Dietary Sugar and Anthropometrics among Young Children in the Guelph Family Health Study: Longitudinal Associations
Publication: Canadian Journal of Dietetic Practice and Research
5 June 2024
Abstract
Purpose: Our understanding of the influence of sugar intake on anthropometrics among young children is limited. Most existing research is cross-sectional and has focused on sugar-sweetened beverages. The study objective was to investigate longitudinal associations between young children’s total, free, and added sugar intake from all food sources at baseline with anthropometric measures at baseline and 18 months.
Methods: The Guelph Family Health Study (GFHS) is an ongoing randomized controlled trial and a family-based health promotion study. Food records and anthropometric data were collected at baseline (n = 109, 55 males; 3.7 ± 1.1 y, mean ± SD) and 18 months (n = 109, 55 males; 5.1 ± 1.1 y) of the GFHS pilots. Associations between sugar intakes and anthropometrics were estimated using linear regression models with generalized estimating equations adjusted for age, sex, household income, and intervention status.
Results: Total sugar intake was inversely associated with body weight at 18 months (P = 0.01). There was no effect of time on any other associations between total, free, and added sugar intakes and anthropometrics.
Conclusions: Early life dietary sugar intakes may not relate to anthropometric measures in the short term. Further investigation into potential associations between dietary sugar intakes and anthropometric variables over longer time periods is warranted.
Résumé
Objectif. Notre compréhension de l’influence de la consommation de sucre sur le profil anthropométrique des jeunes enfants est limitée. La plupart des études existantes sont transversales et portent sur les boissons sucrées. L’objectif de cette étude était d’explorer les associations longitudinales entre la consommation par les jeunes enfants de sucres totaux, libres et ajoutés provenant de toutes sources alimentaires au début de l’étude et les mesures anthropométriques au début de l’étude et après 18 mois.
Méthodes. La Guelph Family Health Study (GFHS) est un essai contrôlé randomisé en cours et une étude de promotion de la santé suivant des familles. Des journaux alimentaires et des données anthropométriques ont été recueillis au début de l’étude (n = 109, 55 garçons; 3,7 ± 1,1 ans, moyenne ± écart-type) et 18 mois (n = 109, 55 garçons; 5,1 ± 1,1 ans) après le début des projets pilotes de la GFHS. Les associations entre la consommation de sucre et les données anthropométriques ont été estimées à l’aide de modèles de régression linéaire avec des équations d’estimation généralisées ajustées en fonction de l’âge, du sexe, du revenu du ménage et du statut de l’intervention.
Résultats. La consommation totale de sucre était inversement associée au poids corporel après 18 mois (P = 0,01). Le temps n’avait d’effet sur aucune autre association entre la consommation de sucres totaux, libres et ajoutés et les données anthropométriques.
Conclusions. La consommation de sucres alimentaires au début de la vie pourrait ne pas être liée aux mesures anthropométriques à court terme. D’autres études sur les associations potentielles entre la consommation de sucres alimentaires et les variables anthropométriques sur des périodes plus longues sont justifiées.
Get full access to this article
View all available purchase options and get full access to this article.
Financial support: Funding for this project provided by Canadian Foundation for Dietetic Research, Canadian Institutes of Health Research and Health for Life Initiative at the University of Guelph; however, none of the organizations had any role in the project design, data collection, analyses, interpretation of data, or writing of the manuscript.
Conflict of interest statement: The authors declare that there are no competing interests.
Author contributions: AM was the co-Principal Investigator and conceptualized the sub-study, reviewed the data, completed the analysis, and wrote the manuscript. ACB was the co-Principal Investigator for this sub-study and supervised the anthropometric data collection for the study. DWLM and JH are the Co-Directors of the GFHS, conceptualized and supervised this project. GD was the statistical advisor. AMD supervised the dietary data collection and analysis. All authors reviewed and revised this manuscript.
Institutional review board statement: The study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board (or Ethics Committee) of University of Guelph Research Ethics Board (REB#14AP009).
Informed consent statement: Informed consent was obtained from all subjects involved in the study.
REFERENCES
1
Government of Canada. Tackling obesity in Canada: Childhood obesity and excess weight rates in Canada. 2018 [cited 2022 Nov 2]. Available from: https://www.canada.ca/en/public-health/services/publications/healthy-living/obesity-excess-weight-rates-canadian-children.html
2
Rao DP, Kropac E, Do MT, Roberts KC, and Jayaraman GC. Childhood overweight and obesity trends in Canada. Heal Promot Chronic Dis Prev Canada. 2016;36(9):194–198.
