title: Usual intake of added sugars and lipid profiles among the U.S. adolescents: National Health and Nutrition Examination Survey, 2005-2010.
abstract: OBJECTIVE
  Although studies suggest that higher consumption of added sugars is associated with cardiovascular risk factors in adolescents, none have adjusted for measurement errors or examined its association with the risk of dyslipidemia.
  
  
  METHODS
  We analyzed data of 4,047 adolescents aged 12-19 years from the 2005-2010 National Health and Nutrition Examination Survey, a nationally representative, cross-sectional survey. We estimated the usual percentage of calories (%kcal) from added sugars using up to two 24-hour dietary recalls and the National Cancer Institute method to account for measurement error.
  
  
  RESULTS
  The average usual %kcal from added sugars was 16.0%. Most adolescents (88.0%) had usual intake of ≥10% of total energy, and 5.5% had usual intake of ≥25% of total energy. After adjustment for potential confounders, usual %kcal from added sugars was inversely associated with high-density lipoprotein (HDL) and positively associated with triglycerides (TGs), TG-to-HDL ratio, and total cholesterol (TC) to HDL ratio. Comparing the lowest and highest quintiles of intake, HDLs were 49.5 (95% confidence interval [CI], 47.4-51.6) and 46.4 mg/dL (95% CI, 45.2-47.6; p = .009), TGs were 85.6 (95% CI, 75.5-95.6) and 101.2 mg/dL (95% CI, 88.7-113.8; p = .037), TG to HDL ratios were 2.28 (95% CI, 1.84-2.70) and 2.73 (95% CI, 2.11-3.32; p = .017), and TC to HDL ratios were 3.41 (95% CI, 3.03-3.79) and 3.70 (95% CI, 3.24-4.15; p = .028), respectively. Comparing the highest and lowest quintiles of intake, adjusted odds ratio of dyslipidemia was 1.41 (95% CI, 1.01-1.95). The patterns were consistent across sex, race/ethnicity, and body mass index subgroups. No association was found for TC, low-density lipoprotein, and non-HDL cholesterol.
  
  
  CONCLUSIONS
  Most U.S. adolescents consumed more added sugars than recommended for heart health. Usual intake of added sugars was significantly associated with several measures of lipid profiles.
authors.affiliation: Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia. Electronic address: zzhang3@cdc.gov.
authors.forename: Zefeng
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Cathleen
authors.initials: C
authors.lastname: Gillespie
authors.affiliation: Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia; Wellness Department, Children's Healthcare of Atlanta, Atlanta, Georgia.
authors.forename: Jean A
authors.initials: JA
authors.lastname: Welsh
authors.affiliation: Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts; Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts.
authors.forename: Frank B
authors.initials: FB
authors.lastname: Hu
authors.affiliation: Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Quanhe
authors.initials: Q
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D001294:Attitude to Health; D002648:Child; D002784:Cholesterol / Q000097:blood; D016001:Confidence Intervals; D019422:Dietary Sucrose / Q000008:administration & dosage*; D050171:Dyslipidemias / Q000453:epidemiology* / Q000517:prevention & control; D002149:Energy Intake; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008055:Lipids / Q000097:blood*; D008297:Male; D009749:Nutrition Surveys; D016017:Odds Ratio; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D014481:United States
chemical_list: D019422:Dietary Sucrose; D008055:Lipids; D002784:Cholesterol
keywords: Added sugars; Dyslipidemia; Lipid profiles; Usual percentage of calories