Proyecto de investigación 2017-2019, financiado por la Universidad Peruana de Ciencias Aplicadas (UPC).

Objective: To determine the association between consumption of snacks and sweetened beverages and risk of overweight among children. Design: Secondary analysis of the Young Lives cohort study in Peru. Setting: Twenty sentinel sites from a total of 1818 districts available in Peru. Subjects: Children in the younger cohort of the Young Lives study in Peru, specifically those included in the third (2009) and the fourth (2013) rounds. Results: A total of 1813 children were evaluated at baseline; 49·2 % girls and mean age 8·0 (sd 0·3) years. At baseline, 3·3 (95 % CI 2·5, 4·2) % reported daily sweetened beverage consumption, while this proportion was 3·9 (95 % CI 3·1, 4·9) % for snacks. Baseline prevalence of overweight was 22·0 (95 % CI 20·1, 23·9) %. Only 1414 children were followed for 4·0 (sd 0·1) years, with an overweight incidence of 3·6 (95 % CI 3·1, 4·1) per 100 person-years. In multivariable analysis, children who consumed sweetened beverages and snacks daily had an average weight increase of 2·29 (95 % CI 0·62, 3·96) and 2·04 (95 % CI 0·48, 3·60) kg more, respectively, than those who never consumed these products, in approximately 4 years of follow-up. Moreover, there was evidence of an association between daily consumption of sweetened beverages and risk of overweight (relative risk=2·12; 95 % CI 1·05, 4·28). Conclusions: Daily consumption of sweetened beverages and snacks was associated with increased weight gain v. never consuming these products; and in the case of sweetened beverages, with higher risk of developing overweight.

Objective: Over the past several decades, increase in SSB consumption has coincided with increasing rates of obesity. This study evaluated the association between SSB consumption and BMI. Methods: FFQ data from NHANES 2003-2004 was used to examine 100% orange juice, sugar-sweetened fruit drinks, soft drinks, and other beverage consumption frequency vs. mean BMI. ANOVA, relative risk, and linear regression analyses were done. Results: ANOVA found significant differences in mean BMI across consumption frequencies for orange juice (p=.001), sugar-sweetened fruit drinks (p<.001), and soft drinks (p<.001). Increased risk of being obese was associated with increasing consumption frequency for orange juice (RR=1.282), sugar-sweetened fruit drinks (RR=1.417), and soft drinks (RR=1.749). Multiple linear regression found significant positive associations between mean BMI and sugar-sweetened fruit drinks (b=.056, p=.004) and soft drinks (b=.134, p=.001). Conclusion: This study found that mean BMI was positively associated with certain beverage consumption frequency (sugar-sweetened fruit drinks, soft drinks consumed during summer, soft drinks consumed during rest of year), but not others (100% orange juice). Fewer significant results were found when confounding variables were controlled. Drinking soft drinks or sugar-sweetened fruit drinks increased the risk of obesity more than drinking natural fruit juices.

Sugar-Sweetened Beverages (SSBs) are liquids sweetened with various forms of added sugar. They are the leading source of calories and added sugar in the American diet (Drewnowski & Rehm, 2014; National Cancer Institute, 2016; Powell, Chriqui, Khan, Wada, & Chaloupka, 2013). The health and nutrition literature has increasingly identified added sugars and SSBs as a key potential contributor to a host of public health issues including obesity, type 2 diabetes, hypertension, and cardiovascular disease (Johnson et al., 2009; Malik, Popkin, Bray, Despres, & Hu, 2010; Vartanian, Schwartz, & Brownell, 2007). Concern about these public health crises has recently animated regional and local campaigns to attempt to limit consumption of these items through taxes and other policies. These policy proposals have raised demand for information and research about the drivers and effects SSB and beverage consumption in general. This study documents the major systems that have been used to categorize different types of SSBs and proposes a new beverage categorization typology – the Synthesized Beverage Categorization System – that cross references information from the What We Eat In America Food Categories and the Food Patterns Equivalents Database to offer the most precise SSB typology available today. The remaining sections use reported dietary intake data from the National Health and Nutrition Examination Survey (NHANES) to analyze consumption patterns of sugary beverage subtypes in a number of ways. First this study lays the groundwork for future studies of beverage consumption by examining consumption patterns of major SSB subtypes for adults and children by a number of variables commonly used in dietary intake analysis. Second, this article provides an analysis of sociodemographic trends in the consumption of several major sugary-beverage subtypes by age group, race and gender. Finally, consumption patterns of conventional and “non-traditional” SSBs are provided for the last 4 NHANES data collection cycles to analyze recent trends in reported intake of calories and added sugars from sugary beverages.

