Nutrition Research and Practice

The Korean Nutrition Society (한국영양학회)
권호 표지
DOI QR코드

DOI QR Code

Association between beverage intake and obesity in children: The Korea National Health and Nutrition Examination Survey (KNHANES) 2013-2015

  • Wang, Hyewon (Nutrition and Functional Food Research Team, National Institute of Food and Drug Safety Evaluation) ;
  • Jeong, HaYoung (Nutrition and Functional Food Research Team, National Institute of Food and Drug Safety Evaluation) ;
  • Kim, Na-Hui (Nutrition and Functional Food Research Team, National Institute of Food and Drug Safety Evaluation) ;
  • Kang, YoonJung (Nutrition and Functional Food Research Team, National Institute of Food and Drug Safety Evaluation) ;
  • Hwang, Kyungmi (Nutrition and Functional Food Research Team, National Institute of Food and Drug Safety Evaluation) ;
  • Lee, HwaJung (Nutrition and Functional Food Research Team, National Institute of Food and Drug Safety Evaluation) ;
  • Hong, Jin-Hwan (Nutrition and Functional Food Research Team, National Institute of Food and Drug Safety Evaluation) ;
  • Oh, Keum-Soon (Nutrition and Functional Food Research Team, National Institute of Food and Drug Safety Evaluation)
  • Received : 2018.01.15
  • Accepted : 2018.06.12
  • Published : 2018.08.01
Download PDF
⟨ Previous Next ⟩

Abstract

BACKGROUND/OBJECTIVES: Numerous researches have studied the association between sugar intake and obesity of children in many countries. This study was undertaken to investigate the association between beverage intake and obesity of children by reviewing a database for total sugar contents established in all foods and presented in a nutrition survey by the Korea National Health and Nutrition Examination Survey (KNHANES). SUBJECTS/METHODS: Data of 1,520 children aged 6-11 years in the 6th KNHANES (2013-2015) were analyzed for this study. A database for total sugar intake comprises the total sugar contents of all foods included in the results of a nutrition survey using the 24-hour recall method of 6th KNHANES. Beverages were categorized into carbonated beverages, fruit & vegetable drinks, other drinks, tea, and coffee. RESULTS: The average daily beverage intake of all children was 131.75 g/day, and the average daily total sugar intake in beverages was 13.76 g/day. Carbonated beverages had the highest intake rate (58.85 g/day) and also ranked highest for sugar intake (6.36 g/day). After adjusting for confounding variables, the odds ratio for obesity in children with beverage intake of ${\geq}200mL/day$ significantly increased by 1.83 times (95% CI, 1.11-3.00) as compared to children with beverage intake of < 200 mL/day. Also, a significant increase was observed in the odds ratio for obesity in total children (2.41 times; 95% CI, 1.35-4.33) and boys (3.15 times; 95% CI, 1.53-6.49) with carbonated beverage intake of ${\geq}200mL/day$ when compared with children who consumed < 200 mL/day. CONCLUSION: A positive association is observed between beverage intake and obesity in Korean children. In particular, an intake of carbonated beverages has a positive correlation with childhood obesity in boys. This study can therefore be used as scientific evidence for reducing sugar, and for the continuous management and research on beverages.

