The Relationships between Sugar-Sweetened Beverage Intake and Cardiometabolic Markers in Young Children

Ethan C. Kosova, Peggy Auinger, Andrew A. Bremer

Research output: Contribution to journalArticle

69 Scopus citations


Background: The consumption of sugar-sweetened beverages has been implicated as a major contributor to the development of obesity and cardiometabolic disease. Objective: To evaluate the relationships between sugar-sweetened beverage intake and cardiometabolic markers in young children. Design: A cross-sectional analysis of the National Health and Nutrition Examination Survey data collected by the National Center for Health Statistics. Participants: A total of 4,880 individuals aged 3 to 11 years from nationally representative samples of US children participating in the National Health and Nutrition Examination Survey during 1999-2004 were studied. Main outcome measures: Concentrations of total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglyceride, and C-reactive protein as well as waist circumference and body mass index percentile for age-sex. Statistical analyses performed: Multivariate linear regression analyses were performed to determine independent associations between each outcome variable and the number of serving equivalents of sugar-sweetened beverages consumed after adjusting for age, sex, race, poverty status, physical activity, and energy intake. Results: Increased sugar-sweetened beverage intake was independently associated with increased C-reactive protein concentrations (P=0.003), increased waist circumference (P=0.04), and decreased high-density lipoprotein cholesterol concentrations (P<0.001). Subgroup analyses demonstrated differences in the association of sugar-sweetened beverage intake with metabolic markers and anthropometric measurements among age ranges, sex, and racial/ethnic groups. Conclusions: In this cross-sectional analysis of children's dietary data, sugar-sweetened beverage intake was independently associated with alterations in lipid profiles, increased markers of inflammation, and increased waist circumference in children. Prospective studies are needed, but awareness of these trends is essential in combating the growing metabolic and cardiovascular disease burden in the pediatric population.

Original languageEnglish (US)
Pages (from-to)219-227
Number of pages9
JournalJournal of the Academy of Nutrition and Dietetics
Issue number2
StatePublished - Feb 2013
Externally publishedYes



  • Epidemiology
  • Lipids
  • Nutrition
  • Sugar-sweetened beverage

ASJC Scopus subject areas

  • Food Science
  • Nutrition and Dietetics

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