a young age; thus, children and adolescents should be provided healthy beverages in accordance with current recommendations. The purpose of this review is to identify and summarize existing beverage recommendations for children and adolescents. This review also discusses the health impacts of beverages and how beverage consumption has changed among children and adolescents over time. RECENT FINDINGS The mean number of calories that children and adolescents are consuming from beverages on a given day has declined in recent years. However, sugar-sweetened beverages (SSB) are the primary source of added sugars in this population. Therefore, SSB consumption remains a concern, and reducing the intake of SSB is still considered a top priority for helping to improve dietary quality. This review uniquely compiles recommendations into one convenient table for the entire age range of 0-19 years and includes recommendations that can be more adequately individualized. Beverage categories where beverage recommendations from authoritative sources are lacking have also been identified. Potential methods that can be implemented to improve beverage patterns and current public policy recommendations have been discussed to provide actionable steps that public health professionals can utilize in practice. The comprehensive table of beverage recommendations could be useful for professionals promoting the health of children and adolescents in research, clinical, and public health settings.
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Affiliation(s)
- Molly K Parker
- Virginia Tech, 295 West Campus Drive, 337 Wallace Hall, Blacksburg, VA, 24061, USA
| | - Brenda M Davy
- Virginia Tech, 295 West Campus Drive, 266B Wallace Hall, Blacksburg, VA, 24061, USA
| | - Valisa E Hedrick
- Virginia Tech, 295 West Campus Drive, 335A Wallace Hall, Blacksburg, VA, 24061, USA.
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Bennett AM, Murray K, Ambrosini GL, Oddy WH, Walsh JP, Zhu K. Prospective Associations of Sugar-Sweetened Beverage Consumption During Adolescence with Body Composition and Bone Mass at Early Adulthood. J Nutr 2021; 152:399-407. [PMID: 34791346 PMCID: PMC8826835 DOI: 10.1093/jn/nxab389] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 09/22/2021] [Accepted: 11/11/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Adolescents have a higher consumption of sugar-sweetened beverages (SSBs) than other age groups, but little is known of the impact of SSB intake during adolescence on body composition and bone mass in early adulthood. OBJECTIVES Associations of SSB intake from 14 to 20 y with fat, lean, and bone mass at 20 y of age were evaluated. METHODS Study participants were 1137 offspring (562 females) from the Raine Study. Food intake, including SSB consumption in servings/d (1 serving = 250 mL), was estimated using FFQs at 14, 17, and 20 y of age. DXA scanning at 20 y measured whole body fat mass, lean mass, and bone mineral content (BMC). Using latent class growth analysis, 4 SSB intake trajectory classes were identified: consistently low (n = 540, intakes mostly <0.5 serving/d), increasing (n = 65), decreasing (n = 258), and consistently high (n = 274, intakes mostly >1.3 servings/d). RESULTS Median total SSB intake was 0.8, 0.7, and 0.5 serving/d, and median carbonated SSB intake was 0.3, 0.3, and 0.4 serving/d at 14, 17, and 20 y, respectively. Mean ± SD BMI (in kg/m2) was 23.9 ± 4.2 at 20 y. After adjustment for covariates including sex, demographic, energy intake, and maternal factors, individuals with "consistently high" SSB consumption had significantly higher total body fat mass at 20 y than those with "consistently low" consumption (23.3 ± 0.6 compared with 21.2 ± 0.4 kg, P = 0.004), which remained significant after further adjustment for "Healthy" and "Western" dietary patterns (23.2 ± 0.6 compared with 21.2 ± 0.4 kg, P = 0.011). No significant associations were observed between SSB intake trajectory classes and lean body mass or BMC at 20 y. CONCLUSIONS In this cohort, consistently higher consumption of SSBs in adolescence and early adulthood are associated with increased fat mass but not with bone mass at 20 y of age.
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Affiliation(s)
| | - Kevin Murray
- School of Population and Global Health, University of Western Australia, Perth, Australia
| | - Gina L Ambrosini
- School of Population and Global Health, University of Western Australia, Perth, Australia
| | - Wendy H Oddy
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - John P Walsh
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Australia,Discipline of Internal Medicine, Medical School, University of Western Australia, Perth, Australia
| | - Kun Zhu
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Australia,Discipline of Internal Medicine, Medical School, University of Western Australia, Perth, Australia
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Differential fructose and glucose appetition in DBA/2, 129P3 and C57BL/6 × 129P3 hybrid mice revealed by sugar versus non-nutritive sweetener tests. Physiol Behav 2021; 241:113590. [PMID: 34509472 DOI: 10.1016/j.physbeh.2021.113590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/04/2021] [Accepted: 09/08/2021] [Indexed: 11/20/2022]
Abstract
Inbred mouse strains differ in their postoral appetite stimulating response (appetition) to fructose as demonstrated in intragastric (IG) sugar conditioning and oral sugar vs. nonnutritive conditioning experiments. For example, FVB and SWR strains show experience-induced preferences for 8% fructose over a 0.1% sucralose + 0.1% saccharin (S + S) solution, whereas C57BL/6 (B6) and BALB/c strains do not. All strains, however, learn to prefer 8% glucose to S + S after experience, which is attributed to the potent appetition actions of this sugar. The present study extended this analysis to DBA/2 (DBA) and 129P3 (129) inbred mice. In Experiment 1A, ad libitum fed DBA and 129 mice preferred S + S to fructose before and after separate experience with the two sweeteners, indicating an indifference to the postoral nutrient effects of the sugar. When food restricted (Experiment 1B), 129 mice continued to prefer S + S to fructose while DBA mice showed equal preference for the sweeteners after experience, indicating some sensitivity to fructose appetition. In Experiment 1C, both strains acquired significant preferences for glucose over S + S after experience, confirming their sensitivity to postoral glucose appetition. Experiment 2 revealed that C57BL/6 × 129P3 (B6:129) hybrid mice responded like inbred B6 mice and 129 mice in acquiring a preference for glucose but not fructose over S + S. This is of interest because sweet "taste-blind" P2 × 2 / P2 × 3 double-knockout (DKO) mice on a B6:129 genetic background prefer fructose to water in 24 h tests, which is indicative of fructose appetition. Whether differences in the genetic makeup of DKO and B6:129 hybrid mice or other factors explain the fructose appetition of the DKO mice remains to be determined.