Keywords

References

  1. Popkin BM, Adair LS, Ng SW. Global nutrition transition and the pandemic of obesity in developing countries. Nutr Rev 2012;70:3-21. https://doi.org/10.1111/j.1753-4887.2011.00456.x
  2. Kelly T, Yang W, Chen CS, Reynolds K, He J. Global burden of obesity in 2005 and projections to 2030. Int J Obes 2008;32:1431-7. https://doi.org/10.1038/ijo.2008.102
  3. Hubert HB, Feinleib M, McNamara PM, Castelli WP. Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study. Circulation 1983;67:968-77. https://doi.org/10.1161/01.CIR.67.5.968
  4. Kopelman PG. Obesity as a medical problem. Nature 2000;404: 635-43. https://doi.org/10.1038/35007508
  5. Haslam DW, James WP. Obesity. Lancet 2005;366:1197-209. https://doi.org/10.1016/S0140-6736(05)67483-1
  6. Wang Y, Lobstein T. Worldwide trends in childhood overweight and obesity. Int J Pediatr Obes 2006;1:11-25. https://doi.org/10.1080/17477160600586747
  7. Flegal KM, Kruszon-Moran D, Carroll MD, Fryar CD, Ogden CL. Trends in obesity among adults in the United States, 2005 to 2014. JAMA 2016;315:2284-91. https://doi.org/10.1001/jama.2016.6458
  8. Lobstein T, Baur L, Uauy R; IASO International Obesity TaskForce. Obesity in children and young people: a crisis in public health. Obes Rev 2004;5 Suppl 1:4-104. https://doi.org/10.1111/j.1467-789X.2004.00133.x
  9. Jackson-Leach R, Lobstein T. Estimated burden of paediatric obesity and co-morbidities in Europe. Part 1. The increase in the prevalence of child obesity in Europe is itself increasing. Int J Pediatr Obes 2006;1:26-32. https://doi.org/10.1080/17477160600586614
  10. Sanchez-Cruz JJ, Jimenez-Moleon JJ, Fernandez-Quesada F, Sanchez MJ. Prevalence of child and youth obesity in Spain in 2012. Rev Esp Cardiol (Engl Ed) 2013;66:371-6. https://doi.org/10.1016/j.recesp.2012.10.016
  11. Kim HM, Park J, Kim HS, Kim DH, Park SH. Obesity and cardiovascular risk factors in Korean children and adolescents aged 10-18 years from the Korean National Health and Nutrition Examination Survey, 1998 and 2001. Am J Epidemiol 2006;164:787-93. https://doi.org/10.1093/aje/kwj251
  12. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. Korea Health Statistics 2015: Korea National Health and Nutrition Examination Survey (KNHANES-VI). Sejong: Ministry of Health and Welfare; 2016.
  13. Charlotte MB. Childhood onset and duration of obesity are significant risk factors for type 2 diabetes in mid-adulthood. Diabetes Care 2011;34:1986-91. https://doi.org/10.2337/dc10-1482
  14. McCrindle BW. Cardiovascular consequences of childhood obesity. Can J Cardiol 2015;31:124-30. https://doi.org/10.1016/j.cjca.2014.08.017
  15. Dietz WH. Childhood weight affects adult morbidity and mortality. J Nutr 1998;128:411S-414S. https://doi.org/10.1093/jn/128.2.411S
  16. Daniels SR, Arnett DK, Eckel RH, Gidding SS, Hayman LL, Kumanyika S, Robinson TN, Scott BJ, St Jeor S, Williams CL. Overweight in children and adolescents: pathophysiology, consequences, prevention, and treatment. Circulation 2005;111:1999-2012. https://doi.org/10.1161/01.CIR.0000161369.71722.10
  17. Flodmark CE, Lissau I, Moreno LA, Pietrobelli A, Widhalm K. New insights into the field of children and adolescents' obesity: the European perspective. Int J Obes Relat Metab Disord 2004;28: 1189-96. https://doi.org/10.1038/sj.ijo.0802787
  18. Koplan JP, Dietz WH. Caloric imbalance and public health policy. JAMA 1999;282:1579-81. https://doi.org/10.1001/jama.282.16.1579
  19. Bishop J, Middendorf R, Babin T, Tilson W. ASPE Research Brief Childhood Obesity [Internet]. 2005 [cited 2017 December 10]. Available from: http://aspe.hhs.gov/health/reports/child_obesity/index.cfm.
  20. Ludwig DS, Peterson KE, Gortmaker SL. Relation between consumption of sugar-sweetened drinks and childhood obesity: a prospective, observational analysis. Lancet 2001;357:505-8. https://doi.org/10.1016/S0140-6736(00)04041-1
  21. Millar L, Rowland B, Nichols M, Swinburn B, Bennett C, Skouteris H, Allender S. Relationship between raised BMI and sugar sweetened beverage and high fat food consumption among children. Obesity (Silver Spring) 2014;22:E96-103. https://doi.org/10.1002/oby.20665
  22. Gibson S, Neate D. Sugar intake, soft drink consumption and body weight among British children: further analysis of National Diet and Nutrition Survey data with adjustment for under-reporting and physical activity. Int J Food Sci Nutr 2007;58:445-60. https://doi.org/10.1080/09637480701288363
  23. Keller A, Bucher Della Torre S. Sugar-sweetened beverages and obesity among children and adolescents: a review of systematic literature reviews. Child Obes 2015;11:338-46. https://doi.org/10.1089/chi.2014.0117
  24. Reedy J, Krebs-Smith SM. Dietary sources of energy, solid fats, and added sugars among children and adolescents in the United States. J Am Diet Assoc 2010;110:1477-84. https://doi.org/10.1016/j.jada.2010.07.010
  25. Song Y, Park MJ, Paik HY, Joung H. Secular trends in dietary patterns and obesity-related risk factors in Korean adolescents aged 10-19 years. Int J Obes 2010;34:48-56. https://doi.org/10.1038/ijo.2009.203
  26. Korea Health Industry Development Institute. 2013 Food Industry Anlalysis Report. Cheongju: Korea Health Industry Development Institute; 2013.
