Sugar-sweetened beverage (SSB) and fruit juice (FJ) consumption may promote lipid abnormalities in childhood. We examined the association between SSB/FJ intake and lipid levels using electronic health record data for 2816 adolescents. Multivariable logistic regression models treated clinical cutpoints for abnormal lipid levels (triglycerides [TG], high-density lipoprotein (HDL), low-density lipoprotein [LDL], and total cholesterol) as dependent variables. In models not adjusted for adiposity, elevated SSB and FJ consumption was associated with increased odds of having abnormally high TG (SSB: odds ratio [OR] = 1.28 (95% confidence interval [CI] = [1.07-1.52], P = .007); FJ: 1.35 ([1.09-1.69], P = .007)) and abnormally low HDL (SSB: 1.47 ([1.17-1.86], P = .001); FJ: 1.35 ([1.02-1.78], P = .03)). Adjusting for adiposity, a likely mediator of the relationship, attenuated these associations. These findings support the need for identifying unhealthy beverage consumption habits during childhood health care visits as a modifiable behavior associated with cardiometabolic risk.
MalikVSHuFB.Sugar-sweetened beverages and cardiometabolic health: an update of the evidence. Nutrients. 2019;11(8):1840.
2.
EbbelingCBFeldmanHAChomitzVR, et al. A randomized trial of sugar-sweetened beverages and adolescent body weight. N Engl J Med. 2012;367(15):1407-1416.
3.
De RuyterJCOlthofMRSeidellJCKatanMB.A trial of sugar-free or sugar-sweetened beverages and body weight in children. N Engl J Med. 2012;367(15):1397-1406.
4.
JohnsonRKAppelLJBrandsM, et al. Dietary sugars intake and cardiovascular health: a scientific statement from the American Heart Association. Circulation. 2009;120(11):1011-1020.
5.
ChanTFLinWTHuangHL, et al. Consumption of sugar-sweetened beverages is associated with components of the metabolic syndrome in adolescents. Nutrients. 2014;6(5):2088-2103.
RosingerAHerrickKGahcheJParkS.Sugar-sweetened beverage consumption among U.S. adults, 2011-2014. NCHS Data Brief. 2017;270:1-8.
9.
TengNIMFJulianaNIzlinNLSemaonNZ. Knowledge, attitude and practices of sugar-sweetened beverages: a cross-sectional study among adolescents in Selangor, Malaysia. Nutrients. 2020;12(12):3617.
10.
PowellLMWadaRKumanyikaSK.Racial/ethnic and income disparities in child and adolescent exposure to food and beverage television ads across the U.S. media markets. Health Place. 2014;29:124-131.
11.
MillerACassidyOGreeneTArshonskyJAlbertSLBraggMA.A qualitative analysis of Black and White adolescents’ perceptions of and responses to racially targeted food and drink commercials on television. Int J Environ Res Public Health. 2021;18(21):11563.
12.
EisenbergMDAveryRJMathiosAErnstPCawleyJ.Disparities in exposure to television advertising of sugar-sweetened and non-nutritive sweetened beverages among U.S. adults and teens, 2007-2013. Prev Med. 2021;150:106628.
13.
OnufrakSJParkSSharkeyJRSherryB. The relationship of perceptions of tap water safety with intake of sugar-sweetened beverages and plain water among U.S. adults. Public Health Nutr. 2014;17(1):179-185.
14.
ParkSOnufrakSJCradockALPatelAHechtCBlanckHM. Perceptions of water safety and tap water taste and their associations with beverage intake among U.S. adults. Am J Health Promot. 2023;37(5):625-637.
15.
ColburnATKavourasSA.Tap water consumption and perceptions in United States Latinx adults. Nutrients. 2021;13(9):2999.
16.
Huerta-SaenzLIrigoyenMBenavidesJMendozaM.Tap or bottled water: drinking preferences among urban minority children and adolescents. J Community Health. 2012;37(1):54-58.
17.
Van RompayMIMcKeownNMGoodmanE, et al. Sugar-sweetened beverage intake is positively associated with baseline triglyceride concentrations, and changes in intake are inversely associated with changes in HDL cholesterol over 12 months in a multi-ethnic sample of children. J Nutr. 2015;145(10):2389-2395.