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Cohen CC, Perng W, Sauder KA, Ringham BM, Bellatorre A, Scherzinger A, Stanislawski MA, Lange LA, Shankar K, Dabelea D. Associations of Nutrient Intake Changes During Childhood with Adolescent Hepatic Fat: The Exploring Perinatal Outcomes Among CHildren Study. J Pediatr 2021; 237:50-58.e3. [PMID: 34171361 PMCID: PMC8478817 DOI: 10.1016/j.jpeds.2021.06.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/21/2021] [Accepted: 06/15/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To examine associations of dietary changes from childhood to adolescence with adolescent hepatic fat and whether the PNPLA3 rs738409 risk allele, a strong genetic risk factor for hepatic fat, modifies associations. STUDY DESIGN Data were from 358 participants in the Exploring Perinatal Outcomes among CHildren (EPOCH) study, a longitudinal cohort in Colorado. Diet was assessed by food frequency questionnaire in childhood (approximately 10 years of age) and adolescence (approximately 16 years of age) and converted to nutrient densities. Hepatic fat was assessed in adolescence by magnetic resonance imaging. Linear regression was used to test associations of dietary changes from childhood to adolescence with adolescent hepatic fat. RESULTS Increases in fiber, vegetable protein, and polyunsaturated fat intake from childhood to adolescence were associated with lower adolescent hepatic fat, and increases in animal protein were associated with higher hepatic fat (β per 5-unit increase on log-hepatic fat: -0.12 [95% CI, -0.21 to -0.02] for ▵fiber; -0.26 [95% CI, -0.45 to -0.07] for ▵vegetable protein; -0.18 [95% CI, -0.35 to -0.02] for ▵polyunsaturated fat; 0.13 [95% CI, 0.04-0.22] for ▵animal protein). There was evidence of effect modification by PNPLA3 variant, whereby inverse associations of ▵fiber and ▵vegetable protein and positive associations of ▵saturated fat with adolescent hepatic fat were stronger in risk allele carriers. Most conclusions were similar after adjusting for obesity in adolescence, but associations of ▵saturated fat with hepatic fat were attenuated toward the null. CONCLUSIONS Our results suggest that nutrient intake changes between childhood and adolescence, particularly decreases in fiber and vegetable protein and increases in saturated fat intake, interact with the PNPLA3 variant to predict higher hepatic fat in adolescence, and may be targets for reducing hepatic fat in high-risk youth.
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Affiliation(s)
- Catherine C. Cohen
- Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO,Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Wei Perng
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO,Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO,Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI
| | - Katherine A Sauder
- Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO,Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Brandy M. Ringham
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO,Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Anna Bellatorre
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Ann Scherzinger
- Department of Radiology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Maggie A. Stanislawski
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO,Department of Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Leslie A. Lange
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO,Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO,Department of Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Kartik Shankar
- Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO,Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Dana Dabelea
- Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO,Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO,Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
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Kaoutar K, Chetoui A, El Kardoudi A, Boutahar K, El Moussaoui S, Chigr F, Najimi M. Eating habits, lifestyle factors and body weight status among Moroccan school adolescents (12–19 years): The case of Beni Mellal city. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2021. [DOI: 10.3233/mnm-200506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Overweight and obesity among children and adolescents are serious public health issues worldwide. A better understanding of the relationships between obesity and lifestyle factors is necessary for effective prevention and management of obesity in youth. AIMS: This study aimed to assess the prevalence of overweight/obesity and associated factors among schoolchildren aged 12–19 years at Beni Mellal city, Morocco. METHODS: A school based cross sectional study was carried out. A total of 516 children were included in the study. The nutritional status was classified according to the reference curves of WHO (2007). Multivariable logistic regression analysis was used to identify factors associated with overweight/obesity. The association between dependent and independent variables were assessed using odds ratio with 95% confidence interval and p value < 0.05 was considered statistically significant. RESULTS: The prevalence of overweight was 12.40% and that of obesity was 5.20%. Overweight and obesity were statistically associated with gender (Odds Ratio (OR) = 10.15[95% CI 1.37–3.81], p = 0.001); skipping breakfast (OR = 9.19 [95% CI 1.42–5.17], p = 0.002) and eating cake, pastry and biscuit 1 to 3 times per week (OR = 4.14 [95% CI 1.02–3.25], p = 0.04) and 4 or more times a week (OR = 7.83 [95% CI 1.31–4.66], p = 0.005). CONCLUSIONS: This study revealed that prevalence of overweight/obesity among school-aged children in Beni Mellal city was high. Thus, promoting healthy dietary practices, particularly improving fruit and vegetable intake is essential to reduce the burden of overweight and obesity. Furthermore, it is important to strengthen nutrition education about avoiding junk food consumption and encouraging regular physical activity.
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Affiliation(s)
- K. Kaoutar
- Biological Engineering Laboratory, Faculty of Sciences and Techniques, Sultan Moulay Slimane University, Beni Mellal, Morocco
| | - A. Chetoui
- Biological Engineering Laboratory, Faculty of Sciences and Techniques, Sultan Moulay Slimane University, Beni Mellal, Morocco
| | - A. El Kardoudi
- Biological Engineering Laboratory, Faculty of Sciences and Techniques, Sultan Moulay Slimane University, Beni Mellal, Morocco
| | - K. Boutahar
- Biological Engineering Laboratory, Faculty of Sciences and Techniques, Sultan Moulay Slimane University, Beni Mellal, Morocco
| | - S. El Moussaoui
- Biological Engineering Laboratory, Faculty of Sciences and Techniques, Sultan Moulay Slimane University, Beni Mellal, Morocco
- Mohamed VI Hospital University, Marrakesh, Morocco
| | - F. Chigr
- Biological Engineering Laboratory, Faculty of Sciences and Techniques, Sultan Moulay Slimane University, Beni Mellal, Morocco
| | - M. Najimi
- Biological Engineering Laboratory, Faculty of Sciences and Techniques, Sultan Moulay Slimane University, Beni Mellal, Morocco
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MORTAŞ H, BİLİCİ S. Contribution of beverages to daily added sugar intake: compliance with guidelines’ recommendations. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2021. [DOI: 10.32322/jhsm.941938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Sakaki JR, Li J, Gao S, Ha K, Tamimi RM, Chavarro JE, Chen MH, Sun Q, Hart JE, Chun OK. Associations between fruit juice and milk consumption and change in BMI in a large prospective cohort of U.S. adolescents and preadolescents. Pediatr Obes 2021; 16:e12781. [PMID: 33648027 PMCID: PMC8355032 DOI: 10.1111/ijpo.12781] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 01/26/2021] [Accepted: 02/08/2021] [Indexed: 01/12/2023]
Abstract
BACKGROUND There are concerns that fruit juice and milk contribute to childhood obesity. OBJECTIVE Determine the relationship between fruit juice and milk intakes and body mass index (BMI) change among preadolescents/adolescents. METHODS Participants aged 9 to 16 years old from the Growing Up Today Study II completed surveys including validated food frequency questionnaires in 2004, 2006 and 2008. The contributions of one serving of juice or milk to total energy intake and 2-year change in BMI were evaluated using multiple linear regression. Additional analyses were conducted with subgroups of juice (orange juice and other fruit juice) and milk (low fat and high fat). Missing values for BMI were imputed using a multiple imputation approach, after which data from 8173 participants and 13 717 2-year interval observations were analysed. RESULTS Baseline fruit juice consumption was inversely associated with BMI change in girls (β = -.102 kg/m2 , SE = 0.038, P value = .008) but not boys after controlling for race, age, baseline BMI, and baseline and 2-year changes in total energy intake and physical activity. Orange juice was inversely associated with BMI change among girls (β = -.137 kg/m2 , SE = 0.053, P value = .010) while other fruit juice, low fat and high fat milk were not associated with BMI change. CONCLUSION Orange juice was inversely associated with 2-year BMI change among preadolescent/adolescent girls but not boys and there were no significant associations with other juices or milk among either gender.
