title: Sugar-sweetened carbonated beverage consumption correlates with BMI, waist circumference, and poor dietary choices in school children.
abstract: BACKGROUND
  The prevalence of obesity and overweight is increasing globally. Frequently coexisting with under-nutrition in developing countries, obesity is a major contributor to chronic disease, and will become a serious healthcare burden especially in countries with a larger percentage of youthful population. 35% of the population of Saudi Arabia are under the age of 16, and adult dietary preferences are often established during early childhood years. Our objective was to examine the dietary habits in relation to body-mass-index (BMI) and waist circumference (W_C), together with exercise and sleep patterns in a cohort of male and female Saudi school children, in order to ascertain whether dietary patterns are associated with obesity phenotypes in this population.
  
  
  METHODS
  5033 boys and 4400 girls aged 10 to 19 years old participated in a designed Food Frequency Questionnaire. BMI and W_C measurements were obtained and correlated with dietary intake.
  
  
  RESULTS
  The overall prevalence of overweight and obesity was 12.2% and 27.0% respectively, with boys having higher obesity rates than girls (P <or= 0.001). W_C and BMI was positively correlated with sugar-sweetened carbonated beverage (SSCB) intake in boys only. The association between male BMI and SSCB consumption was significant in a multivariate regression model (P < 0.0001). SSCB intake was positively associated with poor dietary choices in both males and females. Fast food meal intake, savory snacks, iced desserts and total sugar consumption correlated with SSCB intake in both boys (r = 0.39, 0.13, 0.10 and 0.52 respectively, P < 0.001) and girls (r = 0.45, 0.23, 0.16 and 0.55 respectively, P < 0.001). Older children reported eating significantly less fruit and vegetables than younger children; and less eggs, fish and cereals. Conversely, consumption of SSCB and sugar-sweetened hot beverages were higher in older versus younger children (P < 0.001). BMI and W_C were negatively correlated with hours of night-time sleep and exercise in boys, but only with night time sleep in girls, who also showed the lowest frequency of exercise.
  