Overweight and obesity in Canada has significantly increased during the last three decades, paralleled by increased intake of fat and sugar particularly sugary beverages leading to higher level of energy intake, as well as reduction in physical activity. Canadian Community Health Survey, Cycle 2.2, 2004 (CCHS 2.2), provides the opportunity to evaluate beverage intakes of Canadians in relation to overweight and obesity using Body Mass Index (BMI).<p> To examine the association between sugar-sweetened beverages and BMI in Canadian adults, we used data from CCHS 2.2 (n=14,304, aged >18 year and <65 year) in which dietary intake was assessed using 24-h recall. In various steps, data on beverage consumption were identified, coded and classified. Using descriptive statistics, we determined total gram intake and the contribution of each beverage to total energy intake among age/sex groups. To determine the most suitable patterns of beverage consumptions among Canadian adults, a cluster analysis K-means method was applied. Males and females were classified into distinct clusters based on the dominant pattern of beverage intakes. Finally, step-wise logistic regression models were used to determine associations between sugar-sweetened beverages and BMI, controlling for age, marital status, income, education, physical activity, total energy intake, immigration status, smoking habits and ethnicity. To account for complex survey design, all data were weighted and bootstrapped.<p> BMI in women with predominant fruit drink pattern (791.1±32.9 g) was significantly higher than those with no dominant pattern in beverage consumption (28.3±1 vs. 26.8±0.3 respectively, P<0.001). In women, high intake of fruit drinks was a significant predictor of overweight (OR=1.84, 95% C.I:1.06-3.20), obesity (OR=2.55, 95% C.I:1.46-4.47) and overweight/obesity (OR=2.05, 95% C.I:1.29-3.25). In men, mean BMI was not different among beverage consumption clusters and none of the beverages was a predictor for overweight and obesity. For the first time, in a nationally representative data, we report association of sugar-sweetened beverages and overweight and obesity in Canadian women.

Overweight and obesity in Canada has significantly increased during the last three decades, paralleled by increased intake of fat and sugar particularly sugary beverages leading to higher level of energy intake, as well as reduction in physical activity. Canadian Community Health Survey, Cycle 2.2, 2004 (CCHS 2.2), provides the opportunity to evaluate beverage intakes of Canadians in relation to overweight and obesity using Body Mass Index (BMI).<p> To examine the association between sugar-sweetened beverages and BMI in Canadian adults, we used data from CCHS 2.2 (n=14,304, aged >18 year and <65 year) in which dietary intake was assessed using 24-h recall. In various steps, data on beverage consumption were identified, coded and classified. Using descriptive statistics, we determined total gram intake and the contribution of each beverage to total energy intake among age/sex groups. To determine the most suitable patterns of beverage consumptions among Canadian adults, a cluster analysis K-means method was applied. Males and females were classified into distinct clusters based on the dominant pattern of beverage intakes. Finally, step-wise logistic regression models were used to determine associations between sugar-sweetened beverages and BMI, controlling for age, marital status, income, education, physical activity, total energy intake, immigration status, smoking habits and ethnicity. To account for complex survey design, all data were weighted and bootstrapped.<p> BMI in women with predominant fruit drink pattern (791.1±32.9 g) was significantly higher than those with no dominant pattern in beverage consumption (28.3±1 vs. 26.8±0.3 respectively, P<0.001). In women, high intake of fruit drinks was a significant predictor of overweight (OR=1.84, 95% C.I:1.06-3.20), obesity (OR=2.55, 95% C.I:1.46-4.47) and overweight/obesity (OR=2.05, 95% C.I:1.29-3.25). In men, mean BMI was not different among beverage consumption clusters and none of the beverages was a predictor for overweight and obesity. For the first time, in a nationally representative data, we report association of sugar-sweetened beverages and overweight and obesity in Canadian women.

