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Yan RR, Louie JCY. Sugar guidelines should be evidence-based and contain simple and easily actionable messages. Front Nutr 2023; 10:1227377. [PMID: 37649529 PMCID: PMC10464488 DOI: 10.3389/fnut.2023.1227377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 07/31/2023] [Indexed: 09/01/2023] Open
Affiliation(s)
- Rina Ruolin Yan
- School of Biological Sciences, Faculty of Science, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Jimmy Chun Yu Louie
- Department of Nursing and Allied Health, School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
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Oh SJ, Lee N, Nam KR, Kang KJ, Lee KC, Lee YJ, Seok JH, Choi JY. Effect of developmental stress on the in vivo neuronal circuits related to excitation-inhibition balance and mood in adulthood. Front Psychiatry 2023; 14:1086370. [PMID: 36846229 PMCID: PMC9950095 DOI: 10.3389/fpsyt.2023.1086370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 01/25/2023] [Indexed: 02/12/2023] Open
Abstract
INTRODUCTION Traumatic events in early life have a deleterious effect on the development of normal brain developments, which may be a cause of various psychiatric disorders in adulthood. Most prior studies focused on molecular biological aspects, and research on functional changes in neural circuits is still limited. We aimed to elucidate the effect of early life stress on in vivo excitation-inhibition and serotonergic neurotransmission in the adulthood using non-invasive functional molecular imaging (positron emission tomography, PET). METHODS To compare the effect of stress intensity, early life stress animal models were divided into single trauma (MS) and double trauma groups (MRS). MS was derived from maternal separation, whereas MRS was derived from maternal separation and restraint stress after birth. And to evaluate the stress vulnerability on the sex, we used male and female rats. RESULTS The MRS group showed greater weight loss and more severe depressive/anxiety-like behaviors than the MS and control groups. Corticosterone levels in MRS showed a greater extent of decline than in the MS group; however, there was no significant difference in the change of T3 and T4 between MS and MRS. In the PET, the stress exposure groups showed lower brain uptake for GABAergic, glutamatergic, and serotonergic systems compared with the control group. The excitatory/inhibitory balance, which was derived by dividing glutamate brain uptake into GABAergic uptake, increased as stress intensity increased. Neuronal degeneration in the stress exposure groups was confirmed by immunohistochemistry. In the sex comparison, female showed the greater changes of body weight, corticosterone level, depressive/anxiety-like behavior, and neurotransmission systems than those in male. CONCLUSION Taken together, we demonstrated that developmental stress induces dysfunction of neurotransmission in vivo, and that females are more vulnerable to stress than males.
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Affiliation(s)
- Se Jong Oh
- Division of Applied RI, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Namhun Lee
- Division of Applied RI, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Kyung Rok Nam
- Division of Applied RI, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Kyung Jun Kang
- Division of Applied RI, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Kyo Chul Lee
- Division of Applied RI, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Yong Jin Lee
- Division of Applied RI, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Jeong-Ho Seok
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jae Yong Choi
- Division of Applied RI, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea.,Department of Radiological and Medico-Oncological Sciences, University of Science and Technology (UST), Daejeon, Republic of Korea
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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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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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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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Rocha LL, Pessoa MC, Gratão LHA, do Carmo AS, Cordeiro NG, Cunha CDF, de Oliveira TRPR, Mendes LL. Characteristics of the School Food Environment Affect the Consumption of Sugar-Sweetened Beverages Among Adolescents. Front Nutr 2021; 8:742744. [PMID: 34692751 PMCID: PMC8531082 DOI: 10.3389/fnut.2021.742744] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 09/13/2021] [Indexed: 01/12/2023] Open
Abstract
Sugar-sweetened beverages are widely available and accessible in school environment, and their presence and characteristics of this environment can influence their consumption. This study examines the association of drinking fountains per 100 students, soft drink sales, soft drink advertising, and the presence of street vendors and sugar-sweetened beverages consumption among adolescents in Brazil. This cross-sectional study was carried out using data from the Study of Cardiovascular Risk in Adolescents that was conducted between March 2013 and December 2014. The sample comprised 71,475 adolescents aged 12–17 years from 1,247 public and private schools in Brazilian cities. Sugar-sweetened beverages consumption was the dependent variable. The main effect was the school food environment, which was evaluated based on drinking fountains per 100 students, soft drink sales, soft drink advertising, and the presence of street vendors. Public and private schools that sold soft drinks were associated with higher average sugar-sweetened beverages consumption among adolescents. Our study highlights the importance of creating healthy school food environments by banning sugar-sweetened beverages in schools accordingly.
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Affiliation(s)
- Luana Lara Rocha
- Preventive and Social Medicine Department, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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7
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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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Rocha LL, Pessoa MC, Gratão LHA, do Carmo AS, Cunha CDF, de Oliveira TRPR, Mendes LL. Health behavior patterns of sugar-sweetened beverage consumption among Brazilian adolescents in a nationally representative school-based study. PLoS One 2021; 16:e0245203. [PMID: 33411845 PMCID: PMC7790385 DOI: 10.1371/journal.pone.0245203] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 12/24/2020] [Indexed: 12/22/2022] Open
Abstract
Studies on sugar-sweetened beverage consumption patterns can help in the individual and population level management of chronic non-communicable diseases and other conditions. This study aimed to identify the association between health behavior patterns and the consumption of sugar-sweetened beverages among Brazilian adolescents from a nationally representative school-based study. A cross-sectional study analyzed data from 71,553 adolescents aged 12-17 years who attended public and private schools in Brazilian cities, from the Study of Cardiovascular Risk in Adolescents. Principal component analysis was performed to identify health behavior patterns, and ordered logistic regression was performed to identify the association between health behavior patterns and sugar-sweetened beverage consumption. Sugar-sweetened beverage consumption (mL/day) was used as the dependent variable. The analyses were performed using Stata software version 14.0 with a significance level of 0.05. Patterns 2 (alcoholic beverage and smoking habit) and 3 (ultra-processed food and screen time) of health behaviors and regularly purchasing snacks in the school cafeteria increased the odds of sugar-sweetened beverage consumption, while pattern 1 (water, unprocessed and minimally processed food and physical activity) decreased these odds. The adoption of healthy habits can indirectly stimulate the adoption of other habits beneficial to health. These results indicate the importance of adopting a set of regulatory measures to reduce sugar-sweetened beverage consumption.
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Affiliation(s)
- Luana Lara Rocha
- Pediatrics Department, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Milene Cristine Pessoa
- Nutrition Department, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | | | | | | | - Larissa Loures Mendes
- Nutrition Department, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Van De Maele K, De Geyter C, Vandenplas Y, Gies I, Devlieger R. Eating Habits of Children Born after Maternal Bariatric Surgery. Nutrients 2020; 12:E2577. [PMID: 32854290 PMCID: PMC7551775 DOI: 10.3390/nu12092577] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 08/18/2020] [Accepted: 08/20/2020] [Indexed: 12/14/2022] Open
Abstract
Mothers who underwent bariatric surgery (BS) before pregnancy have worrisome eating habits, but little is known about the eating habits of their offspring. EFFECTOR is a cross-sectional, long-term follow-up study of 4-11-year-old children born from mothers that underwent bariatric surgery before pregnancy (n = 36), mothers with overweight/obesity (OW/OB) in a control group (n = 71), and mothers with a normal weight (NW) in a second control group (n = 35). Data on anthropometry and on eating habits obtained through a Food Frequency Questionnaire were collected prospectively. The children's body mass index (BMI) scores significantly correlated with maternal pre-pregnancy BMI. The prevalence of overweight and obesity was the highest in children of the BS group (38.9% vs. 15.5% for children of the OW/OB group and 5.7% for those of the NW group; p = 0.004). Meal-skipping behavior was comparable between the groups. There was no difference in fruit and vegetable consumption. The BS group consumed more low-calorie sweetened beverages compared to the NW group (p = 0.01) but less fruit juice compared to the NW and OW/OB groups (p = 0.01). Our results may indicate a sugar-avoiding behavior in children of the BS group, fitting dietary maternal habits in a strategy to prevent dumping syndrome. In conclusion, maternal pre-pregnancy bariatric surgery does not alter unhealthy eating behaviors and the risk of development of overweight during childhood in their children.
