Monday, June 18, 2012

Beverage Consumption and Obesity in Canadian Kids

Readers may recall a previous post on the relationship between physical activity or TV viewing and obesity in Canadian kids – the result did not show much of a relationship – if anything, obese kids were probably doing more physical work than normal weight kids.

Now, another study, challenges the widely held notion that, apart from not being as active, obese kids also spend most of their time guzzling sugar-laden beverages, reason enough for policy folks to tax, ban, blame and shame overweight kids into sticking with the water fountain.

While that may well be ok (I grew up drinking little else than water), hoping that this will make a dramatic difference on childhood obesity rates may be more than such efforts may deliver.

Thus, according to a paper by Adrienne Danyliw and colleagues from the University of Saskatchewan, published in Applied Physiology Nutrition and Metabolism, beverage intake patterns identified by cluster analysis of data from the cross-sectional Canadian Community Health Survey 2.2, does not reveal a strong link between beverage consumption and obesity in Canadian kids (with some caveats – see below).

The analyses of beverage consumption of over 10,000 kids, included intake data obtained from a single 24-hour recall, measured height and weight, and sociodemographic data obtained through interviews.

Cluster analyses resulted in two distinct groups of kids: those who drank mostly fruit drinks, soft drinks, 100% juice, milk, high-fat milk and those who drank low-volume and varied beverages (termed “moderate”).

Overall, the researchers failed to find any significant relationship emerged between beverage pattern and overweight and obesity among the kids with one exception: in boys aged 6-11 years, drank more than half a liter (553 g) of softdrinks had a two-fold higher risk of being overweight or obese than kids with a ‘moderate’ beverage pattern.

Thus, with the exceptions of young boys, who drink a fairly impressive amount of soft drinks, this national cross-sectional dietary intake data does not suggest that beverages are a major driver of excess weight in Canadian kids.

This does not mean that drinking a large amount of softdrinks or fruit juices is good for you – it does mean, however, that blaming the obesity epidemic fully or even in part on increased consumption of these beverages may overly simplistic.

Of course, I am more than aware (as are the researchers) about the limitations of these kind of studies. Not only is 24-hour recall data (even when mistakes average out when you have 10,000 participants) not exactly ‘robust’, nor is it ever possible to correct for all possible confounders that may be relevant.

On the other hand, had the researchers found a positive relationship between beverage consumption and obesity, I am guessing that many would have held up this paper as ‘definitive’ evidence that softdrinks are at the root of Canada’s obesity epidemic (see my previous post on white-hat bias).

As it stands, blaming Canada’s obesity problem on inactivity and soft drinks, may be not only too simplistic but simply wrong. This is not to say that being more physically active and turning to the water tap for hydration may not be best for all concerned.

No doubt soft drinks make easier policy targets than getting more sleep, spending more time at home raising your kids, or considering gut bugs, environmental toxins, or epigenetics.

Just too bad that the data does not exactly support the policy.

AMS
Edmonton, Alberta
ResearchBlogging.orgDanyliw AD, Vatanparast H, Nikpartow N, & Whiting SJ (2012). Beverage patterns among Canadian children and relationship to overweight and obesity. Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme PMID: 22694268

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3 Responses to “Beverage Consumption and Obesity in Canadian Kids”

  1. rory robertson says:

    Of course, softdrinks and fruit juices contribute only part of today sugar/fructose intake by today’s children and adults. Many/most manufactured foods contain added sugar/fructose, and humans remain “hard wired” to seek out sugar:

    “Simply put, humans evolved to crave sugar, store it and then use it. For millions of years, our cravings and digestive systems were exquisitely balanced because sugar was rare. Apart from honey, most of the foods our hunter-gatherer ancestors ate were no sweeter than a carrot. The invention of farming made starchy foods more abundant, but it wasn’t until very recently that technology made pure sugar bountiful” (http://www.nytimes.com/2012/06/06/opinion/evolutions-sweet-tooth.html ).

    It’s not an accident that Australian sugar consumption and obesity both have trended up over the past 30 years (http://www.australianparadox.com ). The same probably is true in Canada. Certainly, it’s true in the US.

    The critical problem is that sugar does something bad to APPETITE CONTROL. By promoting food cravings and scrambling appetite control, the unnaturally high level of added sugar in modern diets clearly has been a (the?) major driver of higher rates of obesity and diabetes (http://www.nytimes.com/2011/04/17/magazine/mag-17Sugar-t.html?pagewanted=all ).

    Thousands of Australians in recent years have reversed their trends to obesity simply by avoiding everything that contains added or concentrated fructose, including fruit juice but not whole fruits. Removing fructose “works” for many because it downsizes excessive food cravings, allowing natural appetite controls to resume operation.

    It’s widely understood that tobacco and alcohol are addictive. It is no great stretch from there to view fructose – the “sweet poison” half of added sugar – as addictive. After all, many of us have experienced uncontrollable cravings for sugar.

    As the evidence against excess sugar/fructose continues to mount, reducing added sugar/fructose in our diets increasingly will be seen by public-health authorities the world over as the obvious low-hanging fruit in any serious anti-obesity and anti-diabetes campaign.

  2. David Brown says:

    It’s good to see attention finally being focused on added sugars. It would be good if omega-6 industrial seed oils got some attention as well because consumption of both of these food components has increased dramatically over the past century. http://articles.orlandosentinel.com/2003-09-28/news/0309270148_1_overweight-or-obese-women-were-overweight-south-africa?pagewanted=all

  3. Suzie Pellerin says:

    Let me make some nuances regarding this research and your analyse of it…
    1) The research does not distinguish drinkers of fruit cocktails, of pure juices, of milk or rich milk from soft drinks drinkers, which can create a bias et can contribute to reduce the association (Coke and milk don’t have the same impacts on health)
    2) What is report as an exceptionnal consumer is (1/2L/day) wich represent the average consumption of boys between 14-18 years old… If they’re so many to be considered as consumer of exception, we should be worried….

    For more info and other evidences, consult:
    http://www.cqpp.qc.ca/en/sugar-sweetened-beverages/marketing

    Permmetez-moi d’apporter quelques nuances à ton analyse cher Arya,
    À noter que l’étude ne distingue pas les buveurs de boissons aux fruits, jus de fruits purs, lait ou lait riche en gras, de ceux qui boivent des boissons gazeuses, ce qui peut entraîner un biais et réduire l’association attendue… (le lait n’a potentiellement pas le même effet que le coke!).

    Aussi, ce qui est rapporté comme une consommation exceptionnelle (1/2L/jr) est LA moyenne canadienne pour les garçons de 14-18 ans donc ils sont nombreux à avoir une consommation exceptionnelle dont on doit se préoccuper.

    Pour plus d’info et de données probantes sur les boissons sucrées, consultez
    http://www.cqpp.qc.ca/fr/dossiers/boissons-sucrees/marketing

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