  
  CONCLUSIONS
  A higher intake of SSCB is associated with poor dietary choices. Male SSCB intake correlates with a higher W_C and BMI. Limiting exposure to SSCB could therefore have a large public health impact.
authors.affiliation: Cell Biology & Diabetes Research Unit, Department of Biological & Medical Research, King Faisal Specialist Hospital & Research Centre, PO BOX 3354, Riyadh 11211, Saudi Arabia. kate@kfshrc.edu.sa
authors.forename: Kate S
authors.initials: KS
authors.lastname: Collison
authors.forename: Marya Z
authors.initials: MZ
authors.lastname: Zaidi
authors.forename: Shazia N
authors.initials: SN
authors.lastname: Subhani
authors.forename: Khalid
authors.initials: K
authors.lastname: Al-Rubeaan
authors.forename: Mohammed
authors.initials: M
authors.lastname: Shoukri
authors.forename: Futwan A
authors.initials: FA
authors.lastname: Al-Mohanna
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002253:Carbonated Beverages / Q000009:adverse effects* / Q000706:statistics & numerical data; D002648:Child; D004032:Diet; D019422:Dietary Sucrose / Q000009:adverse effects*; D015444:Exercise; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000209:etiology; D050177:Overweight / Q000209:etiology*; D012529:Saudi Arabia; D011795:Surveys and Questionnaires; D055105:Waist Circumference; D055815:Young Adult
chemical_list: D019422:Dietary Sucrose
references.citation: Am J Clin Nutr. 2007 Jun;85(6):1465-77
references.pmid: 17556681
references.citation: Am J Clin Nutr. 2003 Jan;77(1):257-65
references.pmid: 12499350
references.citation: East Mediterr Health J. 2007 Mar-Apr;13(2):441-8
references.pmid: 17684864
references.citation: Hypertension. 2008 Mar;51(3):629-34
references.pmid: 18287345
references.citation: Am J Public Health. 2007 Apr;97(4):667-75
references.pmid: 17329656
references.citation: Am J Epidemiol. 2008 Jun 15;167(12):1465-75
references.pmid: 18417494
references.citation: Scand J Public Health. 2005;33(2):99-106
references.pmid: 15823970
references.citation: Arch Pediatr Adolesc Med. 2005 Aug;159(8):740-4
references.pmid: 16061781
references.citation: J Am Diet Assoc. 2008 Jan;108(1):131-5
references.pmid: 18155999
references.citation: J Am Coll Nutr. 2003 Dec;22(6):539-45
references.pmid: 14684760
references.citation: Saudi Med J. 2005 Dec;26(12):1918-25
references.pmid: 16380773
references.citation: Prev Med. 2003 Jun;36(6):669-75
references.pmid: 12744909
references.citation: Ann Saudi Med. 2008 Sep-Oct;28(5):334-40
references.pmid: 18779639
references.citation: Ann Epidemiol. 2009 Feb;19(2):134-42
references.pmid: 19185808
references.citation: Public Health Nutr. 2009 Oct;12(10):1816-22
references.pmid: 19195421
references.citation: East Mediterr Health J. 1999 Nov;5(6):1236-42
references.pmid: 11924118
references.citation: Nutr Metab (Lond). 2005 Feb 21;2(1):5
references.pmid: 15723702
references.citation: Int J Paediatr Dent. 2006 May;16(3):168-73
references.pmid: 16643537
references.citation: Gastroenterology. 2007 May;132(6):2087-102
references.pmid: 17498505
references.citation: Pediatrics. 1998 Mar;101(3 Pt 2):518-25
references.pmid: 12224658
references.citation: N Engl J Med. 1992 Nov 5;327(19):1350-5
references.pmid: 1406836
references.citation: Crit Rev Food Sci Nutr. 2007;47(6):561-82
references.pmid: 17653981
references.citation: Int J Obes (Lond). 2008 Dec;32 Suppl 6:S28-34
references.pmid: 19079277
references.citation: Am J Health Promot. 2000 Mar-Apr;14(4):222-8
references.pmid: 10915532
references.citation: Saudi Med J. 2007 Oct;28(10):1569-74
references.pmid: 17914521
references.citation: Ann Saudi Med. 2002 Sep-Nov;22(5-6):303-7
references.pmid: 17146248
references.citation: Methods Mol Biol. 2009;472:57-88
references.pmid: 19107429
references.citation: Br J Sports Med. 2007 May;41(5):311-6
references.pmid: 17395610
references.citation: Obes Rev. 2008 Sep;9(5):474-88
references.pmid: 18331423
references.citation: Saudi Med J. 2004 Nov;25(11):1603-10
references.pmid: 15573186
references.citation: Nutr Hosp. 2009 Jan-Feb;24(1):97-102
references.pmid: 19266121
references.citation: East Mediterr Health J. 2002 Jul-Sep;8(4-5):470-9
references.pmid: 15603027
references.citation: Circulation. 2007 Jul 31;116(5):480-8
references.pmid: 17646581
references.citation: Lancet. 2001 Feb 17;357(9255):505-8
references.pmid: 11229668
references.citation: J Pediatr. 2004 Oct;145(4):439-44
references.pmid: 15480363
references.citation: Am J Clin Nutr. 2008 May;87(5):1212-8
references.pmid: 18469241
references.citation: Saudi Med J. 2007 Mar;28(3):415-21
references.pmid: 17334472
references.citation: Public Health Nutr. 2010 Jun;13(6):797-805
references.pmid: 19772691
references.citation: Obesity (Silver Spring). 2009 Jun;17(6):1255-61
references.pmid: 19214172
references.citation: Am J Prev Med. 2004 Oct;27(3):205-10
references.pmid: 15450632
references.citation: Obes Res. 2005 Jul;13(7):1205-17
references.pmid: 16076990
references.citation: Medscape J Med. 2008;10(8):189
references.pmid: 18924641
references.citation: Diabetes Care. 2005 Sep;28(9):2322-5
references.pmid: 16123512
references.citation: Obes Res. 2001 Mar;9(3):171-8
references.pmid: 11323442
references.citation: J Am Diet Assoc. 2006 Nov;106(11):1846-50
references.pmid: 17081835
references.citation: Int J Obes Relat Metab Disord. 2001 Dec;25(12):1823-33
references.pmid: 11781764
references.citation: Obes Res. 1999 Sep;7(5):438-43
references.pmid: 10509600
references.citation: J Am Diet Assoc. 2008 Dec;108(12):1997-2004
references.pmid: 19027402
references.citation: Am J Prev Med. 2003 Jul;25(1):9-16
references.pmid: 12818304
references.citation: Br J Nutr. 2003 Mar;89(3):419-29
references.pmid: 12628036
references.citation: Obes Res. 2004 May;12(5):778-88
references.pmid: 15166298
references.citation: World Health Organ Tech Rep Ser. 2000;894:i-xii, 1-253
references.pmid: 11234459
references.citation: West J Med. 1988 Oct;149(4):429-41
references.pmid: 3067447
references.citation: J Am Diet Assoc. 2003 Oct;103(10):1326-31
references.pmid: 14520252
references.citation: Obesity (Silver Spring). 2006 Jun;14(6):1073-84
references.pmid: 16861613
references.citation: Pediatr Clin North Am. 2001 Aug;48(4):969-80
references.pmid: 11494646
references.citation: Obes Res. 2003 Sep;11(9):1096-103
references.pmid: 12972680
references.citation: Med Sci Sports Exerc. 2009 May;41(5):998-1005
references.pmid: 19346988