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Affiliation(s)
- Karolien Van De Maele
- Pediatric Endocrinology, KidZ Health Castle, UZ Brussel, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (K.V.D.M.); (I.G.)
- Research Unit Organ Systems, Department of Development and Regeneration, Catholic University of Leuven, 3000 Leuven, Belgium
- Research Unit GRON, Vrije Universiteit Brussel, 1090 Brussels, Belgium;
| | - Charlotte De Geyter
- KidZ Health Castle, UZ Brussel, Vrije Universiteit Brussel, 1090 Brussels, Belgium;
| | - Yvan Vandenplas
- Research Unit GRON, Vrije Universiteit Brussel, 1090 Brussels, Belgium;
- KidZ Health Castle, UZ Brussel, Vrije Universiteit Brussel, 1090 Brussels, Belgium;
| | - Inge Gies
- Pediatric Endocrinology, KidZ Health Castle, UZ Brussel, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (K.V.D.M.); (I.G.)
- Research Unit GRON, Vrije Universiteit Brussel, 1090 Brussels, Belgium;
| | - Roland Devlieger
- Research Unit Organ Systems, Department of Development and Regeneration, Catholic University of Leuven, 3000 Leuven, Belgium
- Department of Obstetrics and Gynecology, University Hospital of Leuven, 3000 Leuven, Belgium
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Mansouri M, Sharifi F, Yaghubi H, Varmaghani M, Tabrizi YM, Nasiri M, Sadeghi O. Sugar-sweetened beverages consumption in relation to hypertension among Iranian university students: the MEPHASOUS study. Eat Weight Disord 2020; 25:973-982. [PMID: 31115792 DOI: 10.1007/s40519-019-00713-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 05/10/2019] [Indexed: 01/01/2023] Open
Abstract
PURPOSE This study aimed to assess the link between sugar-sweetened beverages (SSBs) consumption and hypertension among a large population in the Middle East. METHODS In this cross-sectional study (a part of Mental and Physical Health Assessment of University Student: MEPHASOUS study), 66,634 university students from all provinces of Iran, aged ≥ 18 years, were included. A self-administered dietary habits questionnaire was used to assess SSBs consumption as well as other dietary intakes. Participants were categorized based on three levels of SSB consumption: < 1 time/wk, 1-3 times/wk, and ≤ 3 times/wk. Hypertension was defined as systolic blood pressure (SBP) of ≥ 140 and diastolic blood pressure of ≥ 90. RESULTS Compared with those in the bottom category, students in the top category of SSBs consumption were more likely to have hypertension (OR 1.71, 95% CI 1.54-1.90). This association remained significant even after adjusting for confounding variables; such that participants in the highest category of SSBs consumption had 2.17 times greater odds of hypertension compared with those in the lowest category (OR 2.17, 95% CI 1.91-2.47). Stratified analysis based on gender and BMI status revealed such significant association in men (OR 2.12, 95% CI 1.79-2.50) and women (OR 2.03, 95% CI 1.67-2.48), and in all categories of BMI including students with underweight (OR 2.53, 95% CI 1.81-3.52), normal-weight (OR 2.13, 95% CI 1.81-2.51), overweight (OR 2.14, 95% CI 1.58-2.89) and obesity (OR 1.59, 95% CI 1.00-2.53). CONCLUSION Our results support previous findings indicating a significant positive association between SSBs consumption and hypertension. LEVEL OF EVIDENCE Level III, cross-sectional analytic studies.
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Affiliation(s)
- Masoume Mansouri
- Student Health Services, Students' Health and Consultation Center, Tarbiat Modares University, Tehran, Iran
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Research Institute, University of Tehran, Tehran, Iran
| | - Hamid Yaghubi
- Department of Psychology, Shahed University, Tehran, Iran
| | - Mehdi Varmaghani
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Yousef Moghadas Tabrizi
- Department of Health and Sport Medicine, Faculty of Physical Education and Sport Science, University of Tehran, Tehran, Iran
| | - Morteza Nasiri
- Department of Operating Room Technology, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Omid Sadeghi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, P.O. Box 14155-6117, Iran. .,Gerash University of Medical Sciences, Gerash, Iran. .,Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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11
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Jang C, Wada S, Yang S, Gosis B, Zeng X, Zhang Z, Shen Y, Lee G, Arany Z, Rabinowitz JD. The small intestine shields the liver from fructose-induced steatosis. Nat Metab 2020; 2:586-593. [PMID: 32694791 PMCID: PMC8020332 DOI: 10.1038/s42255-020-0222-9] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 05/20/2020] [Indexed: 02/06/2023]
Abstract
Per capita fructose consumption has increased 100-fold over the last century1. Epidemiological studies suggest that excessive fructose consumption, and especially consumption of sweet drinks, is associated with hyperlipidaemia, non-alcoholic fatty liver disease, obesity and diabetes2-7. Fructose metabolism begins with its phosphorylation by the enzyme ketohexokinase (KHK), which exists in two alternatively spliced forms8. The more active isozyme, KHK-C, is expressed most strongly in the liver, but also substantially in the small intestine9,10 where it drives dietary fructose absorption and conversion into other metabolites before fructose reaches the liver11-13. It is unclear whether intestinal fructose metabolism prevents or contributes to fructose-induced lipogenesis and liver pathology. Here we show that intestinal fructose catabolism mitigates fructose-induced hepatic lipogenesis. In mice, intestine-specific KHK-C deletion increases dietary fructose transit to the liver and gut microbiota and sensitizes mice to fructose's hyperlipidaemic effects and hepatic steatosis. In contrast, intestine-specific KHK-C overexpression promotes intestinal fructose clearance and decreases fructose-induced lipogenesis. Thus, intestinal fructose clearance capacity controls the rate at which fructose can be safely ingested. Consistent with this, we show that the same amount of fructose is more strongly lipogenic when drunk than eaten, or when administered as a single gavage, as opposed to multiple doses spread over 45 min. Collectively, these data demonstrate that fructose induces lipogenesis when its dietary intake rate exceeds the intestinal clearance capacity. In the modern context of ready food availability, the resulting fructose spillover drives metabolic syndrome. Slower fructose intake, tailored to intestinal capacity, can mitigate these consequences.
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Affiliation(s)
- Cholsoon Jang
- Department of Chemistry and Lewis-Sigler Institute for Integrative Genomics, Princeton University, Princeton, NJ, USA.