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Affiliation(s)
- Junichi R. Sakaki
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT
| | - Jing Li
- Department of Statistics, University of Connecticut, Storrs, CT
| | - Simiao Gao
- Department of Statistics, University of Connecticut, Storrs, CT
| | - Kyungho Ha
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT
| | - Rulla M. Tamimi
- Department of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Jorge E. Chavarro
- Department of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Ming-Hui Chen
- Department of Statistics, University of Connecticut, Storrs, CT
| | - Qi Sun
- Department of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA;,Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, and Harvard Medical School, Boston, MA
| | - Jaime E. Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, and Harvard Medical School, Boston, MA
| | - Ock K. Chun
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT;,Corresponding author: , Tel.: +860-486-6275
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Parker MK, Davy BM, Hedrick VE. Preliminary assessment of the Healthy Beverage Index for U.S. Children and Adolescents: a tool to quantify the overall beverage intake quality of 2- to 19-year-olds. J Acad Nutr Diet 2021; 122:371-383.e6. [PMID: 34371228 DOI: 10.1016/j.jand.2021.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 06/24/2021] [Accepted: 07/19/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Improving beverage patterns of children and adolescents is recommended for combatting obesity and reducing disease risk. Therefore, it is important to assess beverage intake quality in this population. For adults, the Healthy Beverage Index (HBI) was created to assess beverage intake quality, but a similar tool did not exist for children and adolescents. OBJECTIVE The objective was to develop an HBI for U.S. Children and Adolescents (HBI-CA), and then assess the validity and reliability of this tool. DESIGN Modeled after the adult HBI, age-specific, evidence-based beverage recommendations were compiled. Ten components were included to assess beverage intake quality. Validity and reliability were assessed using cross-sectional data and methods similar to those used for the evaluation of the Healthy Eating Index. PARTICIPANTS The 2015-2016 National Health and Nutrition Examination Survey provided 24-hour dietary recall data for 2,874 children and adolescents aged 2-19 years. MAIN OUTCOME MEASURES HBI-CA scores were the main outcome measure. STATISTICAL ANALYSES PERFORMED To assess validity, independent t-tests were used to determine differences in HBI-CA component and total scores among groups, and principal component analysis (PCA) was completed to examine multidimensionality of the HBI-CA. Pearson's bivariate correlations were used to assess reliability. RESULTS The HBI-CA produced a (mean±standard error) total score of 69.2±0.8, which is similar to the adult HBI mean total score of 63. PCA identified six factors, indicating the multidimensionality of the HBI-CA, with more than one combination of components contributing to variation in total scores. Most HBI-CA components were significantly correlated to the total score, with met fluid requirements, total beverage energy, sugar-sweetened beverage, and water components demonstrating the strongest correlations (r ranged 0.335-0.735, P-value ≤0.01). CONCLUSIONS The results provide preliminary evidence to support the validity and reliability of the HBI-CA. If future research establishes the predictive validity and sensitivity of the HBI-CA, this tool could be useful to quantify the beverage intake quality of children and adolescents.
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Affiliation(s)
- Molly K Parker
- Doctoral Student, Virginia Tech, 295 West Campus Drive, 337 Wallace Hall, Blacksburg, VA 24061
| | - Brenda M Davy
- Professor, Virginia Tech, 295 West Campus Drive, 266B Wallace Hall, Blacksburg, VA 24061
| | - Valisa E Hedrick
- Assistant Professor, Virginia Tech, 295 West Campus Drive, 335A Wallace Hall, Blacksburg, VA 24061.
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Rakotoambinina B, Hiffler L, Gomes F. Pediatric thiamine deficiency disorders in high-income countries between 2000 and 2020: a clinical reappraisal. Ann N Y Acad Sci 2021; 1498:57-76. [PMID: 34309858 PMCID: PMC9290709 DOI: 10.1111/nyas.14669] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 06/21/2021] [Accepted: 07/05/2021] [Indexed: 12/20/2022]
Abstract
Often thought to be a nutritional issue limited to low- and middle-income countries (LMICs), pediatric thiamine deficiency (PTD) is perceived as being eradicated or anecdotal in high-income countries (HICs). In HICs, classic beriberi cases in breastfed infants by thiamine-deficient mothers living in disadvantaged socioeconomic conditions are thought to be rare. This study aims to assess PTD in HICs in the 21st century. Literature searches were conducted to identify case reports of PTD observed in HICs and published between 2000 and 2020. The analyzed variables were age, country, underlying conditions, clinical manifestations of PTD, and response to thiamine supplementation. One hundred and ten articles were identified, totaling 389 PTD cases that were classified into four age groups: neonates, infants, children, and adolescents. Eleven categories of PTD-predisposing factors were identified, including genetic causes, lifestyle (diabetes, obesity, and excessive consumption of sweetened beverages), eating disorders, cancer, gastrointestinal disorders/surgeries, critical illness, and artificial nutrition. TD-associated hyperlactatemia and Wernicke encephalopathy were the most frequent clinical manifestations. The circumstances surrounding PTD in HICs differ from classic PTD observed in LMICs and this study delineates its mutiple predisposing factors. Further studies are required to estimate its magnitude. Awareness is of utmost importance in clinical practice.