Indiana University-Purdue University Indianapolis (IUPUI) / Communities and States are increasingly targeting the consumption of sugar sweetened beverages (SSBs), especially soda, in their efforts to curb childhood obesity. However, the empirical evidence based on which policy makers design the relevant policies is not causally interpretable. In the present study, we suggest a modeling framework that can be used for making causal estimation and inference in the context of childhood obesity. This modeling framework is built upon the two-stage residual inclusion (2SRI) instrumental variables method and have two levels – level one models children’s lifestyle choices and level two models children’s energy balance which is assumed to be dependent on their lifestyle behaviors. We start with a simplified version of the model that includes only one policy, one lifestyle, one energy balance, and one observable control variable. We then extend this simple version to be a general one that accommodates multiple policy and lifestyle variables. The two versions of the model are 1) first estimated via the nonlinear least square (NLS) method (henceforth NLS-based 2SRI); and 2) then estimated via the maximum likelihood estimation (MLE) method (henceforth MLE-based 2SRI). Using simulated data, we show that 1) our proposed 2SRI method outperforms the conventional method that ignores the inherent nonlinearity [the linear instrumental variables (LIV) method] or the potential endogeneity [the nonlinear regression (NR) method] in obtaining the relevant estimators; and 2) the MLE-based 2SRI provides more efficient estimators (also consistent) compared to the NLS-based one. Real data analysis is conducted to illustrate the implementation of 2SRI method in practice using both NLS and MLE methods. However, due to data limitation, we are not able to draw any inference regarding the impacts of lifestyle, specifically SSB consumption, on childhood obesity. We are in the process of getting better data and, after doing so, we will replicate and extend the analyses conducted here. These analyses, we believe, will produce causally interpretable evidence of the effects of SSB consumption and other lifestyle choices on childhood obesity. The empirical analyses presented in this dissertation should, therefore, be viewed as an illustration of our newly proposed framework for causal estimation and inference.

Purpose: This article examines changes in attitude and beverage consumption after a school-wide policy change replacing sweetened beverages in vending machines with 100% juice and bottled water. Methods: Written questionnaires were administered three times to high school students (n = 278) in an ethnically-diverse, southwest Virginia school district. X ² analysis was utilized and test-retest reliability was assessed with intra-class correlation coefficients. Results: Pearson correlation coefficients for reliability between test and re-test displayed a range from r =0.53 to r =0.73. There were no significant differences in demographics (gender and ethnicity) between time periods. X ² analysis revealed students were significantly more likely to choose healthier beverage vending options after one year compared to baseline (P<0.01). Although beverage vending purchases declined to near significance immediately following the change, there were no significant changes observed between baseline and follow-up (P<0.05). X ² analysis revealed no significant (P<0.05) changes in outside purchase patterns. Students also indicated that the top reasons for snack/beverage choices were hunger, taste, and price. Conclusion: This suggests that students purchase what is convenient and available, regardless of choices. Therefore, environmental changes may be beneficial to promote healthier beverage choices among adolescents.</p> / Master of Science

No description available.

INTRODUCTION: Research has strongly linked increased consumption of sugar-sweetened beverages (SSBs) to obesity/overweight in youth. AIM: This study aims to: (1) examine SSB consumption rates in high school students nationwide, (2) explore association between SSB consumption and adiposity (overweight/obesity), (3) examine gender, racial/ethnic, and physical activity (PA) status differences in SSB consumption. METHODS: The Youth Risk Behavior Survey (YRBS)-2015 was employed in this study. Weighted percentages were used to examine differences in SSB consumption and adiposity prevalence by gender, race and PA status. Multivariate logistic regression was used to determine association between SSB consumption and adiposity. Adjusted and unadjusted odds ratios and 95% CIs were calculated. RESULTS: Overall, 20% of students drank sodas daily ≥ 1 times a day and about 14% drank sports drinks daily. More male students consumed both sodas and sports drinks than female students. Soda consumption was largest in the group with zero days PA (25%) and consumption of sports drinks was highest in the daily PA category (24%) than the other categories. Multivariate logistic regression revealed higher odds of obesity among male students as compared to female students (OR=1.7, 95% CI=1.4, 2.1) and among Hispanic students as compared to white students (OR=1.5, 95% CI=1.2, 1.8), after adjusting for all other covariates. Students who engaged in daily PA had lower odds of obesity than those who had no PA (OR=0.6, 95% CI=0.5, 0.8). There was no significant difference in the odds of obesity between those who consumed SSBs and those who did not. DISCUSSION: This study provides insight into SSB consumption trends in US adolescents by socio- demographic factors and PA status, as well as its association with adiposity. Male gender, certain racial minorities and lack of physical activity can potentially be responsible for greater SSB consumption. Sports drinks consumption is high even in physically active youth. Lack of association between SSB intake and adiposity may be due to the limited SSBs included.