3
World Health Organization. Guideline: Sugars intake for adults and children. Geneva, Switzerland. 2015 [cited 2022 Nov 2]. Available from: https://www.who.int/publications/i/item/9789241549028
4
Keller A and Bucher Della Torre S. Sugar-sweetened beverages and obesity among children and adolescents: A review of systematic literature reviews. Child Obes. 2015;11(4):338–346.
5
Fidler Mis N, Braegger C, Bronsky J, Campoy C, Domellöf M, Embleton ND, et al. Sugar in infants, children and adolescents: A position paper of the European society for paediatric gastroenterology, hepatology and nutrition committee on nutrition. J Pediatr Gastroenterol Nutr. 2017;65(6):681–696.
6
Malik V.S., Willett W.C., and Hu F.B. Global obesity: trends, risk factors and policy implications. Nat. Rev. Endocrinol. 2013;9:13–27.
7
Ricciuto L, Fulgoni VL, Gaine PC, Scott MO, and Difrancesco L. Trends in added sugars intake and sources among US Children, adolescents, and teens using NHANES 2001–2018. J Nutr. 2022;152(2):568–578.
8
Dietitians of Canada. Taxation and sugar-sweetened beverages. Position of dietitians of Canada. 2016 [cited 2022 Nov 2]. Available from: https://dcjournal.ca/doi/pdf/10.3148/cjdpr-2016-008
9
Herrick KA, Fryar CD, Hamner HC, Park S, and Ogden CL. Added Sugars Intake among US Infants and Toddlers. J Acad Nutr Diet. 2020;120(1):23–32 [cited 2022 Nov 2]. Available from:.
10
Skinner AC, Perrin EM, Moss LA, and Skelton JA. Cardiometabolic Risks and Severity of Obesity in Children and Young Adults. N Engl J Med. 2015;373(14):1307–1317.
11
Leermakers ETM, Felix JF, Erler NS, Cerimagic A, Wijtzes AI, Hofman A, et al. Sugar-containing beverage intake in toddlers and body composition up to age 6 years: The Generation R Study. Eur J Clin Nutr. 2015;69(3):314–321.
12
Acton RB, Vanderlee L, Hobin EP, and Hammond D. Added sugar in the packaged foods and beverages available at a major Canadian retailer in 2015: a descriptive analysis. C Open. 2017;5(1):E1–E6.
13
Khan TA and Sievenpiper JL. Controversies about sugars: results from systematic reviews and meta-analyses on obesity, cardiometabolic disease and diabetes. Eur J Nutr. 2016;55(s2):25–43.
14
Davis JN and Lee S. Dietary sugars, obesity, and chronic diseases in children. Diet, Sugars and Health. 2014;(2014):245–55.
15
Vos MB, Kaar JL, Welsh JA, Van Horn L V, Feig DI, Anderson CAM, et al. Added sugars and cardiovascular disease risk in children: A scientific statement from the American Heart Association. Circulation. 2017;135(19):e1017–34.
16
Mahajan A, Yu J, Hogan JL, Jewell K, Carriero A, Annis A, et al. Dietary sugar intake among preschool-aged children: a cross-sectional study. CMAJ Open. 2021;9(3): E855–E863.
17
Te Morenga L, Mallard S, and Mann J. Dietary sugars and body weight: Systematic review and meta-analyses of randomised controlled trials and cohort studies. BMJ. 2013;345(7891):1–25.
18
Haines J, McDonald J, O’Brien A, Sherry B, Bottino CJ, Schmidt ME, et al. Healthy habits, happy homes: Randomized trial to improve household routines for obesity prevention among preschool-aged children. JAMA Pediatr. 2013;167(11):1072–9.
19
Louie JCY, Moshtaghian H, Boylan S, Flood VM, Rangan AM, Barclay AW, et al. A systematic methodology to estimate added sugar content of foods. Eur J Clin Nutr 2015;69(2):154–161 [cited 2022 Nov 2].
20
Devenish G, Golley R, Mukhtar A, Begley A, Ha D, Do L, et al. Free sugars intake, sources and determinants of high consumption among Australian 2-year-olds in the smile cohort. Nutr. J. 2019;11(1).
21
Myatt M, Guevarra E. zscorer: Child Anthropometry z-Score Calculator. R package version 0.3.1. 2019.
22
Kushner RF, Schoeller DA, Field CR, and Danford L. Is the impendence index (ht2/R) significant in predicting total body water? Am J Clin Nutr. 1992;56:835–839.
23
Fomon SJ, Haschke F, Ziegler EE, and Nelson SE. Body composition of reference children from birth to age 10 years. Am J Clin Nutr. 1982;35:1169–1175.
24
Liang KY and Zeger SL. Longitudinal data analysis using generalized linear models. Biometrika. 1986;73:13–22.
