Association of Dietary Sugars and Sugar-Sweetened Beverage Intake with Obesity in Korean Children and Adolescents
Abstract
:1. Introduction
2. Methods
2.1. Study Population and Data Collection
2.2. Dietary Measurement and Sugar Intake
2.3. Anthropometric Measurements and Pediatric Obesity
2.4. Confounding Variables
2.5. Statistical Analyses
3. Results
3.1. General Characteristics of Study Subjects
Boys (n = 1048) | Girls (n = 1551) | p-Value | |||||
---|---|---|---|---|---|---|---|
9–11 Years (n = 422) | 12–14 Years (n = 626) | p-Value | 9–11 Years (n = 950) | 12–14 Years (n = 601) | p-Value | ||
Age (year) (Mean ± SD) | 9.9 ± 0.7 | 13.1 ± 0.7 | <0.0001 | 9.9 ± 0.8 | 13.1 ± 0.7 | <0.0001 | <0.0001 |
Height (cm) (Mean ± SD) | 142.1 ± 7.1 | 162.6 ± 8.3 | <0.0001 | 141.4 ± 8.0 | 157.4 ± 5.9 | <0.0001 | <0.0001 |
Weight (kg) (Mean ± SD) | 39.8 ± 9.1 | 56.3 ± 12.0 | <0.0001 | 36.9 ± 8.2 | 50.9 ± 9.6 | <0.0001 | <0.0001 |
BMI (kg/m2) 1 (Mean ± SD) | 19.5 ± 3.3 | 21.2 ± 3.6 | <0.0001 | 18.3 ± 2.9 | 20.5 ± 3.3 | <0.0001 | <0.0001 |
Weight status 2 (n, (%)) | <0.0001 | 0.6486 | <0.0001 | ||||
Normal | 311 (73.7) | 492 (78.6) | 759 (79.9) | 477 (79.4) | |||
Overweight | 70 (16.6) | 29 (4.6) | 122 (12.8) | 73 (12.2) | |||
Obesity | 41 (9.7) | 105 (16.8) | 69 (7.3) | 51 (8.5) | |||
Maternal education (%) | <0.0001 | <0.0001 | 0.4759 | ||||
Middle school or less | 2.6 | 9.6 | 2.8 | 10.2 | |||
High school | 30.3 | 55.4 | 39.6 | 53.7 | |||
College or more | 67.1 | 35.0 | 57.6 | 36.1 | |||
Physical activity 3 (%) | 0.0001 | <0.0001 | < 00001 | ||||
No | 35.8 | 47.6 | 48.7 | 68.1 | |||
Yes | 64.2 | 52.4 | 51.3 | 32.0 |
3.2. Nutrients and Sugar Intake
Boys (n = 1048) | Girls (n = 1551) | p-Value | |||||
---|---|---|---|---|---|---|---|
9–11 Years (n = 422) | 12–14 Years (n = 626) | p-Value | 9–11 Years (n = 950) | 12–14 Years (n = 601) | p-Value | ||
Energy (kcal/day) (Mean ± SE) | 1695.0 ± 72.8 | 1948.3 ± 61.9 | 0.0409 | 1575.5 ± 35.5 | 1681.9 ± 41.2 | 0.1124 | <0.0001 |
Carbohydrate (g/day) (Mean ± SE) | 258.6 ± 4.6 | 258.8 ± 3.9 | 0.9830 | 238.1 ± 2.4 | 236.6 ± 2.8 | 0.7399 | 0.0356 |
Protein (g/day) (Mean ± SE) | 73.3 ± 1.9 | 71.0 ± 1.6 | 0.4697 | 60.9 ± 1.0 | 64.3 ± 1.2 | 0.0810 | 0.3124 |
Fat (g/day) (Mean ± SE) | 57.4 ± 1.8 | 58.7 ± 1.5 | 0.6687 | 50.6 ± 0.9 | 48.3 ± 1.1 | 0.1826 | 0.9476 |
Percent of EER 1 (%) | 78.8 | 78.7 | 0.9863 | 85.2 | 84.1 | 0.7606 | <0.0001 |
Percent of RNI 2 (%) | |||||||
Thiamin | 143.5 | 143.8 | 0.9944 | 127.7 | 110.2 | 0.0189 | <0.0001 |
