Sugar-Sweetened Beverages and Obesity Risk in Children and Adolescents: A Systematic Analysis on How Methodological Quality May Influence Conclusions

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2016 Apr;116(4):638-59.

doi: 10.1016/j.jand.2015.05.020.

Epub 2015 Jul 17.

Sophie Bucher Della Torre ,

Amelie Keller ,

Jocelyne Laure Depeyre ,

Maaike Kruseman

PMID: 26194333

DOI: 10.1016/j.jand.2015.05.020

Sophie Bucher Della Torre  et al.

J Acad Nutr Diet .

2016 Apr .

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2016 Apr;116(4):638-59.

doi: 10.1016/j.jand.2015.05.020.

Epub 2015 Jul 17.

Authors

Sophie Bucher Della Torre ,

Amelie Keller ,

Jocelyne Laure Depeyre ,

Maaike Kruseman

PMID: 26194333

DOI: 10.1016/j.jand.2015.05.020

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Abstract

Background: In the context of a worldwide high prevalence of childhood obesity, the role of sugar-sweetened beverage (SSB) consumption as a cause of excess weight gain remains controversial. Conflicting results may be due to methodological issues in original studies and in reviews.

Objective: The aim of this review was to systematically analyze the methodology of studies investigating the influence of SSB consumption on risk of obesity and obesity among children and adolescents, and the studies' ability to answer this research question.

Methods: A systematic review of cohort and experimental studies published until December 2013 in peer-reviewed journals was performed on Medline, CINAHL, Web of Knowledge, and ClinicalTrials.gov. Studies investigating the influence of SSB consumption on risk of obesity and obesity among children and adolescents were included, and methodological quality to answer this question was assessed independently by two investigators using the Academy of Nutrition and Dietetics Quality Criteria Checklist.

Results: Among the 32 identified studies, nine had positive quality ratings and 23 studies had at least one major methodological issue. Main methodological issues included SSB definition and inadequate measurement of exposure. Studies with positive quality ratings found an association between SSB consumption and risk of obesity or obesity (n=5) (ie, when SSB consumption increased so did obesity) or mixed results (n=4). Studies with a neutral quality rating found a positive association (n=7), mixed results (n=9), or no association (n=7).

Conclusions: The present review shows that the majority of studies with strong methodology indicated a positive association between SSB consumption and risk of obesity or obesity, especially among overweight children. In addition, study findings highlight the need for the careful and precise measurement of the consumption of SSBs and of important confounders.

Keywords: Adolescents; Children; Food intake measurement; Obesity; Sugar-sweetened beverages.

Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

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Review Actions Search in PubMed Search in MeSH Add to Search

Systematic Review Actions Search in PubMed Search in MeSH Add to Search

MeSH terms

Adolescent Actions Search in PubMed Search in MeSH Add to Search

Beverages / adverse effects* Actions Search in PubMed Search in MeSH Add to Search

Carbonated Beverages / adverse effects Actions Search in PubMed Search in MeSH Add to Search

Child Actions Search in PubMed Search in MeSH Add to Search

Child, Preschool Actions Search in PubMed Search in MeSH Add to Search

Cohort Studies Actions Search in PubMed Search in MeSH Add to Search

Diet Records Actions Search in PubMed Search in MeSH Add to Search

Dietary Sucrose / administration & dosage* Actions Search in PubMed Search in MeSH Add to Search

Dietary Sucrose / adverse effects* Actions Search in PubMed Search in MeSH Add to Search

Female Actions Search in PubMed Search in MeSH Add to Search

Humans Actions Search in PubMed Search in MeSH Add to Search

MEDLINE Actions Search in PubMed Search in MeSH Add to Search

Male Actions Search in PubMed Search in MeSH Add to Search

Obesity / epidemiology* Actions Search in PubMed Search in MeSH Add to Search

Pediatric Obesity / epidemiology Actions Search in PubMed Search in MeSH Add to Search

