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Sugar-sweetened beverages and weight gain in children and adults: a systematic review and meta-analysis
Open accessAbstract
Background The relation between sugar-sweetened beverages (SSBs) and body weight remains controversial.Objective We conducted a systematic review and meta-analysis to summarize the evidence in children and adults.Design We searched PubMed, EMBASE, and Cochrane databases through March 2013 for prospective cohort studies and randomized controlled trials (RCTs) that evaluated the SSB-weight relation. Separate meta-analyses were conducted in children and adults and for cohorts and RCTs by using random- and fixed-effects models.Results Thirty-two original articles were included in our meta-analyses: 20 in children (15 cohort studies, n = 25,745; 5 trials, n = 2772) and 12 in adults (7 cohort studies, n = 174,252; 5 trials, n = 292). In cohort studies, one daily serving increment of SSBs was associated with a 0.06 (95% CI: 0.02, 0.10) and 0.05 (95% CI: 0.03, 0.07)-unit increase in BMI in children and 0.22 kg (95% CI: 0.09, 0.34 kg) and 0.12 kg (95% CI: 0.10, 0.14 kg) weight gain in adults over 1 y in random- and fixed-effects models, respectively. RCTs in children showed reductions in BMI gain when SSBs were reduced [random and fixed effects: -0.17 (95% CI: -0.39, 0.05) and -0.12 (95% CI: -0.22, -0.2)], whereas RCTs in adults showed increases in body weight when SSBs were added (random and fixed effects: 0.85 kg; 95% CI: 0.50, 1.20 kg). Sensitivity analyses of RCTs in children showed more pronounced benefits in preventing weight gain in SSB substitution trials (compared with school-based educational programs) and among overweight children (compared with normal-weight children).Conclusion Our systematic review and meta-analysis of prospective cohort studies and RCTs provides evidence that SSB consumption promotes weight gain in children and adults.
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“Studies among children are more limited and have generally focused on weight gain [4] and dental caries [10], as well as insulin resistance to a lesser extent [11, 12].”
From The negative impact of sugar-sweetened beverages on children’s health: an update of the literature (2018) · cites this paper as [4]
In the citing paper
“Evidence has emerged linking SSB consumption to a number of health consequences among adults including weight gain [4, 5], cardiovascular risk factors (e.g., dyslipidemia) [6], insulin resistance and type 2 diabetes [7, 8] and non-alcoholic fatty liver disease [9].”
From The negative impact of sugar-sweetened beverages on children’s health: an update of the literature (2018) · cites this paper as [4]
In the citing paper
“Moderate quality evidence suggested that the highest versus lowest dietary sugar consumption was associated with increased body weight (sugar sweetened beverages) (class IV evidence)”
From Dietary sugar consumption and health: umbrella review (2023) · cites this paper as [53]
In the citing paper
“Dose-response analysis based on seven cohort studies showed that a one serving/day increment of sugar sweetened beverages was associated with a 0.22 kg weight gain in one year (weighted mean difference 0.22, 0.09 to 0.34).”
From Dietary sugar consumption and health: umbrella review (2023) · cites this paper as [53]
In the citing paper
“The authors conducted a dose-response analysis and showed that body mass index in children increased by 0.07 units for every one serving/day increment of sugar sweetened beverages (weighted mean difference 0.07, 0.01 to 0.12) (low; IV).”
From Dietary sugar consumption and health: umbrella review (2023) · cites this paper as [53]
In the citing paper
“Dietary sugar consumption had harmful associations with endocrine and metabolic outcomes, including changes in body mass index in children,53 changes in body weight,53 changes in body weight (one year),53 gout,11 13 58 high density lipoprotein cholesterol,60 hyperuricaemia,11 59 latent autoimmune diabetes in adults,30 low density lipoprotein cholesterol,60 metabolic syndrome,61 obesity in children”
From Dietary sugar consumption and health: umbrella review (2023) · cites this paper as [53]
In the citing paper
“dietary sugar consumption, especially sugar sweetened beverage consumption, is convincingly associated with the risk of obesity weight gain,1 3 53”
From Dietary sugar consumption and health: umbrella review (2023) · cites this paper as [53]
In the citing paper
“A meta-analysis of seven cohort studies and five randomized controlled trials (RCTs) found SSB’s increased weight by 0.12 kg/serving/year (95% confidence interval [CI]: 0.10–0.14) in adults (124).”