Riboflavin | 103.0 | 78.4 | 0.0080 | 112.0 | 85.3 | 0.0002 | <0.0001 |
Niacin | 131.2 | 110.5 | 0.0864 | 113.1 | 101.8 | 0.0988 | <0.0001 |
Vitamin C | 83.9 | 66.5 | 0.1512 | 84.3 | 65.3 | 0.0465 | 0.0673 |
Calcium | 63.9 | 49.3 | 0.0602 | 58.6 | 52.8 | 0.1590 | 0.1339 |
Phosphorus | 94.2 | 102.3 | 0.3103 | 93.3 | 100.1 | 0.1525 | 0.9329 |
Iron | 166.6 | 112.3 | 0.4549 | 113.7 | 92.6 | 0.3463 | 0.0013 |
Total Sugars (g/day) (Mean ± SE) | 43.3 ± 3.0 | 56.7 ± 2.6 | 0.0096 | 52.9 ± 1.7 | 50.2 ± 1.9 | 0.3792 | <0.0001 |
Total Sugars (% of Energy) | 9.6 | 11.8 | 0.0401 | 12.9 | 12.0 | 0.2036 | <0.0001 |
Sugar intake by food sources (g/day) (Mean ± SE) | |||||||
From milk | 6.4 ± 0.9 | 5.8 ± 0.7 | 0.6726 | 5.8 ± 0.5 | 5.5 ± 0.5 | 0.7516 | 0.0586 |
From fruits | 6.4 ± 1.5 | 7.7 ± 1.2 | 0.6064 | 9.0 ± 0.9 | 7.7 ± 1.1 | 0.4552 | 0.0081 |
From processed foods | 25.6 ± 2.6 | 38.0 ± 2.2 | 0.0060 | 33.2 ± 1.4 | 32.3 ± 1.6 | 0.7249 | <0.0001 |
From commodity type foods | 4.8 ± 0.4 | 5.2 ± 0.3 | 0.5797 | 4.9 ± 0.2 | 4.6 ± 0.3 | 0.5524 | 0.9221 |
3.3. Association between Dietary Sugar Intake and Obesity
Quartiles of Dietary Sugars | |||||
---|---|---|---|---|---|
Q1 | Q2 | Q3 | Q4 | p for Trend | |
Sugar Intake from Milk and Fruits (g/Day) 1 | |||||
Boys (n = 1048) | |||||
Sugar intake (Mean ± SE) | 3.2 ± 0.4 | 8.6 ± 0.4 | 16.0 ± 0.4 | 31.6 ± 0.4 | |
Normal | 1.00 | ||||
Overweight 2 | 1.00 | 1.10 (0.52–2.35) | 1.11 (0.52–2.37) | 1.29 (0.61–2.74) | 0.4617 |
Obesity 2 | 1.00 | 0.98 (0.60–1.60) | 0.81 (0.48–1.38) | 0.71 (0.40–1.26) | 0.1952 |
Girls (n = 1551) | |||||
Sugar intake | 4.2 ± 0.4 | 10.7 ± 0.4 | 17.8 ± 0.4 | 34.6 ± 0.4 | |
Normal | 1.00 | ||||
Overweight | 1.00 | 0.61 (0.39–0.95) | 0.67 (0.43–1.04) | 0.52 (0.32–0.84) | 0.0246 |
Obesity | 1.00 | 0.69 (0.40–1.16) | 0.73 (0.42–1.25) | 0.42 (0.23–0.79) | 0.0113 |
Sugar Intake from Processed Foods (g/day) 1 | |||||
Boys (n = 1048) | |||||
Sugar intake | 15.1 ± 0.5 | 24.9 ± 0.5 | 34.6 ± 0.6 | 54.0 ± 0.5 | |
Normal | 1.00 | ||||
Overweight | 1.00 | 0.88 (0.45–1.72) | 1.34 (0.73–2.46) | 1.14 (0.61–2.14) | 0.4678 |
Obesity | 1.00 | 0.83 (0.52–1.33) | 0.54 (0.32–0.92) | 0.70 (0.42–1.15) | 0.0894 |
Girls (n = 1551) | |||||
Sugar intake | 15.4 ± 0.5 | 25.0 ± 0.5 | 34.6 ± 0.5 | 53.1 ± 0.5 | |
Normal | 1.00 | ||||
Overweight | 1.00 | 1.00 (0.65–1.54) | 0.87 (0.56–1.35) | 1.08 (0.69–1.67) | 0.8152 |
Obesity | 1.00 | 0.86 (0.51–1.46) | 0.80 (0.47–1.37) | 0.92 (0.53–1.58) | 0.7673 |
3.4. Association between Sugar-Sweetened Beverage Intake and Obesity
