title: Using doubly labeled water to validate associations between sugar-sweetened beverage intake and body mass among White and African-American adults.
abstract: BACKGROUND
  Evidence is mixed regarding sugar-sweetened beverage (SSB) intake and adiposity among adults, perhaps because of reporting bias.
  
  
  OBJECTIVE
  The objective of this study is to determine the impact of reporting bias on any associations between increased SSB intake and overweight/obesity.
  
  
  METHODS
  Beverage intake and overweight/obese status (body mass index ≥ 25 kg m(-2)) were examined among adults from a dietary assessment and doubly labeled water study (n=250). Four web-based, 24-h recalls assessed dietary intake. SSB intake was categorized as no intake, 1-99 kcals per day and >99 kcals per day. Logistic regression models adjusted for total caloric intake, age, race, education and diet quality compared SSB intake with overweight/obese status. To investigate dietary self-reporting bias, analyses were replicated in a subset of 'true reporters': those with self-reported total caloric intake within 25% of total energy expenditure per doubly labeled water assessments (n=108).
  
  
  RESULTS
  One-half of participants were overweight/obese; more overweight/obese participants consumed SSB than normal-weight participants (69% vs 47%; P<0.001). Intake of other beverages did not differ by adiposity. Less number of White participants (48%) consumed SSB compared with African-American participants (68%; P=0.002). Compared with no intake, SSB intake up to the median intake doubled the risk of being overweight/obese (odds ratio: 2.1, 95% confidence interval: 1.0-4.3; P=0.046) and SSB intake over the median more than doubled the risk (odds ratio: 2.6, 95% confidence interval: 1.2-6.0; P=0.018). When limited to true reporters, SSB intake significantly increased the risk of being overweight/obese by nearly fourfold.
  
  
  CONCLUSIONS
  Underreporting of SSB intake may be attenuating true associations of SSB intake and the risk of being overweight/obese.
authors.affiliation: 1] Cancer Prevention and Control Program, Moores Cancer Center, University of California, San Diego (UCSD), La Jolla, CA, USA [2] Graduate School of Public Health, San Diego State University, San Diego CA, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Emond
authors.affiliation: Cancer Prevention and Control Program, Moores Cancer Center, University of California, San Diego (UCSD), La Jolla, CA, USA.
authors.forename: R E
authors.initials: RE
authors.lastname: Patterson
authors.affiliation: UCLA Clinical and Translational Research Center, University of California, Los Angeles, Los Angeles, CA, USA.
authors.forename: P M
authors.initials: PM
authors.lastname: Jardack
authors.affiliation: David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
authors.forename: L
authors.initials: L
authors.lastname: Arab
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D015992:Body Mass Index; D002253:Carbonated Beverages / Q000009:adverse effects; D003430:Cross-Sectional Studies; D019422:Dietary Sucrose / Q000009:adverse effects*; D002149:Energy Intake; D004734:Energy Metabolism; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D009765:Obesity / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D012307:Risk Factors; D012959:Socioeconomic Factors; D014481:United States; D014867:Water; D044465:White People / Q000706:statistics & numerical data*
chemical_list: D019422:Dietary Sucrose; D014867:Water