Association between asthma and sugar-sweetened beverage consumption in the United States pediatric population

Abstract

Objectives

United States (US) youth consume an average of 10 teaspoons of added sugar from sugar-sweetened beverages (SSB) on any given day. Few population-based studies have examined the association between SSB consumption and asthma in children and adolescents. This study aimed to examine the association between SSB consumption and asthma in the US pediatric population.

Design

Analytical cross-sectional study.

Setting and Participants

A total of 9,938 children aged 2-to-17 years old who participated in the 2011-2016 National Health and Nutrition Examination Surveys. SSB consumption was categorized into 3 groups based on the caloric intake from 24-hour food recall data as follows: 1) no consumption (0 kcal/day); 2) moderate consumption (1-499 kcal/day); and 3) heavy consumption (≥ 500 kcal/day). The primary outcome of interest was self-reported current asthma condition.

Results

Asthma prevalence estimates were significantly higher in heavy (16.4%) and moderate (11.0%) SSB consumers versus non-consumers (7.5%) (p < 0.05 for both comparisons). The adjusted odds of asthma were twice that among children with heavy SSB consumption (aOR 2.01, 95% confidence interval [CI] 1.31-3.08) versus non-SSB consumers. The odds of asthma were higher among those who consumed fruit drinks (aOR 2.51, 95% CI 1.55-4.08), non-diet soft drinks (aOR 1.89, 95% CI 1.23-2.89) and sweet tea (aOR 1.87, 95% CI 1.13-3.09) compared to nondrinkers. The effect was independent of obesity status (p-interaction = 0.439).

Conclusions

Findings here suggest a dose-response relationship between SSB intake and asthma diagnosis, therefore controlling SSB consumption may potentially improve pulmonary health risk in the US pediatric population.

Keywords:

• Sugar-sweetened beverage
• childhood asthma
• NHANES
• national prevalence
• childhood nutrition

Acknowledgments

We thank the participants who generously shared their time for answering the National Health and Nutrition Examination Survey (NHANES) in 2011-2016.

Declaration of interest

All authors declare no competing interests.

Contributors

LX contributed to study design, data analysis, data interpretation, and drafting of the manuscript. AG and GD provided clinical advice and helped revise the manuscript for important intellectual and clinically relevant content. FA contributed to data analysis and interpretation oversight. SEM was responsible for senior oversight for all phases of the project and the final approval of the version to be published.

Transparency declaration

The lead author LX and senior author SM affirms that this manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned (and, if relevant, registered) have been explained.

Ethics

2011-2016 NHANES is approved by NCHS Research Ethics Review Board, Protocol #2011-17, can be accessed at https://www.cdc.gov/nchs/nhanes/irba98.htm.

Dissemination declaration

We plan to disseminate the results to study participants and the public.

Data sharing statement

The data that support the findings of this study are available in National Center for Health Statistics at https://www.cdc.gov/nchs/nhanes/index.htm. These data were derived from the following resources available in the public domain: https://wwwn.cdc.gov/nchs/nhanes/Default.aspx.