Sugar-Sweetened Beverage (SSB) Intake (mL/Day) 1 | ||||
---|---|---|---|---|
Non-Drinker | <200 mL/Day | ≥200 mL/Day | p for Trend 3 | |
Boys (n = 1048) | ||||
n (%) | 461 (44.0) | 475 (45.3) | 112 (10.7) | |
SSB intake (Mean ± SE) | 0 | 87.8 ± 3.2 | 301.7 ± 5.2 | |
SSB (% of energy) | 0 | 2.1 | 5.8 | |
Normal | 1.00 | |||
Overweight 2 | 1.00 | 1.29 (0.81–2.07) | 0.70 (0.29–1.69) | 0.5150 |
Obesity 2 | 1.00 | 0.61 (0.42–0.90) | 0.52 (0.26–1.05) | 0.0310 |
Girls (n = 1551) | ||||
n (%) | 647 (41.7) | 785 (50.6) | 119 (7.7) | |
SSB intake | 0 | 74.4 ± 2.1 | 260.9 ± 4.0 | |
SSB (% of energy) | 0 | 2.0 | 6.0 | |
Normal | 1.00 | |||
Overweight | 1.00 | 0.95 (0.69–1.30) | 1.00 (0.53–1.87) | 0.9097 |
Obesity | 1.00 | 1.26 (0.84–1.89) | 1.36 (0.62–2.97) | 0.3325 |
4. Discussion
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
Appendix
Study 1 | Study 2 | Study 3 | Study 4 | Study 5 | |
---|---|---|---|---|---|
Sample size (n, (%)) | 1294 (49.8) | 447 (17.2) | 219 (8.4) | 525 (20.2) | 114 (4.4) |
Year of study | 2002–2003 | 2006 | 2008 | 2008–2009 | 2011 |
IRB number 1 | Not applicable | 2006-12-06-28 | 2008-03-28-53 | 2008-10-07-68 | SPIRB-11-033 |
Days of dietary records (Mean ± SD) | 3.0 ± 0.1 | 6.0 ± 0.2 | 3.0 ± 0.0 | 3.0 ± 0.0 | 3.0 ± 0.0 |
Age (year) (Mean ± SD) | 11.6 ± 1.7 | 13.4 ± 0.6 | 10.2 ± 1.0 | 10.0 ± 0.9 | 10.0 ± 1.2 |
Age group (n, (%)) | |||||
9–11 years old | 571 (44.1) | 0 (0) | 204 (93.2) | 498 (94.9) | 99 (86.8) |
12–14 years old | 723 (55.9) | 447 (100) | 15 (6.9) | 27 (5.1) | 15 (13.2) |
Gender (n, (%)) | |||||
Boys | 649 (50.2) | 244 (54.6) | 108 (49.3) | 0 (0) | 47 (41.2) |
Girls | 645 (49.9) | 203 (45.4) | 111 (50.7) | 525 (100) | 67 (58.8) |
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Ha, K.; Chung, S.; Lee, H.-S.; Kim, C.-i.; Joung, H.; Paik, H.-Y.; Song, Y. Association of Dietary Sugars and Sugar-Sweetened Beverage Intake with Obesity in Korean Children and Adolescents. Nutrients 2016, 8, 31. https://doi.org/10.3390/nu8010031
Ha K, Chung S, Lee H-S, Kim C-i, Joung H, Paik H-Y, Song Y. Association of Dietary Sugars and Sugar-Sweetened Beverage Intake with Obesity in Korean Children and Adolescents. Nutrients. 2016; 8(1):31. https://doi.org/10.3390/nu8010031
Chicago/Turabian StyleHa, Kyungho, Sangwon Chung, Haeng-Shin Lee, Cho-il Kim, Hyojee Joung, Hee-Young Paik, and YoonJu Song. 2016. "Association of Dietary Sugars and Sugar-Sweetened Beverage Intake with Obesity in Korean Children and Adolescents" Nutrients 8, no. 1: 31. https://doi.org/10.3390/nu8010031