Effect of Sugar-Sweetened Beverages on Obesity Development

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The balance between the responsibility of individuals, health advocates, and governments and society must be clarified.
The balance between the responsibility of individuals, health advocates, and governments and society must be clarified.

Consuming sugar-sweetened beverages (SSBs) may still be associated with or have an effect on the obesity index of adults and children, according to a systematic review published in Obesity Facts.

Researchers conducted a systematic review of the literature to assess the latest evidence, published between January 2013 and October 2015, regarding the effect of SSBs on weight gain in adults and children. The number of prospective cohort studies and randomized controlled trials (RCTs) in pediatrics were 17 and 3, respectively, whereas in adults they were 9 and 1.

The studies included represented a large geographical sample, with Europe, the United States, Middle and South America, Australia, South Africa, Iran, Thailand, and Japan represented. Comprehensively, 6 of 17 studies assessed underreporting, with only 2 studies including underreporters in the final analysis.

In the prospective cohort studies of children (n=56,340), 94% of the articles demonstrated a relationship between a higher consumption of SSBs and a higher degree of adiposity, with only 1 article not finding a consistent trend or association between SSB consumption and body fat. All the prospective studies in adults (n=186,012) found an association between SSB consumption and body weight changes, with higher consumption associated with an increase in weight.

Three RCTs in children (n=2059) had an average duration of 1 year, with body weight being a measured outcome in all the studies. One study found a BMI increase of 0.11 (95% CI, 0.03-0.25) kg/m2 with each increase of soda intake of 1 glass per day. Overall, there was a statistically significant BMI increase over time in the intervention group when compared with the control group (P =.02). All 3 studies found a relationship between SSB intake and changes in BMI or BMI Z-score.

Only 1 RCT was performed in adults over the course of 9 months measuring BMI as the obesity measure, and relying on 24-hour recall to assess SSB intake. The study found a greater reduction in BMI over the course of 3 months in individuals receiving the water plus education (WEP) intervention when compared with those who only received education (EP; −0.4±0.08 kg/m2 and −0.2±0.08 kg/m2; P =.07, respectively), and an overall average weight loss of 21.2±0.4 kg and 20.8±0.4 kg in the WEP and EP groups, respectively (P =.40).

Overall, 96% of the prospective studies of adults and children found a positive association between SSB consumption and body weight measures, with only 1 study (4%) finding no association, and no studies finding a negative association. In the RCTs of adults and children, lower BMI or BMI Z-scores were found to be associated with a lower SSB consumption, with 93% of studies finding an increase in obesity with SSB consumption.

Researchers concluded that evidence in recent literature points to a positive association between SSB consumption and body measure increases, whereas a reduction in SSB intake is associated with lowering BMI and BMI Z-scores. Therefore, clinicians should routinely assess SSB consumption in both children and adults and provide education regarding healthy beverage options that will assist in reducing BMI and limit SSB intake.

Reference

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.

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