  27. Lee HS, Kwon SO, Yon M, Kim D, Lee JY, Nam J, Park SJ, Yeon JY, Lee SK, Lee HY, Kwon OS, Kim CI. Dietary total sugar intake of Koreans: based on the Korea National Health and Nutrition Examination Survey (KNHANES), 2008-2011. J Nutr Health 2014;47: 268-76. https://doi.org/10.4163/jnh.2014.47.4.268
  28. Lee HS, Kwon SO, Lee Y. Weight status and dietary factors associated with sugar-sweetened beverage intake among Korean children and adolescents - Korea National Health and Nutrition Examination Survey, 2008-2011. Clin Nutr Res 2013;2:135-42. https://doi.org/10.7762/cnr.2013.2.2.135
  29. Ministry of Food and Drug Safety. The First Phase of Sugar Intake Ruduction Plan (2016-2020). Monitoring of Total Sugar and Sodium Contents [Internet]. Cheongju: Ministry of Food and Drug Safety; 2016 [cited 2017 December 15]. Available from: http://www.kfda.go. kr/index.do.
  30. Krebs NF, Jacobson MS; American Academy of Pediatrics Committee on Nutrition. Prevention of pediatric overweight and obesity. Pediatrics 2003;112:424-30. https://doi.org/10.1542/peds.112.2.424
  31. Mikkilä V, Räsänen L, Raitakari OT, Pietinen P, Viikari J. Consistent dietary patterns identified from childhood to adulthood: the cardiovascular risk in Young Finns Study. Br J Nutr 2005;93:923-31. https://doi.org/10.1079/BJN20051418
  32. Committee of Clinical Practice Guidelines, Korean Society for the Study of Obesity. 2014 Clinical Practice Guidelines for Overweight and Obesity in Korea. Seoul: Committee of Clinical Practice Guidelines, Korean Society for the Study of Obesity; 2014.
  33. Ministry of Food and Drug Safety, Korea Health Industry Development Institute. Sugar Database Compilation for Commonly Consumed Foods, 2015. Cheongju: Ministry of Food and Drug Safety, Korea Health Industry Development Institute; 2015.
  34. Newens KJ, Walton J. A review of sugar consumption from nationally representative dietary surveys across the world. J Hum Nutr Diet 2016;29:225-40. https://doi.org/10.1111/jhn.12338
  35. World Health Organization. Guideline: Sugars Intake for Adults and Children. Geneva: World Health Organization; 2015
  36. United States Department of Agriculture. Dietary Guidelines for Americans 2015-2020, 8th edition. Washington, D.C.: United States Department of Agriculture; 2015.
  37. Hursti UK, Becker W. Nordic Nutrition Recommendations 2012: Integrating Nutrition and Physical Activity. Copenhagen: Nordic Council; 2014.
  38. The Korean Nutrition Society. Dietary Reference Intakes for Koreans. Seoul: The Korean Nutrition Society; 2015.
  39. Welsh JA, Sharma AJ, Grellinger L, Vos MB. Consumption of added sugars is decreasing in the United States. Am J Clin Nutr 2011;94: 726-34. https://doi.org/10.3945/ajcn.111.018366
  40. Langlois K, Garriguet D. Sugar consumption among Canadians of all ages. Health Rep 2011;22:23-7.
  41. Monteiro CA, Levy RB, Claro RM, de Castro IR, Cannon G. Increasing consumption of ultra-processed foods and likely impact on human health: evidence from Brazil. Public Health Nutr 2011;14:5-13. https://doi.org/10.1017/S1368980010003241
  42. Olsen NJ, Andersen LB, Wedderkopp N, Kristensen PL, Heitmann BL. Intake of liquid and solid sucrose in relation to changes in body fatness over 6 years among 8- to 10-year-old children: the European Youth Heart Study. Obes Facts 2012;5:506-12. https://doi.org/10.1159/000341631
  43. Ha K, Chung S, Lee HS, Kim CI, Joung H, Paik HY, Song Y. Association of dietary sugars and sugar-sweetened beverage intake with obesity in Korean children and adolescents. Nutrients 2016;8:pii: E31.
  44. Wang YC, Bleich SN, Gortmaker SL. Increasing caloric contribution from sugar-sweetened beverages and 100% fruit juices among US children and adolescents, 1988-2004. Pediatrics 2008;121:e1604-14. https://doi.org/10.1542/peds.2007-2834
  45. Malik VS, Schulze MB, Hu FB. Intake of sugar-sweetened beverages and weight gain: a systematic review. Am J Clin Nutr 2006.84: 274-88. https://doi.org/10.1093/ajcn/84.2.274
  46. Elliott SS, Keim NL, Stern JS, Teff K, Havel PJ. Fructose, weight gain, and the insulin resistance syndrome. Am J Clin Nutr 2002;76:911-22. https://doi.org/10.1093/ajcn/76.5.911
  47. Bray GA, Nielsen SJ, Popkin BM. Consumption of high-fructose corn syrup in beverages may play a role in the epidemic of obesity. Am J Clin Nutr 2004;79:537-43. https://doi.org/10.1093/ajcn/79.4.537
  48. Cassady BA, Considine RV, Mattes RD. Beverage consumption, appetite, and energy intake: what did you expect? Am J Clin Nutr 2012;95:587-93. https://doi.org/10.3945/ajcn.111.025437
  49. Collison KS, Zaidi MZ, Subhani SN, Al-Rubeaan K, Shoukri M, Al-Mohanna FA. Sugar-sweetened carbonated beverage consumption correlates with BMI, waist circumference, and poor dietary choices in school children. BMC Public Health 2010;10:234. https://doi.org/10.1186/1471-2458-10-234
  50. James J, Thomas P, Cavan D, Kerr D. Preventing childhood obesity by reducing consumption of carbonated drinks: cluster randomised controlled trial. BMJ 2004;328:1237. https://doi.org/10.1136/bmj.38077.458438.EE
  51. Malik VS, Pan A, Willett WC, Hu FB. Sugar-sweetened beverages and weight gain in children and adults: a systematic review and meta-analysis. Am J Clin Nutr 2013;98:1084-102. https://doi.org/10.3945/ajcn.113.058362