From Food Consumption and its Impact on Cardiovascular Disease: Importance of Solutions Focused on the Globalized Food System (2015) · cites this paper as [124]
In the citing paper
“This may be an important consideration given the emerging evidence of sugar-sweetened beverages (SSB) in the aetiology of obesity( 102 , 103 ) and cardiometabolic risk( 104 , 105 ).”
From Understanding meal patterns: definitions, methodology and impact on nutrient intake and diet quality (2015) · cites this paper as [103]
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“A recent systematic review and metaanalysis of prospective cohort studies (15 in children and 7 in adults) and randomized controlled trials (5 each in children and adults) provides evidence that SSB consumption is associated with weight gain in children and adults [22].”
BackgroundCafé, A. C. C., Lopes, C. A. D. O., Novais, R. L. R., Bila, W. C., da Silva, D. K., Romano, M. C. C., & Lamounier, J. A. (2018) · Revista Paulista de Pediatria · doi:10.1590/1984-0462/;2018;36;1;00010 · Cited by 12
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“Additionally, SSB consumption during childhood is associated with a range of health outcomes including overweight/obesity [28], metabolic risk [29], and dental caries [30].”
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Consumption of free sugars and excess weight in infants. A longitudinal study
Jardí, C., Aranda, N., Bedmar, C., Ribot, B., Elias, I., Aparicio, E., & Arija, V. (2019) · Anales de Pediatría (English Edition) · doi:10.1016/j.anpede.2018.03.011 · Cited by 11
Beverage consumption among Korean adolescents: data from 2016 Korea Youth Risk Behavior Survey
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“Similar to Korea, carbonated beverages account for more than a half of SSBs (which are the top source of added sugar) among US children and adolescents [23-24].”
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Food, Health & the Environment: A Global Grand Challenge & Some Solutions
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“31 Global consumption of ssb s is rising.”
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“Additionally, sugar sweetened dietary intake not only elevates calories that, in turn, increase fat and weight, but also may affect glucose homeostasis and insulin sensitivity (Malik et al., 2013; Otero-Losada et al., 2015).”
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Background
Metadata
- Authors
- Malik, V. S., Pan, A., Willett, W. C., & Hu, F. B.
- Affiliations
- Brigham and Women's Hospital (US)
- Harvard University (US)
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2013-10
- Volume
- 98
- Issue
- 4
- Pages
- 1084-1102
- ISSN
- 0002-9165 (ISSN-L)
- PMC
- PMC3778861
- OpenAlex
- W2163234420
- Cited by
- 1,668
- References
- 85
- Citations by year
- 2026: 59 · 2025: 95 · 2024: 82 · 2023: 119 · 2022: 143 · 2021: 164 · 2020: 181 · 2019: 174 · 2018: 165 · 2017: 156 · 2016: 118 · 2015: 128 · 2014: 75 · 2013: 4
- FWCI
- 15.49
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Heart, Lung, and Blood Institute (HL60712, R01HL060712)
- National Cancer Institute (U54CA155626)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK058845, P30DK046200, P30 DK-46200, DK58845, T32DK007703)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Keywords
- sugar-sweetened beverages, weight gain, body mass index, children, adults, overweight children, school-based education programs, randomized controlled trials, prospective cohort
- MeSH terms
- Adolescent, Adult, Beverages, Child, Child, Preschool, Female, Humans, Male, Prospective Studies, Cohort Studies, Weight Gain, Bias, Body Mass Index, Randomized Controlled Trials as Topic, Dietary Sucrose
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