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Affiliation(s)
- Benjamin Rakotoambinina
- Cellular Nutrition Research GroupLagny sur MarneFrance
- LRI Isotopic Medicine Physiology LabUniversity of AntananarivoAntananarivoMadagascar
| | | | - Filomena Gomes
- The New York Academy of SciencesNew YorkNew York
- NOVA Medical SchoolUniversidade NOVA de LisboaLisboaPortugal
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Nikniaz L, Abbasalizad-Farhangi M, Vajdi M, Nikniaz Z. The association between Sugars Sweetened Beverages (SSBs) and lipid profile among children and youth: A systematic review and dose-response meta-analysis of cross-sectional studies. Pediatr Obes 2021; 16:e12782. [PMID: 33629539 DOI: 10.1111/ijpo.12782] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 01/14/2021] [Accepted: 02/08/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND The relationship between sugar-sweetened beverages (SSBs) intake and serum lipids among children and youth has been reported in several studies, but the results are still controversial. OBJECTIVE In the current study, we summarized the results of studies that assessed the relationship between SSBs consumption and serum lipids among children and youth in a systematic review and dose-response meta-analysis. METHODS The PubMed, Web of Sciences, Cochrane and Scopus electronic databases were searched for observational studies reporting an association between SSBs intake and serum lipids among children and youth that were published before May 2020. For data extracted from cohort studies, only cross-sectional baseline data were included in the current meta-analysis. The Random effects model was used to estimate the pooled weighted mean difference (WMD) and 95% confidence intervals (CI). Heterogeneity was assessed with the Cochran Q test and I2 statistics. RESULTS In our search, 1845 studies were retrieved of which 13 studies (two cohorts and eleven cross-sectional) were included. High SSB consumption was associated with 1.21 mg/dL increase in low-density lipoprotein cholesterol (LDL-C; pooled WMD: 1.21 mg/dL; 95% CI: 0.23, 2.20; P = .01), 1.45 mg/dL decrease in high-density lipoprotein cholesterol (HDL-C, pooled WMD: -1.46 mg/dL; 95% CI, -2.25, -0.67; P < .0001) and 2.49 mg/dL decrease in total cholesterol (TC, pooled WMD: -2.49 mg/dL; 95% CI, -2.89, -2.10; P < .0001). In dose-response meta-analysis, there was an evidence of departure from linearity in the relationship between SSB consumption and change in LDL-C (P-nonlinearity = .03) and TC (P-nonlinearity = .01). However, no departure from linearity was observed between SSB intake and change in HDL-C (P-nonlinearity = .56) or triglyceride (TG) values (P-nonlinearity = .85). CONCLUSION According to our results, high SSB consumption was significantly associated with higher LDL-C and lower HDL-C and TC among children and youth. However, owing to the limited number of the included studies, further well-designed interventional studies are needed to better elucidate causality.
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Affiliation(s)
- Leila Nikniaz
- Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Mahdi Vajdi
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zeinab Nikniaz
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Czarnecka K, Pilarz A, Rogut A, Maj P, Szymańska J, Olejnik Ł, Szymański P. Aspartame-True or False? Narrative Review of Safety Analysis of General Use in Products. Nutrients 2021; 13:1957. [PMID: 34200310 PMCID: PMC8227014 DOI: 10.3390/nu13061957] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 05/27/2021] [Accepted: 06/03/2021] [Indexed: 12/14/2022] Open
Abstract
Aspartame is a sweetener introduced to replace the commonly used sucrose. It was discovered by James M. Schlatter in 1965. Being 180-200 times sweeter than sucrose, its intake was expected to reduce obesity rates in developing countries and help those struggling with diabetes. It is mainly used as a sweetener for soft drinks, confectionery, and medicines. Despite its widespread use, its safety remains controversial. This narrative review investigates the existing literature on the use of aspartame and its possible effects on the human body to refine current knowledge. Taking to account that aspartame is a widely used artificial sweetener, it seems appropriate to continue research on safety. Studies mentioned in this article have produced very interesting results overall, the current review highlights the social problem of providing visible and detailed information about the presence of aspartame in products. The studies involving the impact of aspartame on obesity, diabetes mellitus, children and fetus, autism, neurodegeneration, phenylketonuria, allergies and skin problems, its cancer properties and its genotoxicity were analyzed. Further research should be conducted to ensure clear information about the impact of aspartame on health.
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Affiliation(s)
- Kamila Czarnecka
- Department of Pharmaceutical Chemistry, Drug Analyses and Radiopharmacy, Faculty of Pharmacy, Medical University of Lodz, Muszyńskiego 1, 90-151 Lodz, Poland; (A.P.); (A.R.); (P.M.); (J.S.); (Ł.O.)
- Department of Radiobiology and Radiation Protection, Military Institute of Hygiene and Epidemiology, 4 Kozielska St., 01-163 Warsaw, Poland
| | - Aleksandra Pilarz
- Department of Pharmaceutical Chemistry, Drug Analyses and Radiopharmacy, Faculty of Pharmacy, Medical University of Lodz, Muszyńskiego 1, 90-151 Lodz, Poland; (A.P.); (A.R.); (P.M.); (J.S.); (Ł.O.)
| | - Aleksandra Rogut
- Department of Pharmaceutical Chemistry, Drug Analyses and Radiopharmacy, Faculty of Pharmacy, Medical University of Lodz, Muszyńskiego 1, 90-151 Lodz, Poland; (A.P.); (A.R.); (P.M.); (J.S.); (Ł.O.)
| | - Patryk Maj
- Department of Pharmaceutical Chemistry, Drug Analyses and Radiopharmacy, Faculty of Pharmacy, Medical University of Lodz, Muszyńskiego 1, 90-151 Lodz, Poland; (A.P.); (A.R.); (P.M.); (J.S.); (Ł.O.)
| | - Joanna Szymańska
- Department of Pharmaceutical Chemistry, Drug Analyses and Radiopharmacy, Faculty of Pharmacy, Medical University of Lodz, Muszyńskiego 1, 90-151 Lodz, Poland; (A.P.); (A.R.); (P.M.); (J.S.); (Ł.O.)
| | - Łukasz Olejnik
- Department of Pharmaceutical Chemistry, Drug Analyses and Radiopharmacy, Faculty of Pharmacy, Medical University of Lodz, Muszyńskiego 1, 90-151 Lodz, Poland; (A.P.); (A.R.); (P.M.); (J.S.); (Ł.O.)
| | - Paweł Szymański
- Department of Pharmaceutical Chemistry, Drug Analyses and Radiopharmacy, Faculty of Pharmacy, Medical University of Lodz, Muszyńskiego 1, 90-151 Lodz, Poland; (A.P.); (A.R.); (P.M.); (J.S.); (Ł.O.)