Cited by

  1. Lack of Association of Coffee Consumption with the Prevalence of Self-Reported Type 2 Diabetes Mellitus in a Mexican Population: A Cross-Sectional Study vol.15, pp.10, 2018, https://doi.org/10.3390/ijerph15102100
  2. Metabolic syndrome as a risk factor for high intraocular pressure: the Korea National Health and Nutrition Examination Survey 2008–2010 vol.12, pp.None, 2019, https://doi.org/10.2147/dmso.s185604
  3. 한국 청소년의 스마트폰 사용과 가당 음료 섭취의 관련성: 제13차 청소년건강행태조사를 기반으로 vol.21, pp.2, 2018, https://doi.org/10.5762/kais.2020.21.2.578
  4. Association between protein‐rich dietary patterns and anthropometric measurements among children aged 6 years vol.77, pp.3, 2018, https://doi.org/10.1111/1747-0080.12609
  5. Trends in Beverage Consumption and Related Demographic Factors and Obesity among Korean Children and Adolescents vol.12, pp.9, 2020, https://doi.org/10.3390/nu12092651
  6. Association between Relative Handgrip Strength and Dyslipidemia in Korean Adults: Findings of the 2014–2015 Korea National Health and Nutrition Examination Survey vol.41, pp.6, 2018, https://doi.org/10.4082/kjfm.19.0073
  7. Dietary Sugar Intake and Its Association with Obesity in Children and Adolescents vol.8, pp.8, 2021, https://doi.org/10.3390/children8080676
  8. Dietary intake and nutritional status of Korean children and adolescents: a review of national survey data vol.64, pp.9, 2018, https://doi.org/10.3345/cep.2020.01655
  9. Association of beverage consumption types with weight, height, and body mass index in grade 3 children in northern Taiwan: A cross-sectional study vol.90, pp.None, 2021, https://doi.org/10.1016/j.nut.2021.111173
  10. Sugar Content of Market Beverages and Children’s Sugar Intake from Beverages in Beijing, China vol.13, pp.12, 2018, https://doi.org/10.3390/nu13124297