Obese Kids Drink As Much Pop As Skinny Kids?

Among all of the popular targets for population-based solutions to the obesity dilemma, sugar-sweetened beverages (SSB) probably head the list.

There is indeed no arguing with the fact that the sugar in these beverages adds a substantial amount of calories to the average Canadian’s diet – calories, with little (if any) nutritional value. Thus, in any simplistic equation of  “calories in and calories out”, SSBs would certainly stand out as a prime candidate for driving obesity.

Unfortunately, this notion (at least the simplistic variants of this notion) are not as unequivocally supported by the actual research on this issue, as some would have us believe.

Case in point is the latest study on this issue by Lana Vanderlee and colleagues from the University of Waterloo School of Public Health (host of the upcoming 4th National Obesity Student Meeting, June 18-21, 2014), published in the Journal of School Health.

The study looks at data from 10,188 youth (ages 13-18) from Hamilton and Thunder Bay, Ontario, and Prince Edward Island (PEI) in 2009 to 2010, who answered 12 questions regarding beverage consumption during the previous day, along with self-reported height, weight, physical activity levels, and demographic information.

While four out of five youth reported to have consumed at least one SBB on the previous day, almost one in two reported consuming three or more!

Although there were interesting geographic differences in SSB consumption, the researchers found virtually no relationship between BMI and SSB consumption, no matter how they analyzed the data.

Funnily enough, PEI, where kids reported the lowest SSB consumption, turned out to have the highest number of overweight kids.

Despite all the usual caveats with studies based on self-reported rather than objectively measured data, one thing is clear: if SSBs are indeed a relevant driver of the obesity epidemic, the data certainly don’t shout it out.

Obviously, one explanation could well be that the methodology of the study was not robust enough to identify this relationship (although I am certain that had a positive relationship been found, this study would  have been widely paraded as conclusive evidence to support the immediate ban of SSBs).

On the other hand, a rather simple explanation for this finding may be that no such relationship exists. Indeed, it is scientifically not at all unreasonable, when your data fail to support your hypothesis, to question the hypothesis.

This is not to say that copious consumption of SSBs may not be detrimental to health – that may well be the case.

But it does seem that the popular story line suggesting that SSBs are anywhere as important a “cause” of the obesity epidemic as proponents of this hypothesis make them out to be, certainly needs to be taken with a grain of salt.

This issue becomes even more important, if such efforts distract us from identifying and addressing the “real” causes of the problem (which I am willing to wager, in the end, may well have surprisingly less to do with either diet or physical activity than we think).

@DrSharma
Edmonton, AB