- Department of Radiobiology and Radiation Protection, Military Institute of Hygiene and Epidemiology, 4 Kozielska St., 01-163 Warsaw, Poland
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High-fat diet-induced splenic, hepatic, and skeletal muscle architecture damage: cellular and molecular players. Mol Cell Biochem 2021; 476:3671-3679. [PMID: 34050900 DOI: 10.1007/s11010-021-04190-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 05/20/2021] [Indexed: 02/02/2023]
Abstract
The trend of consuming food high in calories, fat, and sugar with little nutritional value and reduced physical exercise has resulted in an alarming ratio of overweight and obese subjects worldwide. Low-grade chronic inflammation is the key feature of obesity that causes an increase in pro-inflammatory cytokines and decrease in anti-inflammatory cytokines in circulation. The current study was aimed to investigate the effect of high-fat diet on the architecture of spleen, liver, and skeletal muscle and changes in the expression of hepatic cytokines. Two groups of experimental rats were established, against control that were given different percentage of fats in their diet. After a period of sixteen weeks, rats were dissected and their organs were excised out and processed accordingly. Spleen sections of experimental groups, revealed increased recruitment of lymphocytes, sinusoidal dilatations, necrotic lymphocytes, increased ratio of white-to-red pulp, and hemosiderin and iron deposits in red pulp indicating immune system activation. Hepatic sections showed enlarged sinusoidal spaces, disruptive hepatocytes, necrosis and dilation of portal veins. Sections of skeletal muscle showed degenerating fibers, increased fat accumulation, and recruitment of macrophages. Elevated expression of IFN-γ and decreased expression of IFN-α and IFN-β cytokines verified the adverse effect of high-fat diet on immune system as well. Fats tend to accumulate in organs due to increased intake of fat-rich diet disturbing their normal function and histology. In addition, gene expression analysis of cytokines confirmed the effect of high-fat diet as an inflammatory agent.
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Normand M, Ritz C, Mela D, Raben A. Low-energy sweeteners and body weight: a citation network analysis. BMJ Nutr Prev Health 2021; 4:319-332. [PMID: 34308140 PMCID: PMC8258071 DOI: 10.1136/bmjnph-2020-000210] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 02/12/2021] [Accepted: 02/17/2021] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE Reviews on the relationship of low-energy sweeteners (LES) with body weight (BW) have reached widely differing conclusions. To assess possible citation bias, citation analysis was used to quantify the relevant characteristics of cited articles, and explore citation patterns in relation to review conclusions. DESIGN A systematic search identified reviews published from January 2010 to March 2020. Different characteristics (for example, type of review or research, journal impact factor, conclusions) were extracted from the reviews and cited articles. Logistic regression was used to estimate likelihood of articles with particular characteristics being cited in reviews. A qualitative network analysis linked reviews sub-grouped by conclusions with the types of articles they cited. MAIN OUTCOME MEASURES (OR; 95% CI) for likelihood that articles with particular characteristics were cited as evidence in reviews. RESULTS From 33 reviews identified, 183 different articles were cited (including other reviews). Narrative reviews were 62% less likely to be cited than systematic reviews with meta-analysis (OR 0.38; 0.16 to 0.86; p=0.03). Likelihood of being cited was higher for evidence on children than adults (OR 2.27; 1.59 to 3.25; p<0.0001), and with increased journal impact factor (OR 1.15; 1.00 to 1.31; p=0.04). No other factors were statistically significant in the main analysis, and few factors were significant in subgroup analyses. Network analysis showed that reviews concluding a beneficial relationship of LES with BW cited mainly randomised controlled trials, whereas reviews concluding an adverse relationship cited mainly observational studies. CONCLUSIONS Overall reference to the available evidence across reviews appears largely arbitrary, making citation bias likely. Differences in the conclusions of individual reviews map onto different types of evidence cited. Overall, inconsistent and selective use of the available evidence may account for the diversity of conclusions in reviews on LES and BW. TRIAL REGISTRATION NUMBER Prior to data analysis, the protocol was registered with the Open Science Framework (https://osf.io/9ghws).
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Affiliation(s)
- Mie Normand
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Christian Ritz
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | | | - Anne Raben
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
- Steno Diabetes Center Copenhagen, Copenhagen, Denmark
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Flieh SM, Miguel-Berges ML, González-Gil EM, Gottrand F, Censi L, Widhalm K, Manios Y, Kafatos A, Molnár D, Dallongeville J, Stehle P, Gonzalez-Gross M, Marcos A, De Henauw S, Molina-Hidalgo C, Huybrechts I, Moreno LA. The Association between Portion Sizes from High-Energy-Dense Foods and Body Composition in European Adolescents: The HELENA Study. Nutrients 2021; 13:954. [PMID: 33809476 PMCID: PMC7998698 DOI: 10.3390/nu13030954] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/05/2021] [Accepted: 03/12/2021] [Indexed: 02/06/2023] Open
Abstract
Obesity prevalence has been simultaneously increasing with high consumption of large food portion sizes (PS). However, there is scarce information on PS of energy-dense (ED) foods as a potential risk factor of obesity in adolescents. In the present study, we investigate the association between the PS of the most ED foods and body composition. A sample of 1889 adolescents (54.4% females) from the Healthy Lifestyle in Europe by Nutrition in Adolescence cross-sectional multicenter study (HELENA-CSS) study were included. Most ED foods (e.g., cheese) were selected according to higher fat and/or sugar content and low fiber and water. Linear and ordinal logistic regression models were adjusted for age, physical activity, total energy intake (TEI), and socioeconomic status (SES). Analysis was performed both in those adolescents reporting plausible energy intake according to the approach of Goldberg et al. and in the whole sample. In male plausible reporters, PS from "breakfast cereals" showed a significant and positive association with BMI (β = 0.012; 0.048). PS from "carbonated soft drinks" in males (OR = 1.001; 95% CI 1.000; 1.002) and "bread and rolls" in females (OR = 1.002; 95% CI 1.000; 1.004) were associated with higher probability of having obesity, while "sweet bakery products" were associated with lower probability of having obesity (OR = 0.996; 95% CI 0.991; 0.999) in females. The present study suggests association between PS of ED foods and obesity in European adolescents. Prospective studies are needed to examine the effect of prolonged exposure to large PS and obesity development.
