Abstract MP42: Intakes of Sugar-Sweetened Beverages and Total Sugars are Associated with Higher Triglycerides in a Multi-Ethnic Sample of Children
Authors: Van Rompay Maria I , McKeown Nicola M , Eliasziw Misha , Goodman Elizabeth , Chomitz Virginia R , Gordon Catherine M , Economos Christina D , Sacheck Jennifer M 
Published: July 2021

Background:
Intakes of sugar-sweetened beverages (SSB) and added sugars have been targeted in efforts to reduce childhood obesity and cardiovascular disease risk factors in children. Although evidence is sparse in children, overconsumption of SSB and added sugars has been linked to greater dyslipidemia in adults.

Objectives:
To examine the association between intakes of SSB, added sugars, and total sugars, with blood lipids in a multi-ethnic sample of children with prevalent obesity.

Methods:
In this cross-sectional study, we examined associations between intakes of SSB, added sugars, and total sugars with high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG) in a sample of 276 children aged 8-15 y (mean age 11.8 y; 39% white, 14% black, 16% Hispanic/Latino, 12% Asian, and 19% multi-racial/other) with prevalent overweight/obesity (45% with ≥85
th
BMI percentile and 25% with ≥95
th
). Percentage of daily calories from SSB, as well as intakes of added sugars (tsp) and total sugars (g), were estimated using the 2004 Block Food Frequency Questionnaire for Children. HDL-C and TG were obtained from a fasting blood sample. Percentage of calories from SSB, added sugars, and energy-adjusted total sugars were dichotomized at their upper tertile cut-points, specifically, at 7%, 13 tsp, and 116 g, respectively, creating two intake categories for each dietary exposure. ANCOVA was used to analyze the data; covariates were age, sex, race/ethnicity, obesity, total calories, and intakes of saturated fat and dietary fiber. TG was log-transformed prior to analysis; low HDL-C was defined as ≤45 mg/dL and borderline/high TG, as ≥75 (aged ≤9 y) or ≥90 mg/dL (≥10 y).

Results:
Median daily intake of total sugars was 94.2 g, 47% of which was derived from added sugars (median: 9.9 tsp, range: 1-76 tsp). Only 12% of children followed the American Heart Association calorie-specific recommendations for intake of added sugars. Median contribution of SSB to total calories was 4.4% (range: 0 to 51%), and SSB calories contributed 36% (range: 0 to 100%) of calories from added sugars. Both low HDL-C and borderline/high TG were prevalent (26-27% overall) and were more common in children classified as obese (61% and 53%, respectively) than in those who were not obese (16% and 17%, respectively, P<0.0001 for each); however, intakes of SSB, added sugars, and total sugars did not differ with obesity. In multivariate-adjusted models, higher TG was associated with high intakes of SSB (75.3 vs. 67.6 mg/dL, P=0.04) and total sugars (76.5 vs. 67.0 mg/dL, P=0.01), while the association with added sugars was not significant. There were no associations with HDL-C.

Conclusions:
Among children with prevalent obesity, higher intakes of SSB and total sugars were associated with higher TG concentrations, but not with lower HDL-C. Further research is needed on the health implications of lower SSB and sugar intakes in diverse samples.