Currently there is intense interest in the possible role of beverages in increases in childhood obesity, particularly sugar-sweetened beverages (SSB) and artificially-sweetened beverages (ASB). Observational and intervention studies in adults have linked the consumption of SSB to weight gain, insulin resistance and dyslipidaemia [1], and CVD incidence in women [2]. Less research has been conducted on children and adolescents. However, limited evidence suggests that SSB and ASB are associated with weight gain and have metabolic effects in young people [3]. Whereas, fruit juice and milk consumption have not been associated with weight gain in children [4].

There have been concurrent increases in obesity prevalence and sweetened beverage consumption in the UK (as well as Australia and USA) over the past two decades. Therefore, the possible association between sweetened beverage (caloric and non caloric) consumption and the development of adiposity during childhood and adolescence deserves investigation.

Hypotheses to be examined in ALSPAC cohort:

1. SSB intake at an early age (7 yrs) predicts SSB intake throughout middle childhood and adolescence, i.e. SSB intake tracks modestly from early childhood into adolescence.

2. Greater intakes of SSB (sugar-sweetened fizzy drinks, squashes, fruit drinks) are independently associated with the longitudinal development of excess adiposity (fat mass, fat mass index) between the ages of 9 and 15 years.

3. Greater intakes of ASB are independently associated with the longitudinal development of excess adiposity between the ages of 9 and 15 years.

4. Greater intakes of fruit juice are not associated with the longitudinal development of excess adiposity between 9 and 15 years of age.

The following will be considered as potential confounding variables in longitudinal models: sex, age, height, baseline fat mass/fat mass index, pubertal stage, physical activity levels. To investigate whether associations with beverage intake are independent of overall diet quality, we will also adjust for score for an energy dense, high fat, low fibre dietary pattern measured at the same time points as beverages.

Data required -

1. 3 day food diary data collected at 7, 10 and 13 years of age (foods and nutrients)

2. Fat mass measured at 9, 10 and 13 years of age

3. Height, weight and BMI at 7 through 15 years

4. Pubertal development (Tanner Stage) from 9 through 15 years

5. Physical activity (accelerometer data) at 11 and 13 years

6. Age (months) from 7 year follow up through to 15 y follow up

Note that the applicants have the data required for this project'- data were obtained for another ALSPAC analyses being conducted by the applicants examining 'Dietary determinants of fat mass in adolescents' (WCRF funded).

References

[1] Malik VS, Popkin BM, Bray GA, Despres J-P, Hu FB. Sugar-sweetened beverages, obesity, Type 2 Diabetes Mellitus, and cardiovascular disease risk. Circulation. 2010;121(11):1356-64.

[2] Fung TT, Malik V, Rexrode KM, Manson JE, Willett WC, Hu FB. Sweetened beverage consumption and risk of coronary heart disease in women. Am J Clin Nutr. 2009;89(4):1037-42.

[3] Brown RJ, de Banate MA, Rother KI. Artificial sweeteners: a systematic review of metabolic effects in youth. Int J Pediatr Obesity. 2010;5(4):305-12.

[4] Fiorito LM, Marini M, Francis LA, Smiciklas-Wright H, Birch LL. Beverage intake of girls at age 5 y predicts adiposity and weight status in childhood and adolescence. Am J Clin Nutr. 2009;90(4):935-42.