title: Consumption of sugar-sweetened beverages is associated with components of the metabolic syndrome in adolescents.
abstract: Sugar-sweetened beverages (SSBs) are the principle source of added sugar in diets. Cardiometabolic disturbances can occur from early childhood to adulthood. The aim of this cross-sectional study was to examine the gender-specific association of SSB intake with metabolic syndrome (MetS) and its components among adolescents in Taiwan. A total of 2727 adolescents aged 12 to 16 years randomly selected from three diverse economic areas in Southern Taiwan by using a multistage-sampling strategy participated in this study. Demographic, dietary, physical and anthropometric parameters were measured, and serum lipid profiles and glucose levels were determined. The International Diabetes Federation (IDF) specifies that MetS requires abdominal obesity and ≥2 abnormal components, and Cook criteria for MetS require ≥3 abnormal components. We applied survey-data modules to data analyses, and used multiple regression and logistic models to adjust for covariates. An increased SSB intake was linked to a greater waist circumference in both sexes and to systolic blood pressure in boys (P for trend: ≤0.043). Male moderate and high consuming SSB drinkers exhibited triglyceride levels that were 8.0 and 8.2 mg/dL significantly higher, respectively, than those of nondrinkers. Compared with nondrinkers, boys who consumed >500 mL/day (high quantity) of SSBs exhibited 10.3-fold (95% confidence intervals (CIs): 1.2-90.2) and 5.1-fold (95% CIs: 1.01-25.5) risks of contracting MetS, as defined by the IDF and Cook criteria for MetS, respectively. In girls, the risk estimates for the same comparison were not significant by the IDF criteria (6.5-fold risk, 95% CIs: 0.9-∞) or Cook criteria (5.9-fold risk, 95% CIs: 0.8-43.8) for MetS. High SSB consumption was also linked to 1.9-fold (95% CIs: 1.1-3.1) and 2.7-fold (95% CIs: 1.3-5.7) higher risks of being at a greater overall metabolic risk in girls and boys, respectively. In conclusion, a high SSB intake is associated with adolescent MetS among boys but not girls in Taiwan.
authors.affiliation: Graduate Institute of Medicine, College of Medicine and Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung 807, Taiwan. tefu.chan@msa.hinet.net.
authors.forename: Te-Fu
authors.initials: TF
authors.lastname: Chan
authors.affiliation: Institute of Environmental and Occupational Health Sciences, National Yang Ming University, 155, Section 2, Li-Nong Street, Taipei 112, Taiwan. wtlin0123@gmail.com.
authors.forename: Wei-Ting
authors.initials: WT
authors.lastname: Lin
authors.affiliation: Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung 807, Taiwan. hhuang@kmu.edu.tw.
authors.forename: Hsiao-Ling
authors.initials: HL
authors.lastname: Huang
authors.affiliation: Department of Public Health, College of Health Sciences, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung 807, Taiwan. cying@ms19.hinet.net.
authors.forename: Chun-Ying
authors.initials: CY
authors.lastname: Lee
authors.affiliation: Department of Public Health, College of Health Sciences, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung 807, Taiwan. catstar1211@gmail.com.
authors.forename: Pei-Wen
authors.initials: PW
authors.lastname: Wu
authors.affiliation: Health Policy and Systems Management Program, Health Sciences Center, School of Public Health, Louisiana State University, 433 Bolivar St, New Orleans, LA 70112, USA. YChiu@lsuhsc.edu.
authors.forename: Yu-Wen
authors.initials: YW
authors.lastname: Chiu
authors.affiliation: Department of Laboratory Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, 482 Shanming Road, Kaohsiung 812, Taiwan. 0870791@kmhk.org.tw.
authors.forename: Chun-Chi
authors.initials: CC
authors.lastname: Huang
authors.affiliation: Department of Laboratory Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, 482 Shanming Road, Kaohsiung 812, Taiwan. 0870718@kmhk.org.tw.
authors.forename: Sharon
authors.initials: S
authors.lastname: Tsai
authors.affiliation: Department of Surgery, College of Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung 807, Taiwan. cnhung@kmu.edu.tw.
authors.forename: Chih-Lung
authors.initials: CL
authors.lastname: Lin
authors.affiliation: Department of Public Health, College of Health Sciences, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung 807, Taiwan. cnhung@kmu.edu.tw.
authors.forename: Chien-Hung
authors.initials: CH
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D001628:Beverages / Q000032:analysis*; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D002648:Child; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL; D003430:Cross-Sectional Studies; D004032:Diet; D019422:Dietary Sucrose / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D056128:Obesity, Abdominal / Q000453:epidemiology; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013549:Sweetening Agents / Q000008:administration & dosage* / Q000009:adverse effects; D013624:Taiwan; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D019422:Dietary Sucrose; D013549:Sweetening Agents; D014280:Triglycerides