- Department of Biological Chemistry, University of California, Irvine, Irvine, CA, USA.
| | - Shogo Wada
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Steven Yang
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Bridget Gosis
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Xianfeng Zeng
- Department of Chemistry and Lewis-Sigler Institute for Integrative Genomics, Princeton University, Princeton, NJ, USA
| | - Zhaoyue Zhang
- Department of Chemistry and Lewis-Sigler Institute for Integrative Genomics, Princeton University, Princeton, NJ, USA
| | - Yihui Shen
- Department of Chemistry and Lewis-Sigler Institute for Integrative Genomics, Princeton University, Princeton, NJ, USA
| | - Gina Lee
- Meyer Cancer Center and Department of Pharmacology, Weill Cornell Medicine, New York, NY, USA
| | - Zoltan Arany
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Joshua D Rabinowitz
- Department of Chemistry and Lewis-Sigler Institute for Integrative Genomics, Princeton University, Princeton, NJ, USA.
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12
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Somogyi E, Sigalet D, Adrian TE, Nyakas C, Hoornenborg CW, van Beek AP, Koopmans HS, van Dijk G. Ileal Transposition in Rats Reduces Energy Intake, Body Weight, and Body Fat Most Efficaciously When Ingesting a High-Protein Diet. Obes Surg 2020; 30:2729-2742. [PMID: 32342267 PMCID: PMC7260147 DOI: 10.1007/s11695-020-04565-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Purpose Ileal transposition (IT) allows exploration of hindgut effects of bariatric procedures in inducing weight loss and reducing adiposity. Here we investigated the role of dietary macronutrient content on IT effects in rats. Methods Male Lewis rats consuming one of three isocaloric liquid diets enriched with fat (HF), carbohydrates (HC), or protein (HP) underwent IT or sham surgery. Body weight, energy intake, energy efficiency, body composition, and (meal-induced) changes in plasma GIP, GLP-1, PYY, neurotensin, and insulin levels were measured. Results Following IT, HC intake remained highest leading to smallest weight loss among dietary groups. IT in HF rats caused high initial weight loss and profound hypophagia, but the rats caught up later, and finally had the highest body fat content among IT rats. HP diet most efficaciously supported IT-induced reduction in body weight and adiposity, but (as opposed to other diet groups) lean mass was also reduced. Energy efficiency decreased immediately after IT irrespective of diet, but normalized later. Energy intake alone explained variation in post-operative weight change by 80%. GLP-1, neurotensin, and PYY were upregulated by IT, particularly during (0–60 min) and following 17-h post-ingestive intake, with marginal diet effects. Thirty-day post-operative cumulative energy intake was negatively correlated to 17-h post-ingestive PYY levels, explaining 47% of its variation. Conclusion Reduction in energy intake underlies IT-induced weight loss, with highest efficacy of the HP diet. PYY, GLP-1, and neurotensin levels are upregulated by IT, of which PYY may be most specifically related to reduced intake and weight loss after IT.
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Affiliation(s)
- Edit Somogyi
- School of PhD Studies, University of Physical Education, Budapest, Hungary.,Department of Behavioral Neuroscience, Groningen Institute for Evolutionary Life Sciences (GELIFES), University of Groningen, Groningen, the Netherlands.,Faculty of Medicine, University of Calgary, Calgary, AB, Canada
| | - David Sigalet
- Faculty of Medicine, University of Calgary, Calgary, AB, Canada
| | - Thomas E Adrian
- Department of Basic Medical Sciences, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE
| | - Csaba Nyakas
- School of PhD Studies, University of Physical Education, Budapest, Hungary.,Department of Behavioral Neuroscience, Groningen Institute for Evolutionary Life Sciences (GELIFES), University of Groningen, Groningen, the Netherlands.,Department of Morphology and Physiology, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
| | - Christiaan W Hoornenborg
- Department of Behavioral Neuroscience, Groningen Institute for Evolutionary Life Sciences (GELIFES), University of Groningen, Groningen, the Netherlands.,Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - André P van Beek
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Henry S Koopmans
- Department of Physiology and Biophysics, Faculty of Medicine, University of Calgary, Calgary, Canada
| | - Gertjan van Dijk
- Department of Behavioral Neuroscience, Groningen Institute for Evolutionary Life Sciences (GELIFES), University of Groningen, Groningen, the Netherlands.
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13
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Modelling the Effects of Beverage Substitution during Adolescence on Later Obesity Outcomes in Early Adulthood: Results from the Raine Study. Nutrients 2019; 11:nu11122928. [PMID: 31816850 PMCID: PMC6950484 DOI: 10.3390/nu11122928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 11/21/2019] [Accepted: 11/26/2019] [Indexed: 12/25/2022] Open
Abstract
High sugar-sweetened beverage (SSB) consumption has been linked with obesity. The present study examined the associations between adolescent SSB intake and body mass index (BMI), waist circumference (WC), and overweight status in early adulthood, and modelled the association of alternative beverage substitution with BMI and WC. Data of offspring from the Western Australian Pregnancy Cohort (Raine) Study at ages 14 and 22 years were used (n = 667). SSB intake at 14 years (100 g/day) was associated with higher BMI (β = 0.19 kg/m2, 95% CI 0.04, 0.33), WC (β = 0.41cm, 95% CI 0.04, 0.78), and being overweight at 22 years (OR 1.10, 95% CI 1.02, 1.18). Every 100g modelled substitution of SSB with milk at age 14 years was associated with lower BMI (−0.19 kg/m2) and WC (−0.52 cm) at age 22 years. Replacement of SSB with diet drink was associated with higher BMI and WC. No association was found for substitutions of SSB with water, tea/coffee, or 100% fruit juice with BMI or WC. SSB intake during adolescence was associated with higher BMI, WC, and being overweight in early adulthood. Milk as an alternative to SSB was associated with less adiposity. Caution is necessary in recommending diet drinks as a SSB alternative.
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14
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Young J, Conway EM, Rother KI, Sylvetsky AC. Low-calorie sweetener use, weight, and metabolic health among children: A mini-review. Pediatr Obes 2019; 14:e12521. [PMID: 30983091 DOI: 10.1111/ijpo.12521] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 01/23/2019] [Accepted: 02/01/2019] [Indexed: 01/08/2023]
Abstract
A reduction in the consumption of added sugars and sugar-sweetened beverages (SSBs) is a key focus of public health recommendations for a healthy diet among children. One approach to lower added sugar intake is to instead use low-calorie sweeteners (LCSs), which contain no or few calories. Consumption of LCSs is increasing worldwide, with the most marked rise observed among children and adolescents. However, the extent to which LCS consumption is helpful or harmful for weight management is controversial, particularly when LCS consumption begins in childhood. Herein, we summarize the limited existing literature examining effects of paediatric LCS consumption on appetite, energy intake, and body weight. While positive associations between LCS consumption and weight gain are reported in observational analyses, the majority of intervention studies, some of which blinded children to the contents of the drinks, report benefits of LCSs for reducing excessive child weight gain. Several potential mechanisms have been proposed to explain LCS effects on body weight, including LCS-induced promotion of appetite and energy intake. Yet studies assessing effects of beverages with LCSs (LCSBs) compared with SSBs on child appetite report mixed findings. Some demonstrate that children completely compensate for the diluted energy content of LCSBs by eating more solid food calories at subsequent meals compared with children administered SSBs, while others report a reduction in total energy intake with LCSB ingestion. Given the limited studies and resulting uncertainty as to whether LCSs benefit or worsen weight and metabolic health in children is integral that effects of LCS use during childhood continue to be investigated in future prospective studies.