Quality Control Actions Search in PubMed Search in MeSH Add to Search

Reproducibility of Results Actions Search in PubMed Search in MeSH Add to Search

Retrospective Studies Actions Search in PubMed Search in MeSH Add to Search

Risk Factors Actions Search in PubMed Search in MeSH Add to Search

Selection Bias Actions Search in PubMed Search in MeSH Add to Search

Surveys and Questionnaires Actions Search in PubMed Search in MeSH Add to Search

Weight Gain Actions Search in PubMed Search in MeSH Add to Search

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Search in PubMed. Search in NLM Catalog. Add to Search. . 2016 Apr;116(4):638-59. doi: 10.1016/j.jand.2015.05.020. Epub 2015 Jul 17. Sophie Bucher Della Torre , Amelie Keller , Jocelyne Laure Depeyre , Maaike Kruseman. PMID: 26194333. DOI: 10.1016/j.jand.2015.05.020. Sophie Bucher Della Torre  et al. J Acad Nutr Diet . 2016 Apr . Show details. Display options. Format. Search in PubMed. Search in NLM Catalog. Add to Search. . 2016 Apr;116(4):638-59. doi: 10.1016/j.jand.2015.05.020. Epub 2015 Jul 17. Authors. Sophie Bucher Della Torre , Amelie Keller , Jocelyne Laure Depeyre , Maaike Kruseman. PMID: 26194333. DOI: 10.1016/j.jand.2015.05.020. Cite. Display options. Format. Abstract. Background: In the context of a worldwide high prevalence of childhood obesity, the role of sugar-sweetened beverage (SSB) consumption as a cause of excess weight gain remains controversial. Conflicting results may be due to methodological issues in original studies and in reviews. Objective: The aim of this review was to systematically analyze the methodology of studies investigating the influence of SSB consumption on risk of obesity and obesity among children and adolescents, and the studies' ability to answer this research question. Methods: A systematic review of cohort and experimental studies published until December 2013 in peer-reviewed journals was performed on Medline, CINAHL, Web of Knowledge, and ClinicalTrials.gov. Studies investigating the influence of SSB consumption on risk of obesity and obesity among children and adolescents were included, and methodological quality to answer this question was assessed independently by two investigators using the Academy of Nutrition and Dietetics Quality Criteria Checklist. Results: Among the 32 identified studies, nine had positive quality ratings and 23 studies had at least one major methodological issue. Main methodological issues included SSB definition and inadequate measurement of exposure. Studies with positive quality ratings found an association between SSB consumption and risk of obesity or obesity (n=5) (ie, when SSB consumption increased so did obesity) or mixed results (n=4). Studies with a neutral quality rating found a positive association (n=7), mixed results (n=9), or no association (n=7). Conclusions: The present review shows that the majority of studies with strong methodology indicated a positive association between SSB consumption and risk of obesity or obesity, especially among overweight children. In addition, study findings highlight the need for the careful and precise measurement of the consumption of SSBs and of important confounders. Keywords: Adolescents; Children; Food intake measurement; Obesity; Sugar-sweetened beverages. Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved. Similar articles. Beverage Consumption and Growth, Size, Body Composition, and Risk of Overweight and Obesity: A Systematic Review [Internet]. Mayer-Davis E, Leidy H, Mattes R, Naimi T, Novotny R, Schneeman B, Kingshipp BJ, Spill M, Cole NC, Bahnfleth CL, Butera G, Terry N, Obbagy J. Mayer-Davis E, et al. Alexandria (VA): USDA Nutrition Evidence Systematic Review; 2020 Jul. Alexandria (VA): USDA Nutrition Evidence Systematic Review; 2020 Jul. PMID: 35349233 Free Books & Documents. Review. Sugar-Sweetened Beverages and Obesity among Children and Adolescents: A Review of Systematic Literature Reviews. Keller A, Bucher Della Torre S. Keller A, et al. Child Obes. 2015 Aug;11(4):338-46. doi: 10.1089/chi.2014.0117. Child Obes. 2015. PMID: 26258560 Free PMC article. Review. Intake of sugar-sweetened beverages and weight gain: a systematic review. Malik VS, Schulze MB, Hu FB. Malik VS, et al. Am J Clin Nutr. 2006 Aug;84(2):274-88. doi: 10.1093/ajcn/84.1.274. Am J Clin Nutr. 2006. PMID: 16895873 Free PMC article. Review. Sugar-sweetened beverage consumption and age at menarche in a prospective study of US girls. Carwile JL, Willett WC, Spiegelman D, Hertzmark E, Rich-Edwards J, Frazier AL, Michels KB. Carwile JL, et al. Hum Reprod. 2015 Mar;30(3):675-83. doi: 10.1093/humrep/deu349. Epub 2015 Jan 27. Hum Reprod. 