25
R Core Team. R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. 2020 [cited 2022 Nov 2]. Available from: https://www.R-project.org/
26
Song WO, Wang Y, Chung CE, Song B, Lee W, and Chun OK. Is obesity development associated with dietary sugar intake in the U.S. Nutrition. 2012;28(11–12):1137–1141.
27
O’Connor TM, Yang SJ, and Nicklas TA. Beverage intake among preschool children and its effect on weight status. Pediatrics. 2006;118(4)1707–8.
28
Newby PK, Peterson KE, Berkey CS, Leppert J, Willett WC, and Colditz GA. Beverage Consumption is Not Related to Changes in Weight and Body Mass among Low-income Preschool Children in North Dakota. J Am Diet Assoc. 2004;104:1086–1094.
29
Yin J, Zhu Y, Malik V, Li X, Peng X, Zhang FF, Shan Z, and Liu L. Intake of sugar-sweetened and low-calorie sweetened beverages and risk of cardiovascular disease: A meta-analysis and systematic review. Adv Nutr. 2021;12(1):89–101.
30
Drouin-Chartier JP, Zheng Y, Li Y, Malik V, Pan A, Bhupathiraju SN, Tobias DK, Manson JE, Willett WC, and Hu FB. Changes in consumption of sugary beverages and artificially sweetened beverages and subsequent risk of type 2 diabetes: Results from three large prospective U.S. cohorts of women and men. Diabetes Care. 2019; 42(12):2181–2189.
31
Gonzalez-Palacios S, Navarette-Munoz EM, Garcia-de-la-Hera M, Torres-Collado L, Santa-Marina L, Amiano P, et al. Sugar-containing beverages consumption and obesity in children aged 4–5 years in Spain: the INMA study. Nutr. J. 2019:11:1–13.
32
Dubois L, Farmer A, Girard M, and Peterson K. Regular sugar-sweetened beverage consumption between meals increases risk of overweight among preschool-aged children. J Am Diet Assoc. 2007;107(6):924–934.
33
Pan L, Li R, Park S, Galuska DA, Sherry B, and Freedman DS. A longitudinal analysis of sugar-sweetened beverage intake in infancy and obesity at 6 years. Pediatrics. 2014;134(September): S29–S35.
34
Herbst A, Diethelm K, Cheng G, Icks UA, and Buyken AE. Direction of associations between added sugar intake in early childhood and body mass index at age 7 years may depend on intake levels. J Nutr. 2011;141(7):1348–1354.
35
De Boer MD, Scharf RJ, and Demmer RT. Sugar-sweetened beverages and weight gain in 2-to 5-year-old children. Pediatrics. 2013;132(3):413–420.
36
Lim S, Zoellner JM, Lee JM, Burt BA, Sandretto AM, Sohn W, et al. Obesity and sugar-sweetened beverages in African-American preschool children: A longitudinal study. Obesity. 2009;17(6):1262–1268.
37
Birken CS, Tu K, Oud W, Carsley S, Hanna M, Lebovic G, and Guttman A. Determining rates of overweight and obese status in children using electronic medical records. Cross-sectional study. Can Fam Physician. 2017;63, e114–e122.
38
Biro S, Barber D, Williamson T, Morkem R, Khan S, and Janssen I. Prevalence of toddler, child and adolescent overweight and obesity derived from primary care electronic medical records: an observational study. CMAJ Open. 2016;4(3), E538–E544.
Information & Authors
Information
Published In
Canadian Journal of Dietetic Practice and Research
e-First
Pages: 1 - 8
Editor: Naomi Cahill
History
Version of record online: 5 June 2024
Copyright
© 2024.
Data Availability Statement
The GFHS welcomes external collaborators. Interested investigators can contact GFHS investigators to explore this option, which preserves participant confidentiality and meets the requirements of our Research Ethics Board, to protect human subjects. Due to Research Ethics Board restrictions, we do not make participant data publicly available.
Key Words
Mots-clés
Authors
Metrics & Citations
Metrics
Other Metrics
Citations
Cite As
AnishaMahajanPhD, RD, Alison M.DuncanPhD, RD, GerardaDarlingtonPhD, JessHainesPhD, RD, David W.L.MAPhD, Andrea C.BuchholzPhD, RD, and On behalf of the Guelph Family Health Study. Dietary Sugar and Anthropometrics among Young Children in the Guelph Family Health Study: Longitudinal Associations. Canadian Journal of Dietetic Practice and Research.
e-First
https://doi.org/10.3148/cjdpr-2024-001
Export Citations
If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.
There are no citations for this item
View Options
Get Access
Login options
Check if you access through your login credentials or your institution to get full access on this article.
Subscribe
Click on the button below to subscribe to Canadian Journal of Dietetic Practice and Research