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Affiliation(s)
- Jordan Young
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Ellen M Conway
- Section on Pediatric Diabetes and Metabolism, NIDDK, NIH, Bethesda, MD, USA
| | - Kristina I Rother
- Section on Pediatric Diabetes and Metabolism, NIDDK, NIH, Bethesda, MD, USA
| | - Allison C Sylvetsky
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA.,Section on Pediatric Diabetes and Metabolism, NIDDK, NIH, Bethesda, MD, USA.,Sumner M. Redstone Global Center for Prevention and Wellness, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
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15
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Garden FL, Toelle BG, Mihrshahi S, Webb KL, Almqvist C, Tovey ER, Brew BK, Ayer JG, Skilton MR, Jones G, Ferreira MAR, Cowie CT, Weber-Chrysochoou C, Britton WJ, Celermajer DS, Leeder SR, Peat JK, Marks GB. Cohort profile: The Childhood Asthma Prevention Study (CAPS). Int J Epidemiol 2019; 47:1736-1736k. [PMID: 29800224 DOI: 10.1093/ije/dyy078] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2018] [Indexed: 12/22/2022] Open
Affiliation(s)
- Frances L Garden
- South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia.,Ingham Institute for Applied Medical Research, Sydney, NSW, Australia.,Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia
| | - Brett G Toelle
- Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia.,Sydney Local Health District, Sydney, NSW, Australia
| | - Seema Mihrshahi
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Karen L Webb
- Nutrition Policy Institute, University of California, Berkeley, CA, USA
| | - Catarina Almqvist
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Pediatric Allergy and Pulmonology Unit at Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Euan R Tovey
- Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia
| | - Bronwyn K Brew
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Julian G Ayer
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,Heart Centre for Children, Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Michael R Skilton
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, Sydney, NSW, Australia
| | - Graham Jones
- School of Science and Health, Western Sydney University, Sydney, NSW, Australia
| | | | - Christine T Cowie
- South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia.,Ingham Institute for Applied Medical Research, Sydney, NSW, Australia.,Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia
| | | | - Warwick J Britton
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,Mycobacterial Research Program, Centenary Institute, Sydney, NSW, Australia
| | - David S Celermajer
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Stephen R Leeder
- Menzies Centre for Health Policy, University of Sydney, Sydney, NSW, Australia
| | - Jennifer K Peat
- Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia
| | - Guy B Marks
- South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia.,Ingham Institute for Applied Medical Research, Sydney, NSW, Australia.,Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia
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16
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Sundborn G, Thornley S, Merriman TR, Lang B, King C, Lanaspa MA, Johnson RJ. Are Liquid Sugars Different from Solid Sugar in Their Ability to Cause Metabolic Syndrome? Obesity (Silver Spring) 2019; 27:879-887. [PMID: 31054268 DOI: 10.1002/oby.22472] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Accepted: 01/29/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Intake of sugary drinks, especially soft drinks, carries increased risk for obesity and diabetes. This article reviews whether sugary drinks carry different risks for metabolic syndrome compared with foods that contain natural or added sugars. METHODS A narrative review was performed to evaluate differences between liquid and solid sugars in their ability to induce metabolic syndrome and to discuss potential mechanisms to account for the differences. RESULTS Epidemiological studies support liquid added sugars, such as soft drinks, as carrying greater risk for development of metabolic syndrome compared with solid sugar. Some studies suggest that fruit juice may also confer relatively higher risk for weight gain and insulin resistance compared with natural fruits. Experimental evidence suggests this may be due to differences in how fructose is metabolized. Fructose induces metabolic disease by reducing the energy levels in liver cells, mediated by the concentration of fructose to which the cells are exposed. The concentration relates to the quantity and speed at which fructose is ingested, absorbed, and metabolized. CONCLUSIONS Although reduced intake of added sugars (sucrose and high-fructose corn syrup) remains a general recommendation, there is evidence that sugary soft drinks may provide greater health risks relative to sugar-containing foods.
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Affiliation(s)
- Gerhard Sundborn
- Department of Pacific Health, The University of Auckland, Auckland, New Zealand
| | - Simon Thornley
- Auckland Regional Public Health Service, Auckland, New Zealand
| | - Tony R Merriman
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
| | - Bodo Lang
- Department of Marketing, Business School, The University of Auckland, Auckland, New Zealand
| | - Christopher King
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Miguel A Lanaspa
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Richard J Johnson
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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17
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Association of free sugar intake with blood pressure and obesity measures in Australian adults. Eur J Nutr 2019; 59:651-659. [PMID: 30826906 DOI: 10.1007/s00394-019-01932-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 02/16/2019] [Indexed: 01/09/2023]
Abstract
PURPOSE This study examined the association of free sugar (FS) intake with obesity measures and blood pressure (BP) among a nationally representative sample of Australian adults. METHODS Data from adults (weighted n = 5136) who completed 2 × 24-h recalls and had complete data for BP, waist circumference (WC), waist-to-height ratio (WHtR), and body mass index (BMI) were analyzed. Associations between percentage energy of FS from all food sources (%EFStotal), beverages only (%EFSbeverages), and non-beverages sources only (%EFSnon-beverages) and obesity measures and BP were examined using linear and non-linear regressions. Logistic regression was used to calculate the odds ratios (OR) of being classified as overweight and/or obese, having increased cardiometabolic risks, and elevated BP per 5% point increase in %EFStotal, %EFSbeverages, and %EFSnon-beverages. All regression analyses were adjusted for known socio-economic and lifestyle confounders. RESULTS %EFSbeverage was positively associated with BMI, WC, and WHtR (all p < 0.05), while %EFSnon-beverage was inversely associated with these outcomes. Increases in odds of having an undesirable WC/WHtR were found with increasing %EFSbeverages (OR per 5% point increase in %EFSbeverages: 1.19 for WC; 1.23 for WHtR, both p < 0.001). %EFStotal and %EFSnon-beverages were weakly and negatively associated with diastolic BP. A 5% point increase in %EFStotal and %EFSnon-beverage was associated with a 10-25% reduction in odds of having elevated BP. CONCLUSIONS Our results suggested that only a higher FS intake from beverages may be associated with obesity, and higher FS intake was associated with reduced odds of having elevated BP.