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Affiliation(s)
- Sondos M. Flieh
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain; (S.M.F.); (M.L.M.-B.); (L.A.M.)
| | - María L. Miguel-Berges
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain; (S.M.F.); (M.L.M.-B.); (L.A.M.)
- Instituto Agroalimentario de Aragón (IA2), 50013 Zaragoza, Spain
| | - Esther M. González-Gil
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain; (S.M.F.); (M.L.M.-B.); (L.A.M.)
- Instituto Agroalimentario de Aragón (IA2), 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain
- Center of Biomedical Research (CIBM), Department of Biochemistry and Molecular Biology II, Instituto de Nutrición y Tecnología de los Alimentos, University of Granada, 18071 Granada, Spain
| | - Frédéric Gottrand
- CHU Lille, University Lille, INSERM U1286 Infinite, F-59000 Lille, France;
| | - Laura Censi
- Council for Agricultural Research and Economics, Research Centre for Food and Nutrition, 00178 Roma, Italy;
| | - Kurt Widhalm
- Department of Gastroenterology and Hepatology, Medical University of Vienna, 1090 Vienna, Austria;
- Austrian Academic Institute for Clinical Nutrition, A-3100 Vienna, Austria
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece;
- Institute of Agri-Food and Life Sciences, Hellenic Mediterranean University Research Centre, 71410 Heraklion, Greece
| | - Anthony Kafatos
- Faculty of Medicine, University of Crete, GR-71003 Crete, Greece;
| | - Dénes Molnár
- Department of Pediatrics, Medical School, University of Pécs, H-7624 Pécs, Hungary;
| | - Jean Dallongeville
- Department of Epidemiology and Public Health, Institut Pasteur de Lille, 59000 Lille, France;
| | - Peter Stehle
- Department of Nutrition and Food Sciences, University of Bonn, D-53115 Bonn, Germany;
| | - Marcela Gonzalez-Gross
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain;
- ImFINE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Ascensión Marcos
- Inmunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), 28040 Madrid, Spain;
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium;
| | - Cristina Molina-Hidalgo
- EFFECTS 262 Department of Medical Physiology, School of Medicine, University of Granada,18071 Granada, Spain;
| | - Inge Huybrechts
- International Agency for Research on Cancer (IARC), 69372 Lyon, France;
- Department of Public Health, Ghent University, 9000 Ghent, Belgium
| | - Luis A. Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain; (S.M.F.); (M.L.M.-B.); (L.A.M.)
- Instituto Agroalimentario de Aragón (IA2), 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain;
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Ufholz K, Salvy SJ, Feda DM, Epstein LH, Roemmich JN. Weight discordant siblings' ability to reduce energy intake at a meal as compensation for prior energy intake from sugar-sweetened beverages (SSBs). Nutr Health 2021; 27:59-67. [PMID: 33045926 PMCID: PMC8085904 DOI: 10.1177/0260106020960990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Insufficient compensation for energy from sugar-sweetened beverages (SSBs) consumed prior to meals may promote greater overall energy intake. If so, ability to compensate for prior energy intake may account for difference in adiposity between adolescents with and without overweight. Studies of fraternal siblings discordant for weight status control for some genetic and shared within-family factors, which allows for testing how putative non-shared factors, such as parental control of feeding, predicts sibling weight differences. AIM To determine whether same-sex weight-discordant (one with, one without overweight) adolescent siblings differ in ability to compensate for prior energy intake. METHODS Same-sex biological sibling pairs (mean age = 15.4; 95% confidence interval (CI) 15.1, 15.7) (n = 38 pairs; 21 male pairs) consumed a sugar-sweetened (450 kcal) or a non-nutritive-sweetened (10 kcal) liquid preload of equal volumes on separate days, followed by an ad libitum lunch. Multilevel models examined ability to compensate, dietary restraint, and parental control of child's feeding. RESULTS Siblings showed insufficient compensation and overate (with overweight = 44 kcal; without overweight = 32 kcal). Siblings shared little within-family similarity in compensation (intra-class correlation coefficient (ICC) = 0.20). Compensation was predicted by parental restriction and general restriction (p = 0.02) Differences in siblings' BMI z-scores were associated with differences in dietary restraint (p = 0.04) not with differences in compensation. CONCLUSION Sibling differences in compensation for energy from sweetened beverages were not associated with differences in their adiposity. Compensation may be determined by a constellation of factors, including age, parental feeding practices, and food characteristics.
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Affiliation(s)
- Kelsey Ufholz
- United States Department of Agriculture, Agricultural Research Service, Grand Forks, ND, USA
| | - Sarah-Jeanne Salvy
- Cedars-Sinai Medical Center, Research Center for Health Equity, Los Angeles, CA, USA
| | - Denise M Feda
- University at Buffalo, Department of Pediatrics, Buffalo, NY, USA
- University at Buffalo, Department of Epidemiology and Environmental Health, Buffalo, NY, USA
| | | | - James N Roemmich
- United States Department of Agriculture, Agricultural Research Service, Grand Forks, ND, USA
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Shum B, Georgia S. The Effects of Non-Nutritive Sweetener Consumption in the Pediatric Populations: What We Know, What We Don't, and What We Need to Learn. Front Endocrinol (Lausanne) 2021; 12:625415. [PMID: 33868167 PMCID: PMC8049500 DOI: 10.3389/fendo.2021.625415] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 03/05/2021] [Indexed: 12/12/2022] Open
Abstract
Childhood obesity is increasing at an alarming rate in the United States. This trend carries serious risk of children developing obesity-related diseases including Type 2 diabetes and cardiovascular disease. Non-nutritive sweeteners (NNS) are used as substitution for table sugar as a way to prevent weight gain. Their consumption is ubiquitous in adults and children; however the long-term health outcomes of chronic NNS consumption in children are unclear. Conflicting observational studies suggest that children consuming NNS are at risk of obesity and development of type 2 diabetes, while others concluded some benefits in weight reduction. Here, we review the physiological mechanisms that can contribute to the negative metabolic effects of NNS. We will focus on how NNS alters the sweet perception leading to increase caloric consumption, how NNs alters the gut microbiota, and how NNS may disrupt glucose homeostasis and initiate a vicious cycle of pancreatic endocrine dysfunction. Studies focused on the pediatric population are limited but necessary to determine whether the potential weight loss benefits outweigh the potential negative metabolic outcomes during this critical development period.