2015. PMID: 25628346 Free PMC article. Resolved: there is sufficient scientific evidence that decreasing sugar-sweetened beverage consumption will reduce the prevalence of obesity and obesity-related diseases. Hu FB. Hu FB. Obes Rev. 2013 Aug;14(8):606-19. doi: 10.1111/obr.12040. Epub 2013 Jun 13. Obes Rev. 2013. PMID: 23763695 Free PMC article. Review. See all similar articles. Cited by. Effects of a mobile health nutrition intervention on dietary intake in children who have autism spectrum disorder. Kral TVE, O'Malley L, Johnson K, Benvenuti T, Chittams J, Quinn RJ, Thomas JG, Pinto-Martin JA, Levy SE, Kuschner ES. Kral TVE, et al. Front Pediatr. 2023 Feb 15;11:1100436. doi: 10.3389/fped.2023.1100436. eCollection 2023. Front Pediatr. 2023. PMID: 36873654 Free PMC article. The Severity of Obesity Promotes Greater Dehydration in Children: Preliminary Results. Kozioł-Kozakowska A, Wojcik M, Stochel-Gaudyn A, Szczudlik E, Suder A, Piorecka B. Kozioł-Kozakowska A, et al. Nutrients. 2022 Dec 3;14(23):5150. doi: 10.3390/nu14235150. Nutrients. 2022. PMID: 36501180 Free PMC article. Childhood Obesity: Position Statement of Polish Society of Pediatrics, Polish Society for Pediatric Obesity, Polish Society of Pediatric Endocrinology and Diabetes, the College of Family Physicians in Poland and Polish Association for Study on Obesity. Mazur A, Zachurzok A, Baran J, Deren K, Łuszczki E, Weres A, Wyszynska J, Dylczyk J, Szczudlik E, Drozdz D, Metelska P, Brzezinski M, Kozioł-Kozakowska A, Matusik P, Socha P, Olszanecka-Gilianowicz M, Jackowska T, Walczak M, Peregud-Pogorzelski J, Tomiak E, Wojcik M. Mazur A, et al. Nutrients. 2022 Sep 15;14(18):3806. doi: 10.3390/nu14183806. Nutrients. 2022. PMID: 36145182 Free PMC article. How the "Are We Drinking Ourselves Sick?" Communication Campaign Built Support for Policy Action on Sugary Drinks in Jamaica. Christian D, Maharjan M, Kotov A, Cotter T, Mullin S, Nurse V, McGaw B, Chen D, Puri P, Wang S, Negi NS, Murukutla N. Christian D, et al. Nutrients. 2022 Jul 13;14(14):2866. doi: 10.3390/nu14142866. Nutrients. 2022. PMID: 35889823 Free PMC article. Ecological factors and childhood eating behaviours at 5 years of age: findings from the ROLO longitudinal birth cohort study. Delahunt A, Conway MC, O'Brien EC, Geraghty AA, O'Keeffe LM, O'Reilly SL, McDonnell CM, Kearney PM, Mehegan J, McAuliffe FM. Delahunt A, et al. BMC Pediatr. 2022 Jun 27;22(1):366. doi: 10.1186/s12887-022-03423-x. BMC Pediatr. 2022. PMID: 35754036 Free PMC article. Clinical Trial. See all "Cited by" articles. Publication types. Research Support, Non-U.S. Gov't Actions Search in PubMed Search in MeSH Add to Search. Review Actions Search in PubMed Search in MeSH Add to Search. Systematic Review Actions Search in PubMed Search in MeSH Add to Search. MeSH terms. Adolescent Actions Search in PubMed Search in MeSH Add to Search. Beverages / adverse effects* Actions Search in PubMed Search in MeSH Add to Search. Carbonated Beverages / adverse effects Actions Search in PubMed Search in MeSH Add to Search. Child Actions Search in PubMed Search in MeSH Add to Search. Child, Preschool Actions Search in PubMed Search in MeSH Add to Search. Cohort Studies Actions Search in PubMed Search in MeSH Add to Search. Diet Records Actions Search in PubMed Search in MeSH Add to Search. Dietary Sucrose / administration & dosage* Actions Search in PubMed Search in MeSH Add to Search. Dietary Sucrose / adverse effects* Actions Search in PubMed Search in MeSH Add to Search. Female Actions Search in PubMed Search in MeSH Add to Search. Humans Actions Search in PubMed Search in MeSH Add to Search. MEDLINE Actions Search in PubMed Search in MeSH Add to Search. Male Actions Search in PubMed Search in MeSH Add to Search. Obesity / epidemiology* Actions Search in PubMed Search in MeSH Add to Search. Pediatric Obesity / epidemiology Actions Search in PubMed Search in MeSH Add to Search. Quality Control Actions Search in PubMed Search in MeSH Add to Search. Reproducibility of Results Actions Search in PubMed Search in MeSH Add to Search. Retrospective Studies Actions Search in PubMed Search in MeSH Add to Search. Risk Factors Actions Search in PubMed Search in MeSH Add to Search. Selection Bias Actions Search in PubMed Search in MeSH Add to Search. Surveys and Questionnaires Actions Search in PubMed Search in MeSH Add to Search. Weight Gain Actions Search in PubMed Search in MeSH Add to Search. Substances. Dietary Sucrose Actions Search in PubMed Search in MeSH Add to Search. Related information. MedGen. LinkOut - more resources. Full Text Sources ClinicalKey ClinicalKey Nursing Elsevier Science. Other Literature Sources scite Smart Citations. Medical Genetic Alliance MedlinePlus Health Information.