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18
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Marshall TA, Curtis AM, Cavanaugh JE, Warren JJ, Levy SM. Child and Adolescent Sugar-Sweetened Beverage Intakes Are Longitudinally Associated with Higher Body Mass Index z Scores in a Birth Cohort Followed 17 Years. J Acad Nutr Diet 2019; 119:425-434. [PMID: 30638821 PMCID: PMC6389369 DOI: 10.1016/j.jand.2018.11.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 09/16/2018] [Accepted: 11/05/2018] [Indexed: 01/28/2023]
Abstract
BACKGROUND Sugar-sweetened beverages (SSB) are considered a risk factor for obesity. OBJECTIVE The objective of the current study was to investigate associations between the predictors of beverage and energy intakes and mean adequacy ratios (MARs), and the outcome of body mass index (BMI) z scores, in a birth cohort using longitudinal models. DESIGN This was a longitudinal analysis of secondary data. PARTICIPANTS/SETTING Participants in the Iowa Fluoride and Iowa Bone Development Studies with two beverage intake questionnaires completed between ages 2 and 4.7 years or 5 and 8.5 years or one questionnaire between ages 9 and 10.5, 11 and 12.5, 13 and 14.5, or 15 and 17 years (n=720); two food and beverage diaries completed between ages 2 and 4.7 years or 5 and 8.5 years or completion of the Block's Kids' Food Frequency Questionnaires at age 11, 13, 15, or 17 years (n=623); and anthropometric measures at the corresponding age 5-, 9-, 11-, 13-, 15-, or 17-year examination(s). PREDICTORS Mean daily 100% juice, milk, SSB, water/sugar-free beverage, and energy intakes and MARs averaged over ages 2 to 4.7, 5 to 8.5, 9 to 10.5, 11 to 12.5, 13 to 14.5, or 15 to 17 years were predictors. OUTCOME BMI z score was the outcome. STATISTICAL ANALYSES Linear mixed models were fit for each beverage, energy, and MAR variable, with the beverage, energy, or MAR variable as the predictor and BMI z score as the outcome. Beverage models were adjusted for energy and MAR and baseline socioeconomic status. RESULTS SSB intake adjusted for energy intake, MAR, and baseline socioeconomic status was associated with BMI z score; each additional 8 oz SSB consumed/day throughout childhood and adolescence increased the BMI z score an average 0.050 units (95% CI 0.022 to 0.079; P=0.001). Adjusted water/sugar-free beverage intake (0.026 units; 95% CI 0.006 to 0.046; P=0.013) was modestly associated with BMI z score, while 100% juice (-0.001 units; 95% CI -0.059 to 0.057; P=0.97) and milk (0.022 units; 95% CI -0.007 to 0.052; P=0.13) intakes were not associated with BMI z scores. CONCLUSIONS Higher SSB intakes were associated with increased BMI z scores throughout childhood and adolescence in Iowa Fluoride Study participants. Public health initiatives targeting SSB consumption during childhood and adolescence remain relevant.
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Affiliation(s)
- Teresa A. Marshall
- Department of Preventive & CommunityDentistry, College of Dentistry, The University of Iowa, Iowa City, IA USA; . 319-335-7190
| | - Alexandra M. Curtis
- Department of Biostatistics, College of Public Health, The University of Iowa, Iowa City, IA USA; ; 319-335-7186
| | - Joseph E. Cavanaugh
- Department of Biostatistics, College of Public Health & Department of Statistics and Actuarial Science, College of Liberal Arts and Sciences, The University of Iowa, Iowa City, IA USA; ; 319-384-1602
| | - John J. Warren
- Department of Preventive & Community Dentistry, College of Dentistry, The University of Iowa, Iowa City, IA USA; ; 319-335-7205
| | - Steven M. Levy
- Department of Preventive & Community Dentistry, College of Dentistry, The University of Iowa, Iowa City, IA USA. . 319-335-7185
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19
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Hoare E, Varsamis P, Owen N, Dunstan DW, Jennings GL, Kingwell BA. Sugar- and Intense-Sweetened Drinks in Australia: A Systematic Review on Cardiometabolic Risk. Nutrients 2017; 9:E1075. [PMID: 28956823 PMCID: PMC5691692 DOI: 10.3390/nu9101075] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 09/11/2017] [Accepted: 09/25/2017] [Indexed: 12/13/2022] Open
Abstract
Sugar-sweetened beverages (SSBs) are consumed globally, and have been associated with adverse health outcomes, including weight gain, high blood pressure, type 2 diabetes (T2D), and cardiovascular disease (CVD). There is global variation in beverage formulation in terms of glucose and fructose concentration, which may pose unique health risks linked to glycemic control for Australian consumers. However, previous systematic reviews have overlooked Australian-based literature. A systematic review was performed to synthesise evidence for the associations between consumption of SSBs and intense-sweetened beverages with clinical cardiometabolic risk factors in the Australian population. Articles were sourced from Global Health, Health Source: Nursing/Academic Edition, Medline, and Culmative Index to Nursing and Allied Health Literature. To be eligible for review, studies had to report on the consumption of sugar-sweetened (including fruit juice and fruit drinks) and/or intense-sweetened beverages, and at least one clinical cardiometabolic risk factor. Eighteen studies were included in this review. Research has mostly focused on the relationship between SSB consumption and adiposity-related outcomes. No studies have examined indices of glycaemic control (glucose/insulin), and the evidence for the health impact of intense-sweetened drinks is limited. In addition, studies have primarily been of cross-sectional design, and have examined children and adolescents, as opposed to adult populations. In the Australian population, there is modest but consistent evidence that SSB consumption has adverse associations with weight, but there is insufficient data to assess relationships with cardiometabolic outcomes.
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Affiliation(s)
- Erin Hoare
- Baker Heart and Diabetes Institute, Melbourne 3000, Australia.
| | - Pia Varsamis
- Baker Heart and Diabetes Institute, Melbourne 3000, Australia.
- Department of Physiology, Monash University, Clayton 3800, Australia.
| | - Neville Owen
- Baker Heart and Diabetes Institute, Melbourne 3000, Australia.
- School of Medicine, Monash University, Clayton 3800, Australia.
- Centre for Urban Transitions, Swinburne University, Hawthorn 3122, Australia.
| | - David W Dunstan
- Baker Heart and Diabetes Institute, Melbourne 3000, Australia.
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne 3004, Australia.
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne 3000, Australia.
| | - Garry L Jennings
- Baker Heart and Diabetes Institute, Melbourne 3000, Australia.
- Sydney Medical School, University of Sydney, Camperdown 2006, Australia.
| | - Bronwyn A Kingwell
- Baker Heart and Diabetes Institute, Melbourne 3000, Australia.
- Department of Physiology, Monash University, Clayton 3800, Australia.
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20
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Consumption of ultra-processed foods and body fat during childhood and adolescence: a systematic review. Public Health Nutr 2017; 21:148-159. [DOI: 10.1017/s1368980017001331] [Citation(s) in RCA: 161] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
AbstractObjectiveTo review the available literature on the association between consumption of ultra-processed foods and body fat during childhood and adolescence.DesignA systematic review was conducted in the PubMed, Web of Science and LILACS databases. Studies that evaluated the association between consumption of ultra-processed food (exposure) and body fat (outcome) during childhood and adolescence were eligible.SubjectsHealthy children and adolescents.ResultsTwenty-six studies that evaluated groups of ultra-processed foods (such as snacks, fast foods, junk foods and convenience foods) or specific ultra-processed foods (soft drinks/sweetened beverages, sweets, chocolate and ready-to-eat cereals) were selected. Most of the studies (n15) had a cohort design. Consumption was generally evaluated by means of FFQ or food records; and body composition, by means of double indirect methods (bioelectrical impedance analysis and skinfolds). Most of the studies that evaluated consumption of groups of ultra-processed foods and soft drinks/sweetened beverages found positive associations with body fat.ConclusionsOur review showed that most studies have found positive associations between consumption of ultra-processed food and body fat during childhood and adolescence. There is a need to use a standardized classification that considers the level of food processing to promote comparability between studies.
