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Relationship Between Insulin Resistance–Associated Metabolic Parameters and Anthropometric Measurements With Sugar-Sweetened Beverage Intake and Physical Activity Levels in US Adolescents: Findings From the 1999-2004 National Health and Nutrition Examination Survey
Open accessAbstract
OBJECTIVE: To evaluate the relationship between insulin resistance-associated metabolic parameters and anthropometric measurements with sugar-sweetened beverage intake and physical activity levels. DESIGN: A cross-sectional analysis of the National Health and Nutrition Examination Survey data collected by the National Center for Health Statistics. SETTING: Nationally representative samples of US adolescents participating in the National Health and Nutrition Examination Survey during the years 1999-2004. PARTICIPANTS: A total of 6967 adolescents aged 12 to 19 years. MAIN EXPOSURE: Sugar-sweetened beverage consumption and physical activity levels. OUTCOME MEASURES: Glucose and insulin concentrations, a homeostasis model assessment of insulin resistance (HOMA-IR), total, high-density lipoprotein, and low-density lipoprotein cholesterol concentrations, triglyceride concentrations, systolic and diastolic blood pressure, waist circumference, and body mass index (calculated as weight in kilograms divided by height in meters squared) percentile for age and sex. RESULTS: Multivariate linear regression analyses showed that increased sugar-sweetened beverage intake was independently associated with increased HOMA-IR, systolic blood pressure, waist circumference, and body mass index percentile for age and sex and decreased HDL cholesterol concentrations; alternatively, increased physical activity levels were independently associated with decreased HOMA-IR, low-density lipoprotein cholesterol concentrations, and triglyceride concentrations and increased high-density lipoprotein cholesterol concentrations. Furthermore, low sugar-sweetened beverage intake and high physical activity levels appear to modify each others' effects of decreasing HOMA-IR and triglyceride concentrations and increasing high-density lipoprotein cholesterol concentrations. CONCLUSIONS: Sugar-sweetened beverage intake and physical activity levels are each independently associated with insulin resistance-associated metabolic parameters and anthropometric measurements in adolescents. Moreover, low sugar-sweetened beverage intake and high physical activity levels appear to modify each others' effects on several health-related outcome variables.
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“A number of cross-sectional studies found a positive association in the whole or a subset of their study population [62–65].”
From The negative impact of sugar-sweetened beverages on children’s health: an update of the literature (2018) · cites this paper as [65]
In the citing paper
“A modest number of studies reported a positive association between SSB consumption and insulin resistance risk among children and adolescents, with the majority conducted cross-sectionally [62–65], one conducted longitudinally [66] and no intervention studies conducted (Table 2).”
From The negative impact of sugar-sweetened beverages on children’s health: an update of the literature (2018) · cites this paper as [65]
In the citing paper
“A modest number of studies reported a positive association between SSB consumption and insulin resistance risk among children and adolescents, with the majority conducted cross-sectionally [62–65], one conducted longitudinally [66] and no intervention studies conducted (Table 2).”
From The negative impact of sugar-sweetened beverages on children’s health: an update of the literature (2018) · cites this paper as [65]
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MethodSelf-citationBel‐Serrat, S., Mouratidou, T., Jiménez‐Pavón, D., Huybrechts, I., Cuenca‐García, M., Mistura, L., Gottrand, F., González‐Gross, M., Dallongeville, J., Kafatos, A., et al. (2013) · Pediatric Obesity · doi:10.1111/j.2047-6310.2013.00187.x · Cited by 53
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“This is first meta-analysis to assess the association of SSB intake with measures of diabetic risk factors and confirms the positive association between SSB consumption and insulin resistance (HOMA-IR or fasting insulin) suggested by cross-sectional studies in adults [10, 11], young children [49] and adolescents [50,…”
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“Increased sugar-sweetened beverages consumption have been associated with increased HOMA-IR, SBP, waist circumference and decreased HDL-c concentrations in US adolescents (26) and with increased glucose concentrations in Mexican children (6).”