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Affiliation(s)
- Betty Shum
- Center for Endocrinology, Diabetes, and Metabolism, Department of Pediatrics, The Saban Research Institute, Childrens Hospital, Los Angeles, CA, United States
| | - Senta Georgia
- Center for Endocrinology, Diabetes, and Metabolism, Department of Pediatrics, The Saban Research Institute, Childrens Hospital, Los Angeles, CA, United States
- Department of Stem Cell Biology & Regenerative Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
- *Correspondence: Senta Georgia,
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47
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Flieh SM, Moreno LA, Miguel-Berges ML, Stehle P, Marcos A, Molnár D, Widhalm K, Béghin L, De Henauw S, Kafatos A, Leclercq C, Gonzalez-Gross M, Dallongeville J, Molina-Hidalgo C, González-Gil EM. Free Sugar Consumption and Obesity in European Adolescents: The HELENA Study. Nutrients 2020; 12:nu12123747. [PMID: 33291491 PMCID: PMC7762126 DOI: 10.3390/nu12123747] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 11/27/2020] [Accepted: 12/02/2020] [Indexed: 12/22/2022] Open
Abstract
Few studies have evaluated the association between dietary free sugars intake (FSI) and obesity in adolescents. We examined the relation between FSI and their contributors from the main food groups and obesity in European adolescents. We included 843 adolescents (51.6% male) from the cross-sectional HELENA study with two completed 24 h recalls and anthropometric data. Linear mixed models were applied to investigate the relation between FSI and different anthropometric indices. Odds ratios for having a high body mass index (BMI) were also estimated by multilevel ordinal regression. Total FSI was higher in males than females (102.60 g and 87.58 g, respectively, p < 0.001). No effect was observed between free sugar from the main food groups and BMI. Consumers of FSI from "cakes, pies and biscuits" in males (odd ratio (OR) = 0.455; 95% Confidence interval (CI) 0.251, 0.824) and from "breakfast cereals" in females had a lower probability of having obesity (OR = 0.423; 95%CI 0.204, 0.878), whereas females consuming FSI from 'fruit and vegetables juices' had a higher probability of obesity (OR= 2.733; 95% CI 1.286, 5.810). This study provides no evidence that increased FSI is associated with obesity in adolescents. Further studies are needed to assess the longitudinal exposure to FSI and their effect on obesity development.
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Affiliation(s)
- Sondos M. Flieh
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain; (S.M.F.); (M.L.M.-B.); (E.M.G.-G.)
| | - Luis A. Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain; (S.M.F.); (M.L.M.-B.); (E.M.G.-G.)
- Instituto Agroalimentario de Aragón (IA2), 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain;
- Correspondence:
| | - María L. Miguel-Berges
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain; (S.M.F.); (M.L.M.-B.); (E.M.G.-G.)
- Instituto Agroalimentario de Aragón (IA2), 50013 Zaragoza, Spain
| | - Peter Stehle
- Department of Nutrition and Food Sciences, University of Bonn, D-53115 Bonn, Germany;
| | - Ascensión Marcos
- Inmunonutrition Research Group, Department of Metabolism and Nutrition, Instituto del Frío, Institute of Food Science and Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), 28040 Madrid, Spain;
| | - Dénes Molnár
- Department of Pediatrics, Medical School, University of Pécs, H-7624 Pécs, Hungary;
| | - Kurt Widhalm
- Division of Clinical Nutrition and Prevention, Department of Pediatrics, Medical University of Vienna, 1090 Vienna, Austria;
| | - Laurent Béghin
- Inserm, U1286—INFINITE—Clinical Investigation Center—Institute for Translational Research in Inflammation and CIC 1403, University Lille, CHU Lille, F-59000 Lille, France;
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium;
| | - Anthony Kafatos
- Faculty of Medicine, University of Crete, GR-71003 Crete, Greece;
| | - Catherine Leclercq
- Food and Nutrition Research Centre—Council for Agricultural Research and Economics, 00198 Rome, Italy;
| | - Marcela Gonzalez-Gross
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain;
- ImFINE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Jean Dallongeville
- Department of Epidemiology and Public Health, Institut Pasteur de Lille, 59000 Lille, France;
| | - Cristina Molina-Hidalgo
- EFFECTS 262, Department of Physiology, Faculty of Medicine, University of Granada, 18016 Granada, Spain;
| | - Esther M. González-Gil
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain; (S.M.F.); (M.L.M.-B.); (E.M.G.-G.)
- Instituto Agroalimentario de Aragón (IA2), 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain
- Center of Biomedical Research (CIBM), Department of Biochemistry and Molecular Biology II, Instituto de Nutrición y Tecnología de los Alimentos, University of Granada, 18071 Granada, Spain
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Russo RG, Northridge ME, Wu B, Yi SS. Characterizing Sugar-Sweetened Beverage Consumption for US Children and Adolescents by Race/Ethnicity. J Racial Ethn Health Disparities 2020; 7:1100-1116. [PMID: 32152835 PMCID: PMC7483241 DOI: 10.1007/s40615-020-00733-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 02/07/2020] [Accepted: 02/19/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To examine racial/ethnic differences in type of SSB most frequently consumed and in correlates of youth sugar-sweetened beverage (SSB) intake. METHODS Data were obtained from the National Health and Nutrition Examination Survey (NHANES), 2011-2016, for children and adolescents aged 5-17 years (n = 6507). The main outcome was SSB consumption (i.e., sodas, sweetened fruit drinks, nectars, sports and energy drinks, sweetened coffees and teas, enhanced waters). Mean and proportions of SSB intake were estimated accounting for complex sampling strategy and weighting. Multivariable regression models were developed for each race/ethnicity and age group. RESULTS Two-thirds of children and adolescents reported consuming SSB on a given day. Among consumers, mean SSB consumption was greatest for Black children and White adolescents and lowest for Asian American children and adolescents. The most popular type of SSB consumed was sweetened fruit drinks among children and soda among adolescents, except among White and Mexican American children for whom soda and Black adolescents for whom sweetened fruit drinks were most popular. Female sex and water intake were negatively associated with SSB consumption across most races/ethnicities. Screen time, dentist visits, nativity, and guardian education were associated with SSB intake among a subset of races/ethnicities. CONCLUSIONS Associations between covariates and SSB intake as well as types of beverages preferred vary by race/ethnicity, as such chronic disease policies should not be 'one size fits all'. Targeted interventions for specific groups of vulnerable youths hold promise for further reducing SSB consumption, including directing efforts towards reducing sweetened fruit drinks for Black children.