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21
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A modeling study of beverage substitution and obesity outcomes among Australian adults. Nutrition 2017; 39-40:71-75. [DOI: 10.1016/j.nut.2017.03.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 03/08/2017] [Accepted: 03/18/2017] [Indexed: 01/09/2023]
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22
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Mead E, Brown T, Rees K, Azevedo LB, Whittaker V, Jones D, Olajide J, Mainardi GM, Corpeleijn E, O'Malley C, Beardsmore E, Al‐Khudairy L, Baur L, Metzendorf M, Demaio A, Ells LJ. Diet, physical activity and behavioural interventions for the treatment of overweight or obese children from the age of 6 to 11 years. Cochrane Database Syst Rev 2017; 6:CD012651. [PMID: 28639319 PMCID: PMC6481885 DOI: 10.1002/14651858.cd012651] [Citation(s) in RCA: 210] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Child and adolescent overweight and obesity has increased globally, and can be associated with significant short- and long-term health consequences. This is an update of a Cochrane review published first in 2003, and updated previously in 2009. However, the update has now been split into six reviews addressing different childhood obesity treatments at different ages. OBJECTIVES To assess the effects of diet, physical activity and behavioural interventions (behaviour-changing interventions) for the treatment of overweight or obese children aged 6 to 11 years. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, PsycINFO, CINAHL, LILACS as well as trial registers ClinicalTrials.gov and ICTRP Search Portal. We checked references of studies and systematic reviews. We did not apply any language restrictions. The date of the last search was July 2016 for all databases. SELECTION CRITERIA We selected randomised controlled trials (RCTs) of diet, physical activity, and behavioural interventions (behaviour-changing interventions) for treating overweight or obese children aged 6 to 11 years, with a minimum of six months' follow-up. We excluded interventions that specifically dealt with the treatment of eating disorders or type 2 diabetes, or included participants with a secondary or syndromic cause of obesity. DATA COLLECTION AND ANALYSIS Two review authors independently screened references, extracted data, assessed risk of bias, and evaluated the quality of the evidence using the GRADE instrument. We contacted study authors for additional information. We carried out meta-analyses according to the statistical guidelines in the Cochrane Handbook for Systematic Reviews of Interventions. MAIN RESULTS We included 70 RCTs with a total of 8461 participants randomised to either the intervention or control groups. The number of participants per trial ranged from 16 to 686. Fifty-five trials compared a behaviour-changing intervention with no treatment/usual care control and 15 evaluated the effectiveness of adding an additional component to a behaviour-changing intervention. Sixty-four trials were parallel RCTs, and four were cluster RCTs. Sixty-four trials were multicomponent, two were diet only and four were physical activity only interventions. Ten trials had more than two arms. The overall quality of the evidence was low or very low and 62 trials had a high risk of bias for at least one criterion. Total duration of trials ranged from six months to three years. The median age of participants was 10 years old and the median BMI z score was 2.2.Primary analyses demonstrated that behaviour-changing interventions compared to no treatment/usual care control at longest follow-up reduced BMI, BMI z score and weight. Mean difference (MD) in BMI was -0.53 kg/m2 (95% confidence interval (CI) -0.82 to -0.24); P < 0.00001; 24 trials; 2785 participants; low-quality evidence. MD in BMI z score was -0.06 units (95% CI -0.10 to -0.02); P = 0.001; 37 trials; 4019 participants; low-quality evidence and MD in weight was -1.45 kg (95% CI -1.88 to -1.02); P < 0.00001; 17 trials; 1774 participants; low-quality evidence.Thirty-one trials reported on serious adverse events, with 29 trials reporting zero occurrences RR 0.57 (95% CI 0.17 to 1.93); P = 0.37; 4/2105 participants in the behaviour-changing intervention groups compared with 7/1991 participants in the comparator groups). Few trials reported health-related quality of life or behaviour change outcomes, and none of the analyses demonstrated a substantial difference in these outcomes between intervention and control. In two trials reporting on minutes per day of TV viewing, a small reduction of 6.6 minutes per day (95% CI -12.88 to -0.31), P = 0.04; 2 trials; 55 participants) was found in favour of the intervention. No trials reported on all-cause mortality, morbidity or socioeconomic effects, and few trials reported on participant views; none of which could be meta-analysed.As the meta-analyses revealed substantial heterogeneity, we conducted subgroup analyses to examine the impact of type of comparator, type of intervention, risk of attrition bias, setting, duration of post-intervention follow-up period, parental involvement and baseline BMI z score. No subgroup effects were shown for any of the subgroups on any of the outcomes. Some data indicated that a reduction in BMI immediately post-intervention was no longer evident at follow-up at less than six months, which has to be investigated in further trials. AUTHORS' CONCLUSIONS Multi-component behaviour-changing interventions that incorporate diet, physical activity and behaviour change may be beneficial in achieving small, short-term reductions in BMI, BMI z score and weight in children aged 6 to 11 years. The evidence suggests a very low occurrence of adverse events. The quality of the evidence was low or very low. The heterogeneity observed across all outcomes was not explained by subgrouping. Further research is required of behaviour-changing interventions in lower income countries and in children from different ethnic groups; also on the impact of behaviour-changing interventions on health-related quality of life and comorbidities. The sustainability of reduction in BMI/BMI z score and weight is a key consideration and there is a need for longer-term follow-up and further research on the most appropriate forms of post-intervention maintenance in order to ensure intervention benefits are sustained over the longer term.
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Affiliation(s)
- Emma Mead
- Teesside UniversityHealth and Social Care InstituteMiddlesbroughUKTS1 3BA
| | - Tamara Brown
- Teesside UniversityHealth and Social Care InstituteMiddlesbroughUKTS1 3BA
- Durham University Queen's CampusSchool of Medicine, Pharmacy and HealthDurhamUKTS17 6BH
| | - Karen Rees
- Warwick Medical School, University of WarwickDivision of Health SciencesCoventryUKCV4 7AL
| | - Liane B Azevedo
- Teesside UniversityHealth and Social Care InstituteMiddlesbroughUKTS1 3BA
| | - Victoria Whittaker
- Teesside UniversityHealth and Social Care InstituteMiddlesbroughUKTS1 3BA
| | - Dan Jones
- Teesside UniversityHealth and Social Care InstituteMiddlesbroughUKTS1 3BA
| | - Joan Olajide
- Teesside UniversityHealth and Social Care InstituteMiddlesbroughUKTS1 3BA
| | - Giulia M Mainardi
- School of Medicine, University of São PauloDepartment of Preventive MedicineSão PauloBrazilCEP 01246 903
| | - Eva Corpeleijn
- University Medical Centre GroningenDepartment of EpidemiologyHanzeplein 1GroningenNetherlands9713 GZ
| | - Claire O'Malley
- Durham University Queen's CampusSchool of Medicine, Pharmacy and HealthDurhamUKTS17 6BH
| | | | - Lena Al‐Khudairy
- Warwick Medical School, University of WarwickDivision of Health SciencesCoventryUKCV4 7AL
| | - Louise Baur
- The University of SydneyDepartment of Paediatrics and Child HealthLocked Bag 4001WestmeadAustraliaNSW 2145
| | - Maria‐Inti Metzendorf
- Institute of General Practice, Medical Faculty of the Heinrich‐Heine‐University DüsseldorfCochrane Metabolic and Endocrine Disorders GroupMoorenstr. 5DüsseldorfGermany40225
| | | | - Louisa J Ells
- Teesside UniversityHealth and Social Care InstituteMiddlesbroughUKTS1 3BA
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Marcial GE, Ford AL, Haller MJ, Gezan SA, Harrison NA, Cai D, Meyer JL, Perry DJ, Atkinson MA, Wasserfall CH, Garrett T, Gonzalez CF, Brusko TM, Dahl WJ, Lorca GL. Lactobacillus johnsonii N6.2 Modulates the Host Immune Responses: A Double-Blind, Randomized Trial in Healthy Adults. Front Immunol 2017; 8:655. [PMID: 28659913 PMCID: PMC5466969 DOI: 10.3389/fimmu.2017.00655] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 05/18/2017] [Indexed: 12/12/2022] Open
Abstract