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“Several investigators have examined the impact of isolated nutrients/foods and physical activity/ sedentary life on several health outcomes (that is, IR; Pereira et al., 2002; Lara-Castro and Garvey, 2004; Isganaitis and Lustig, 2005; Slinger et al., 2008; Szamosi et al., 2008; Bremer et al., 2009; Hirschler et al., 2…”
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“However, it should be noted that four of seven studies in the meta-analysis of TC reported lower TC levels in higher SSB intake categories vs lower consumers.(26,40,42,44) Although the results of some studies included in our meta-analysis were adjusted for possible confounders which might affect the final effect size…”
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“…added sweeteners (e.g., sucrose, glucose and fructose), which might favor nonalcoholic fatty liver disease (Ouyang et al. 2008), insulin resistance (Bremer, Auinger, and Byrd 2009; Hochuli et al. 2012; McKeown et al. 2018), type 2 diabetes (Imamura et al. 2016; 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15…”
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“In one study, a reduction in sugar-sweetened beverages coupled with increased physical activity levels was associated with lower triglyceride levels and reduced insulin resistance in boys, but not girls [105].”
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Santiago‐Torres, M., Cui, Y., Adams, A. K., Allen, D. B., Carrel, A. L., Guo, J. Y., Delgado‐Rendon, A., LaRowe, T. L., & Schoeller, D. A. (2016) · Pediatric Obesity · doi:10.1111/ijpo.12020 · Cited by 26
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“SSB intake was defined as the number of SSB serving equivalents a subject consumed per day, whereas PA levels were defined as: (the mean number of times a subject did activity per day) × (the average duration of each time in minutes) × (the MET score).(24) As would be expected from its determination from multiple vari…”
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“However, while Bremer et al. 2009 [20] reported a significant association for girls only (β = 0.38; p < 0.05), Chan et al. 2009 [21] found such an association for boys (β = 1.6; p < 0.043) but not for girls (β = 0.8; p = 0.171).”
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“Nevertheless, because SSB consumption is associated with adverse metabolic parameters (8, 9, 11) , efforts need to be taken to reduce their intake, especially in those individuals at higher risk for insulin resistance-associated disorders.”
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“For studies that did not define the portion size, we converted the portion size by using recommended conversions (a serving equivalent of 250 g) (Gui et al. 2017; Bremer, Auinger, and Byrd 2009).”
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“These dietary factors include the consumption of sugarsweetened beverages((7,8)), PUFA((9)) or dietary pattern((6,10)).”
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Childhood Obesity and Insulin Resistance: How Should It Be Managed?
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“Sugarsweetened beverages and other processed foodstuffs have also been linked to metabolic syndrome components (12,15).”
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“Physical activity is helpful in increasing HDL-C and decreasing both LDL-C and TG levels [36].”
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“Also, Bremer et al.(14) found adolescents’ increased consumption of sugar-sweetened beverages to be connected with anthropometrics.”
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Just a spoonful of sugar helps the blood pressure go up
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Metadata
- Authors
- Bremer, A. A., Auinger, P., & Byrd, R. S.
- Affiliations
- University of California Davis Medical Center (US)
- University of Rochester (US)
- Venue
- Archives of Pediatrics & Adolescent Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2009-04-06
- Volume
- 163
- Issue
- 4
- Pages
- 328
- ISSN
- 1072-4710 (ISSN-L)
- PMC
- PMC4264593
- OpenAlex
- W2133450325
- Cited by
- 132
- References
- 58
- Citations by year
- 2025: 5 · 2024: 2 · 2023: 4 · 2022: 7 · 2021: 8 · 2020: 6 · 2019: 3 · 2018: 7 · 2017: 5 · 2016: 12 · 2015: 9 · 2014: 17 · 2013: 11 · 2012: 15
- FWCI
- 8.71
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Archives of Pediatrics and Adolescent Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Center for Research Resources (UL1RR024146, KL2RR024144)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- sugar-sweetened beverages, physical activity, insulin resistance, adolescents, HOMA-IR, anthropometry, body mass index, waist circumference, blood pressure, HDL cholesterol, LDL cholesterol, triglycerides, glucose and insulin, dietary change
- MeSH terms
- Adolescent, Age Factors, Anthropometry, Beverages, Blood Glucose, Child, Cross-Sectional Studies, Energy Metabolism, Female, Health Promotion, Humans, Insulin Resistance, Male, Motor Activity, Nutrition Surveys, Probability, Sex Factors, Sweetening Agents, United States, Body Mass Index, Multivariate Analysis, Linear Models, Young Adult
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