Beverage consumption and weight gain in children

Nutrition Research Newsletter, August, 2004

Obesity is a serious problem for children, for whom there are significant short- and long-term health consequences. Overweight children may have difficulty making friends because of discrimination, possibly impeding normal social development. Overweight children are also at increased risk of respiratory disorders such as asthma and decreased ventilatory function. Cardiovascular disease (CVD) risk factors such as hyperlipidemia, hyperinsulinemia, glucose intolerance, and hypertension are present in overweight children. Because of the difficulty in treating pediatric obesity there is a need to identify modifiable risk factors, such as diet, to prevent its onset. Changes in beverage consumption patterns over the past several decades may be related to the high prevalence of obesity among children 2 to 5 years of age, which increased from 7.5% in 1988-1994 to 10.4% in 1999-2000. In the past 50 years, fruit juice consumption has increased among children. Other changes in beverage intakes include an increase in soft drink consumption and decrease in milk consumption. Previous studies show consumption of sweetened beverages such as non-diet soda and fruit drinks (not 100% fruit juices) were positively related while diet soda was inversely related to obesity among children age 11 to 12 years. The objective of this study was to examine prospectively the relationship of multiple beverages (fruit juice, fruit drinks, milk, soda, and diet soda) with changes in weight and BMI among low-income preschool children participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in the state of North Dakota.

The study population included 1,345 children age 2 to 5 years participating in the North Dakota Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) on two visits between 6 and 12 months apart WIC staff collected dietary and anthropometric data at each clinic visit. Dietary data were collected using a semiquantitative food frequency questionnaire (FFQ) that assessed dietary intake during the previous month At the first clinic visit, 13% of girls and 15% of boys were at risk of overweight and 5% of girls and 8% of boys were overweight. There were few subjects of African American Hispanic, or Asian ethnicity who participated in the study Similar beverage intakes were seen for girls and boys at baseline. Almost 50% of children consumed 12 oz or more fruit juice per day, and more than 30% of all children consumed 24 oz or more milk per day. Daily intakes of soda and diet soda were low for both girls and boys.

There were no significant associations between intakes of fruit juice, fruit drinks, milk, soda, or diet soda and changes in weight or BMI in this population of low-income preschool children in North Dakota. Results were similar when the researchers dichotomized intakes of fruit juice, fruit drinks, and milk. Milk intakes were higher and soda intakes slightly lower among younger (compared with older) children, whereas intakes of fruit juice, fruit drinks, and diet soda were similar across age groups. Mean consumption of fruit juice in the study population (10.8 oz/day for girls and 10.6 oz/day for boys) was more than double that reported for children age 2 to 18 years from CSFII 1994-96, 1998, which reported 4.6 oz/day.

The current study does not show an association between beverage consumption and changes in weight or BMI in this population of low-income preschool children in North Dakota. The results are consistent with other prospective studies that have found that fruit juice is not related to childhood obesity but are inconsistent with some reports that have found that sweetened beverages such as soda and fruit drinks are related to obesity among older children. High intakes of fruit juice and mill and low intakes of soda, fruit drinks, and diet soda were seen in this study, possibly related to the fact that WIC does not provide vouchers for sweetened beverages. Low intakes and limited variation of soda and fruit drinks in this sample likely limited the ability to see an association with these beverages and weight or BMI. Current scientific evidence does not support a positive association between fruit juice and milk consumption and obesity; hence, they may still be recommended to children in reasonable amounts because they are an important source of nutrients and energy.

P.K. Newby, K Peterson, C Berkey, J Leppert, Walter C. Willett, G Colditz. Beverage consumption is not associated with changes in weight and body mass index among low-income preschool children in North Dakota. J Am Diet Assoc 104:1086-1094 (July 2004) [Correspondence to: P. K. Newby, ScD, MPH, MS, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, 711 Washington St, 9th Floor, Boston, MA 02111 USA; Email: pknewby@post.harvard.edu]