Lactobacillus johnsonii N6.2 mitigates the onset of type 1 diabetes (T1D) in biobreeding diabetes-prone rats, in part, through changes in kynurenine:tryptophan (K:T) ratios. The goal of this pilot study was to determine the safety, tolerance, and general immunological response of L. johnsonii N6.2 in healthy subjects. A double-blind, randomized clinical trial in 42 healthy individuals with no known risk factors for T1D was undertaken to evaluate subject responses to the consumption of L. johnsonii N6.2. Participants received 1 capsule/day containing 108 colony-forming units of L. johnsonii N6.2 or placebo for 8 weeks. Comprehensive metabolic panel (CMP), leukocyte subpopulations by complete blood count (CBC) and flow cytometry, serum cytokines, and relevant metabolites in the indoleamine-2,3-dioxygenase pathway were assessed. L. johnsonii N6.2 survival and intestinal microbiota was analyzed. Daily and weekly questionnaires were assessed for potential effects of probiotic treatment on general wellness. The administration of L. johnsonii N6.2 did not modify the CMP or CBC of participants suggesting general safety. In fact, L. johnsonii N6.2 administration significantly decreased the occurrence of abdominal pain, indigestion, and cephalic syndromes. As predicted, increased serum tryptophan levels increased resulting in a decreased K:T ratio was observed in the L. johnsonii N6.2 group. Interestingly, immunophenotyping assays revealed that monocytes and natural killer cell numbers were increased significantly after washout (12 weeks). Moreover, an increase of circulating effector Th1 cells (CD45RO+CD183+CD196−) and cytotoxic CD8+ T cells subset was observed in the L. johnsonii N6.2 group. Consumption of L. johnsonii N6.2 is well tolerated in adult control subjects, demonstrates systemic impacts on innate and adaptive immune populations, and results in a decreased K:T ratio. These data provide support for the safety and feasibility of using L. johnsonii N6.2 in prevention trials in subjects at risk for T1D. Trial registration: This trial was registered at http://clinicaltrials.gov as NCT02349360.
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Affiliation(s)
- Guillermo E Marcial
- Department of Microbiology and Cell Science, Genetics Institute, Institute of Food and Agricultural Sciences, University of Florida, Gainesville, FL, United States
| | - Amanda L Ford
- Food Science and Human Nutrition Department, Institute of Food and Agricultural Sciences, University of Florida, Gainesville, FL, United States
| | - Michael J Haller
- Department of Pediatrics, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Salvador A Gezan
- School of Forest Resources and Conservation, Institute of Food and Agricultural Sciences, University of Florida, Gainesville, FL, United States
| | - Natalie A Harrison
- Department of Microbiology and Cell Science, Genetics Institute, Institute of Food and Agricultural Sciences, University of Florida, Gainesville, FL, United States
| | - Dan Cai
- Department of Microbiology and Cell Science, Genetics Institute, Institute of Food and Agricultural Sciences, University of Florida, Gainesville, FL, United States
| | - Julie L Meyer
- Department of Soil and Water Science, Institute of Food and Agricultural Sciences, University of Florida, Gainesville, FL, United States
| | - Daniel J Perry
- Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Mark A Atkinson
- Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Clive H Wasserfall
- Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Timothy Garrett
- Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Claudio F Gonzalez
- Department of Microbiology and Cell Science, Genetics Institute, Institute of Food and Agricultural Sciences, University of Florida, Gainesville, FL, United States
| | - Todd M Brusko
- Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Wendy J Dahl
- Food Science and Human Nutrition Department, Institute of Food and Agricultural Sciences, University of Florida, Gainesville, FL, United States
| | - Graciela L Lorca
- Department of Microbiology and Cell Science, Genetics Institute, Institute of Food and Agricultural Sciences, University of Florida, Gainesville, FL, United States
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Frantsve-Hawley J, Bader JD, Welsh JA, Wright JT. A systematic review of the association between consumption of sugar-containing beverages and excess weight gain among children under age 12. J Public Health Dent 2017; 77 Suppl 1:S43-S66. [PMID: 28556932 DOI: 10.1111/jphd.12222] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 04/12/2017] [Indexed: 02/01/2023]
Abstract
OBJECTIVE A systematic review was conducted to address this clinical question: Does consumption of (non-dairy) sugar-containing beverages (SCBs) among children under age 12 result in excess weight gain? METHODS The authors searched four databases for controlled trials (randomized and non-randomized) and cohort studies published in English through March 29, 2016: PubMed, EMBASE, Cochrane Database of Systematic Reviews, CINAHL. Initial and full-text screening, data abstraction, and risk of bias assessment were performed independently and in duplicate. RESULTS Thirty-eight studies met inclusion criteria for this systematic review. One was a randomized controlled trial, and 37 were cohort studies. Though the results of these studies were mixed, the majority demonstrated a statistically significant positive association between SCB consumption in children under age 12 and total adiposity and central adiposity. In contrast, most studies that assessed 100 percent fruit juice consumption only with either total adiposity or central adiposity did not support an association. Among only children under age 5 at baseline, no studies examined central adiposity, but nearly all studies examining SCBs and total adiposity, and a majority examining only fruit juice consumption, demonstrated a statistically significant positive association. CONCLUSION Our results support a statistically significant positive association between SCBs and total and central adiposity among children under age 12. This association is most consistent for total adiposity among children <5. Our results for 100 percent fruit juice only suggest differences by age, as most studies among those < 12 were negative but most among those <5 were positive.
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Affiliation(s)
- Julie Frantsve-Hawley
- American Association of Public Health Dentistry, Springfield, IL, USA; College of Dentistry, University of Illinois at Chicago, Chicago, IL, USA
| | - James D Bader
- School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Jean A Welsh
- Department of Pediatrics, Emory University School of Medicine, Wellness Department, Children's Healthcare of Atlanta, Nutrition and Health Sciences Doctoral Program, Laney Graduate School, Emory University, Atlanta, GA, USA
| | - J Timothy Wright
- Department of Pediatric Dentistry, UNC School of Dentistry, Chapel Hill, NC, USA
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Luger M, Lafontan M, Bes-Rastrollo M, Winzer E, Yumuk V, Farpour-Lambert N. Sugar-Sweetened Beverages and Weight Gain in Children and Adults: A Systematic Review from 2013 to 2015 and a Comparison with Previous Studies. Obes Facts 2017; 10:674-693. [PMID: 29237159 PMCID: PMC5836186 DOI: 10.1159/000484566] [Citation(s) in RCA: 182] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 10/19/2017] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Partly inconsistent findings from previous reviews have fueled discussions on the impact of sugar-sweetened beverages (SSBs) on obesity development. The aim was to systematically review the recent evidence in children and adults. METHODS Data were retrieved from the databases MEDLINE, EMBASE, and Cochrane library for the period January 2013 to October 2015. A systematic review of prospective cohort studies and randomized controlled trials (RCTs) relating SSBs to weight measures was conducted. RESULTS 30 publications met the inclusion criteria. Prospective cohort studies (96%; n = 26) showed a positive association between consumption of SSBs and weight/BMI in adults and children (n = 242,352), and only one cohort study in children showed no association. Findings from three RCTs in children demonstrated that SSB consumption had an effect on BMI/BMI z-score. The one RCT in adults showed no significant effect of the intervention. 63% of the studies were of good, 30% of medium quality, and none was funded by industry. CONCLUSION Recent evidence suggests that SSB consumption is positively associated with or has an effect on obesity indices in children and adults. By combining the already published evidence with the new one, we conclude that public health policies should aim to reduce the consumption of SSBs and encourage healthy alternatives such as water.
