The Association of Sugar-Sweetened Beverages Consumption Patterns and Overweight/Obesity: Evidence from a Large-Scale Survey of Chinese Children and Adolescents

TL;DR

This study finds that drinking sugar-sweetened beverages is linked to higher rates of overweight and obesity in Chinese children and adolescents.

Contribution

The study identifies distinct SSB consumption patterns and their specific associations with childhood overweight/obesity in China.

Findings

Three SSB consumption patterns were linked to increased odds of overweight/obesity.

Higher consumption of multiple SSB types was associated with greater risk of being overweight/obese.

The Plant Hybrid Pattern showed sex-specific associations with overweight/obesity.

Abstract

Objective: To identify major sugar-sweetened beverage (SSB) consumption patterns among Chinese children and adolescents and examine their associations with childhood overweight/obesity. Methods: Data were drawn from the Chinese Food Consumption Survey (2017–2020), including 7979 children and adolescents. SSB intake was assessed using a non-consecutive 3-day 24 h dietary recall and classified into nine types. Principal component analysis identified SSB consumption patterns. Nutritional status was defined using BMI Z-scores, following the World Health Organization growth standards. Multivariable logistic regression was used to assess the associations between SSB patterns and overweight/obesity, with subgroup analyses by sex, age, and residence area. Results: Three major SSB patterns were identified: (1) Carbonated Beverage and Milk Tea Pattern (dominated by carbonated beverages and milk tea); (2) Functional Beverages Pattern (dominated by coffee beverages and sports beverages); and (3) Plant Hybrid Pattern (dominated by plant protein beverages and plant-based beverages). Preschool-aged children exhibited lower scores across all three patterns. Higher pattern scores were observed among school-aged children and adolescents and those with lower parental education levels, parents working as unskilled labor or homemakers, lower family annual income per capita, and residence in rural areas. All three identified SSB consumption patterns demonstrated significant positive associations with overweight/obesity in children, where higher consumption levels corresponded to greater odds of overweight/obesity. Children exhibiting higher scores in two or more patterns had higher odds of being overweight/obese (Medium-high: OR = 1.249, 95% CI = 1.053, 1.482; High: OR = 1.256, 95% CI = 1.081, 1.459). Subgroup analysis further indicated that the association between the Plant Hybrid Pattern score and overweight/obesity varied significantly by sex. Conclusions: Three SSB consumption patterns were associated with a higher likelihood of overweight/obesity among Chinese children, particularly among those with preferences for multiple SSB types. Interventions should be tailored to SSB consumption habits and socioeconomic contexts, with special attention to rural populations.

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