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Affiliation(s)
- Rienna G Russo
- Department of Population Health, NYU School of Medicine, 180 Madison Avenue, New York, NY, 10016, USA.
| | - Mary E Northridge
- Department of Plastic Surgery, NYU School of Medicine, 550 First Avenue, New York, NY, 10016, USA
| | - Bei Wu
- NYU Rory Meyers College of Nursing, 433 First Avenue, New York, NY, 10010, USA
| | - Stella S Yi
- Department of Population Health, NYU School of Medicine, 180 Madison Avenue, New York, NY, 10016, USA
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Sylvetsky AC, Visek AJ, Halberg S, Rhee DK, Ongaro Z, Essel KD, Dietz WH, Sacheck J. Beyond taste and easy access: Physical, cognitive, interpersonal, and emotional reasons for sugary drink consumption among children and adolescents. Appetite 2020; 155:104826. [PMID: 32800838 DOI: 10.1016/j.appet.2020.104826] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/13/2020] [Accepted: 08/06/2020] [Indexed: 12/19/2022]
Abstract
Consumption of sugary drinks is associated with the development of obesity and cardiometabolic diseases among children and adolescents. In addition to high added sugar content, many sugary drinks also contain caffeine. However, whether the combination of sugar and caffeine uniquely influences children's sugary drink intake is presently unknown. This study aimed to evaluate contextual factors surrounding children's sugary drink consumption and investigate reasons for sugary drink intake among children and adolescents, with a specific focus on caffeinated sodas and sweet tea. We also evaluated how sugary drink consumption makes children feel and how they anticipated that they would respond if sugary drinks were restricted. Focus group discussions (n = 9, 2-8 participants per group) were conducted with 37 predominantly AfricanAmerican children and adolescents, ages 8-14 years, who consumed ≥1 caffeine-containing sugary drink(s) daily, based on parental report. Focus groups were audio-recorded and transcribed verbatim. Transcripts were independently coded by two coders, after which emergent themes were identified. Reported reasons for sugary drink consumption encompassed five themes: 1) perceived need (e.g., satisfy cravings, quench thirst); 2) physical and cognitive benefits (e.g., provide energy, improve attention); 3) emotional and interpersonal benefits (e.g., relieve anger, facilitate socializing); 4) sensory properties (e.g., taste, carbonation); and, 5) external cues (e.g., family/peer modeling, availability). Negative consequences resulting from excess intake were also reported, including gastrointestinal symptoms, headaches, fatigue, hyperactivity, and chronic disease. Perceived physical, cognitive, emotional, and interpersonal benefits encourage sugary drink consumption and exacerbate well-described challenges of sugary drink reduction, including their palatability, accessibility, and affordability. Findings also suggest that incorporation of strategies to enhance physical, cognitive, and emotional health may hold promise in reducing sugary drink consumption among children and adolescents.
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Affiliation(s)
- Allison C Sylvetsky
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue NW, Suite 200, Washington, DC, 20052, USA; Sumner M. Redstone Global Center for Prevention and Wellness, Milken Institute School of Public Health, The George Washington University 950 New Hampshire Avenue NW, Suite 300, Washington, DC, 20052, USA.
| | - Amanda J Visek
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue NW, Suite 200, Washington, DC, 20052, USA
| | - Sabrina Halberg
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue NW, Suite 200, Washington, DC, 20052, USA
| | - Dong Keun Rhee
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue NW, Suite 200, Washington, DC, 20052, USA
| | - Zoe Ongaro
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue NW, Suite 200, Washington, DC, 20052, USA
| | - Kofi D Essel
- School of Medicine and Health Sciences, The George Washington University, 2300 I Street NW, Washington, DC, 20052, USA; Division of General & Community Pediatrics, Children's National Hospital, 111 Michigan Avenue NW, Washington, DC, 20010, USA
| | - William H Dietz
- Sumner M. Redstone Global Center for Prevention and Wellness, Milken Institute School of Public Health, The George Washington University 950 New Hampshire Avenue NW, Suite 300, Washington, DC, 20052, USA
| | - Jennifer Sacheck
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue NW, Suite 200, Washington, DC, 20052, USA
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Consumption of non-nutritive sweeteners during pregnancy. Am J Obstet Gynecol 2020; 223:211-218. [PMID: 32275895 DOI: 10.1016/j.ajog.2020.03.034] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 03/25/2020] [Accepted: 03/26/2020] [Indexed: 01/15/2023]
Abstract
In an effort to reduce sugar consumption to prevent diabetes mellitus and cardiovascular diseases, "sugar-free" or "no added sugar" products that substitute sugar with non-nutritive sweeteners (NNSs) (eg, Splenda, Sweet'N Low, and Stevia) have become increasingly popular. The use of these products during pregnancy has also increased, with approximately 30% of pregnant women reporting intentional NNS consumption. In clinical studies with nonpregnant participants and animal models, NNSs were shown to alter gut hormonal secretion, glucose absorption, appetite, kidney function, in vitro insulin secretion, adipogenesis, and microbiome dysbiosis of gut bacteria. In pregnant animal models, NNS consumption has been associated with altered sweet taste preference later in life and metabolic dysregulations in the offspring (eg, elevated body mass index, increased risk of obesity, microbiome dysbiosis, and abnormal liver function tests). Despite the accumulating evidence, no specific guidelines for NNS consumption are available for pregnant women. Furthermore, there are limited clinical studies on the effects of NNS consumption during pregnancy and postpartum and long-term outcomes in the offspring.
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