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Affiliation(s)
- Maria Luger
- Special Institute for Preventive Cardiology And Nutrition SIPCAN, Salzburg, Austria
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria
- *Maria Luger, PhD MSc, Special Institute for Preventive Cardiology and Nutrition SIPCAN, Rabenfleckweg 8, 5061 Elsbethen/Salzburg, Austria,
| | - Max Lafontan
- Inserm/University Paul Sabatier UMR 1048, Institute of Metabolic and Cardiovascular Diseases, Hôpital Rangueil, Toulouse cedex, France
| | - Maira Bes-Rastrollo
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
- CIBERobn, Instituto de Salud Carlos III, Madrid, Spain
- IdiSNA, Navarra's Health Research Institute, Pamplona, Spain
| | - Eva Winzer
- Special Institute for Preventive Cardiology And Nutrition SIPCAN, Salzburg, Austria
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria
| | - Volkan Yumuk
- Division of Endocrinology, Metabolism and Diabetes, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Nathalie Farpour-Lambert
- Obesity Prevention and Care Program, Service of Therapeutic Education for Chronic Diseases, Department of Community Health, Primary Care and Emergency, University Hospital of Geneva and University of Geneva, Geneva, Switzerland
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Nakhimovsky SS, Feigl AB, Avila C, O’Sullivan G, Macgregor-Skinner E, Spranca M. Taxes on Sugar-Sweetened Beverages to Reduce Overweight and Obesity in Middle-Income Countries: A Systematic Review. PLoS One 2016; 11:e0163358. [PMID: 27669014 PMCID: PMC5036809 DOI: 10.1371/journal.pone.0163358] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 09/06/2016] [Indexed: 01/02/2023] Open
Abstract
Background The consumption of sugar-sweetened beverages (SSBs), which can lead to weight gain, is rising in middle-income countries (MICs). Taxing SSBs may help address this challenge. Systematic reviews focused on high-income countries indicate that taxing SSBs may reduce SSB consumption. Responsiveness to price changes may differ in MICs, where governments are considering the tax. To help inform their policy decisions, this review compiles evidence from MICs, assessing post-tax price increases (objective 1), changes in demand for SSBs and other products, overall and by socio-economic groups (objective 2), and effects on overweight and obesity prevalence (objective 3). Methods and Findings We conducted a systematic review on the effectiveness of SSB taxation in MICs (1990–2016) and identified nine studies from Brazil, Ecuador, India, Mexico, Peru, and South Africa. Estimates for own-price elasticity ranged from -0.6 to -1.2, and decreases in SSB consumption ranged from 5 to 39 kilojoules per person per day given a 10% increase in SSB prices. The review found that milk is a likely substitute, and foods prepared away from home, snacks, and candy are likely complements to SSBs. A quasi-experimental study and two modeling studies also found a negative relationship between SSB prices and obesity outcomes after accounting for substitution effects. Estimates are consistent despite variation in baseline obesity prevalence and per person per day consumption of SSBs across countries studied. Conclusions The review indicates that taxing SSBs will increase the prices of SSBs, especially sugary soda, in markets with few producers. Taxing SSBs will also reduce net energy intake by enough to prevent further growth in obesity prevalence, but not to reduce population weight permanently. Additional research using better survey data and stronger study designs is needed to ascertain the long-term effectiveness of an SSB tax on obesity prevalence in MICs.
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Affiliation(s)
- Sharon S. Nakhimovsky
- International Health Division, Abt Associates, Bethesda, Maryland, United States of America
- * E-mail:
| | - Andrea B. Feigl
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Carlos Avila
- International Health Division, Abt Associates, Bethesda, Maryland, United States of America
| | - Gael O’Sullivan
- International Health Division, Abt Associates, Bethesda, Maryland, United States of America
| | | | - Mark Spranca
- Office of Reputational Capital, Abt Associates, Cambridge, Massachusetts, United States of America
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Discretionary food and beverage consumption and its association with demographic characteristics, weight status, and fruit and vegetable intakes in Australian adults. Public Health Nutr 2016; 20:274-281. [PMID: 27572276 DOI: 10.1017/s1368980016002305] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Excessive consumption of discretionary foods/beverages in the Australian population has been identified, increasing the risk of obesity and chronic disease. The present study aimed to examine the associations between demographic, anthropometric and dietary factors and the consumption of discretionary foods, discretionary beverages and discretionary foods/beverages combined. DESIGN Discretionary food/beverage consumption reported in two 24 h recalls was analysed, stratified by gender, age, socio-economic status, country of birth, BMI, waist circumference, and fruit and vegetable intakes. SETTING 2011-12 National Nutrition and Physical Activity Survey. SUBJECTS Australian adults (n 7873) aged 19 years or above. RESULTS Mean discretionary food and beverage consumption was 631 g (28 % by weight from foods; 72 % from beverages), providing 2721 kJ of energy intake (72 % from foods; 28 % from beverages). Total discretionary food/beverage consumption was higher in younger age groups (P<0·001), those in lower socio-economic categories (P<0·001), those born in Australia (P<0·001), those with higher BMI (P<0·001) and those with lower fruit (P<0·001) or vegetable intake (P<0·001). Discretionary beverage consumption (β=6·6, P<0·001) was more strongly associated with BMI than discretionary food consumption (β=0·5, P=0·01). CONCLUSIONS Total discretionary food/beverage consumption as well as discretionary foods alone and discretionary beverages alone were associated with BMI in Australian adults. In addition, high intakes were associated with younger age, lower socio-economic status, and lower consumption of fruit and vegetables.
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Caloric compensation for sugar-sweetened beverages in meals: A population-based study in Brazil. Appetite 2015; 98:67-73. [PMID: 26708263 DOI: 10.1016/j.appet.2015.12.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 10/07/2015] [Accepted: 12/15/2015] [Indexed: 12/13/2022]
Abstract
Sugar-sweetened beverage (SSB) consumption can cause positive energy balance, therefore leading to weight gain. A plausible biological mechanism to explain this association is through weak caloric compensation for liquid calories. However, there is an ongoing debate surrounding SSB calorie compensation. The body of evidence comes from a diversity of study designs and highly controlled settings assessing food and beverage intake. Our study aimed to test for caloric compensation of SSB in the free-living setting of daily meals. We analyzed two food records of participants (age 10 years or older) from the 2008-2009 National Dietary Survey (Brazil, N = 34,003). We used multilevel analyses to estimate the within-subject effects of SSB on food intake. Sugar-sweetened beverage calories were not compensated for when comparing daily energy intake over two days for each individual. When comparing meals, we found 42% of caloric compensation for breakfast, no caloric compensation for lunch and zero to 22% of caloric compensation for dinner, differing by household per capita income. In conclusion, SSB consumption contributed to higher energy intake due to weak caloric compensation. Discouraging the intake of SSB especially during lunch and dinner may help reduce excessive energy intake and lead to better weight management.
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