18.
HermanMASamuelVT.The sweet path to metabolic demise: fructose and lipid synthesis. Trends Endocrinol Metab. 2016;27(10):719-730.
19.
RaitakariOTJuonalaMKähönenM, et al. Cardiovascular risk factors in childhood and carotid artery intima-media thickness in adulthood: the Cardiovascular Risk in Young Finns Study. JAMA. 2003;290(17):2277-2283.
20.
LewisKHSkeltonJAHsuFCEzouahPTaverasEMBlockJP.Implementing a novel electronic health record approach to track child sugar-sweetened beverage consumption. Prev Med Rep. 2018;11:169-175.
21.
HowardTGroselJ.Updated guidelines for lipid screening in children and adolescents. JAAPA. 2015;28(3):30-36.
22.
GrundySMStoneNJBaileyAL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: a report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines. Circulation. 2019;139(25):e1144-e1161.
23.
Guasch-FerréMHuFB.Are fruit juices just as unhealthy as sugar-sweetened beverages?JAMA Netw Open. 2019;2(5):e193109.
24.
AuerbachBJDibeySVallila-BuchmanPKratzMKriegerJ.Review of 100% fruit juice and chronic health conditions: implications for sugar-sweetened beverage policy. Adv Nutr. 2018;9(2):78-85.
25.
PalakshappaDLenoirKBrownCL, et al. Identifying geographic differences in children’s sugar-sweetened beverage and 100% fruit juice intake using health system data. Pediatr Obes. 2020;15(11):e12663.
26.
JolliffeCJJanssenI.Distribution of lipoproteins by age and gender in adolescents. Circulation. 2006;114(10):1056-1062.
27.
U.S. Census Bureau. American Community Survey. 2017. Accessed March 25, 2022. www.census.gov
28.
LeermakersETMFelixJFJaddoeVWVRaatHFrancoOHKiefte-De JongJC. Sugar-containing beverage intake at the age of 1 year and cardiometabolic health at the age of 6 years: the Generation R Study. Int J Behav Nutr Phys Act. 2015;12(1):114.
29.
EnyKMJeyakumarNDaiDWHMaguireJLParkinPCBirkenCS.Sugar-containing beverage consumption and cardiometabolic risk in preschool children. Prev Med Rep. 2020;17:101054.
30.
AmbrosiniGLOddyWHHuangRCMoriTABeilinLJJebbSA.Prospective associations between sugar-sweetened beverage intakes and cardiometabolic risk factors in adolescents. Am J Clin Nutr. 2013;98(2):327-334.
31.
SeferidiPMillettCLavertyAA.Sweetened beverage intake in association to energy and sugar consumption and cardiometabolic markers in children. Pediatr Obes. 2018;13(4):195-203.
32.
KosovaECAuingerPBremerAA.The relationships between sugar-sweetened beverage intake and cardiometabolic markers in young children. J Acad Nutr Diet. 2013;113(2):219-227.
33.
Crowe-WhiteKO’NeilCEParrottJS, et al. Impact of 100% fruit juice consumption on diet and weight status of children: an evidence-based review. Crit Rev Food Sci Nutr. 2016;56(5):871-884.
34.
AuerbachBJWolfFMHikidaA, et al. Fruit juice and change in BMI: a meta-analysis. Pediatrics. 2017;139(4):e20162454.
35.
FaithMSDennisonBAEdmundsLSStrattonHH.Fruit juice intake predicts increased adiposity gain in children from low-income families: weight status-by-environment interaction. Pediatrics. 2006;118(5):2066-2075.
36.
DennisonBARockwellHLBakerSL.Excess fruit juice consumption by preschool-aged children is associated with short stature and obesity. Pediatrics. 1997;99(1):15-22.
37.
LundeenEAParkSDooyemaCBlanckHM.Total sugar-sweetened beverage intake among U.S. adults lower when measured using a one-question versus four-question screener. Am J Health Promot. 2018;32(6):1431-1437.
38.
AdlerNESteadWW.Patients in context—EHR capture of social and behavioral determinants of health. N Engl J Med. 2015;372(8):698-701.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
