Article

Pattern of beverage consumption and long-term association with body-weight status in German adolescents - Results from the DONALD study

Research Institute of Child Nutrition (FKE), Heinstueck 11, D-44225 Dortmund, Germany.
The British journal of nutrition (Impact Factor: 3.45). 07/2008; 99(6):1370-9. DOI: 10.1017/S0007114507862362
Source: PubMed

ABSTRACT

In the present study the relationship between the consumption of different beverage groups and body-weight status in 5 years of study participation in German adolescents was investigated. We used anthropometric and dietary data from 3 d weighed records of 244 subjects between 9 and 18 years of age participating in the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study. Only subjects with at least four out of six possible weighed dietary records were considered. A repeated-measures regression model (PROC MIXED) was used to analyse the effect of beverage consumption on body-weight status. BMI standard deviation scores (BMI-SDS) and body fat percentage (%BF) were chosen as the dependent variables. In boys, energetic beverage consumption was not associated with BMI-SDS or %BF, neither cross-sectionally nor prospectively. In girls, baseline consumption of energetic beverages did not predict baseline BMI-SDS, baseline %BF, or change in either variable over the study period. However, an increase in energetic beverage consumption over the study period was associated with an increase in BMI-SDS (+0.070 SDS/MJ increase in energetic beverage consumption; P = 0.01). Separate consideration of regular soft drinks and fruit juices revealed that, in girls, BMI-SDS increased with increased fruit juice consumption (+0.096 SDS/MJ increase in fruit juice consumption; P = 0.01), and to a lesser extent with regular soft drink consumption (+0.055 SDS/MJ increase in regular soft drink consumption; P = 0.08). In conclusion, these results suggest that an increase in energetic beverage consumption may result in weight gain, at least in adolescent girls.

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Available from: Anette E Buyken, Feb 05, 2014
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    • "This mechanism has been proposed as an explanation for the sensation of fullness and increase in satiety after viscous fiber intake [21]. In turn, soluble fiber decreases the postprandial secretion of insulin [22], which may contribute to satiety. Soluble fiber can also delay or reduce the intestinal digestion and absorption of macronutrients, thus increasing feacal energy losses. "
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    ABSTRACT: In this study, we evaluated the effect of Apple-lite for 4 weeks on body weight, lipid profiles, kidney functions and histological structure of kidney in male rats. Twenty adult male albino rats (240 -250 gm) were divided into 2 groups: The first group was considered as control group. The second group was treated orally with Apple-lite (55 mg/kg b.w) by use of intragastric tube. Different physiological parameters were performed including recording of the body weight and measuring lipid profiles, creatinine and urea levels. Body weight gain, total cholesterol, triglyceride, LDL cholesterol, and VLDL cholesterol levels were significantly (p< 0.05) reduced in Apple-lite treated rats when compared with the control rats. Urea level was significantly (p< 0.05) increased in Apple-lite treated rats, but HDL cholesterol and creatinine levels were none significantly (P >0.05) increased when compared with the control rats. Histological examination of Apple-lite treated rat's kidney showed aggregation of inflammatory cells (monocytes) around glomerulus, fibrosis around Bowman's capsule, and congestion of blood vessels. From these results it can be conclude that the treatment with Apple-lite produced a significant reduction in body weight and lipid profiles, but it is incapable of improving the kidney functions. Also there are histopathological effects on kidney tissue in treated rats.
    Full-text · Article · Jan 2013
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    • "Two unpublished or incompletely published cohort studies (see Dubois et al., 2007; O'Connor et al., 2006) are said to demonstrate no link between overweight and SSD intake—because these studies provide insufficient data to enter into meta-analyses, they contribute further to the publication bias found by Forshee et al. (2008). Three reported cohort studies (Blum et al., 2005; Libuda et al., 2008; Tam et al., 2006) were analyzed inversely, that is, they linked SSD intake to body weight as a determinant. These studies showed obese persons to consume more SSDs than average (not SSDs causing obesity). "
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    ABSTRACT: Fructose occurs in fruits, vegetable, and sweetened drinks alongside glucose as free sugars or bound in sucrose, but may also be bought in a pure form. A link between sugar-sweetened drinks (SSD) and body mass index (BMI, kg/m2) is inferred from systematic reviews of both prospective cohort studies (PCSs) and randomized, controlled trials (RCTs) (Malik et al., 200616. Malik , V. S. , Schulze , M. B. and Hu , F. B. 2006. Intake of sugar-sweetened beverages and weight gain: a systematic review. Am. J. Clin. Nutr., 84: 274–288. [PubMed], [Web of Science ®]View all references; Wolf and Dansinger, 200824. Wolf , E. and Dansinger , M. L. 2008. Soft drinks and weight gain: How strong is the link?. Medscape J. Med., 10: 189–196. View all references). The link is seemingly strong because such studies rank highly among types of studies according to evidence-based principles on causality. On the other hand, the study results are heterogeneous, and more objective meta-analysis shows SSDs to have a “small” effect on BMI (Forshee et al., 20087. Forshee , R. A. , Anderson , P. A. and Storey , M. L. 2008. Sugar-sweetened beverages and body mass index in children and adolescents: a meta-analysis. Am. J. Clin. Nutr., 87: 1662–1671. [PubMed], [Web of Science ®]View all references); therefore, a focus on fructose and SSD may then serve only to divert attention from major causes of obesity (Storey, 200822. Storey , M. 2008. Reply to M Bes-Rastrollo and MA Martinez-Gonzalez. Am. J. Clin. Nutr., 88: 1451–1452. View all references).A number of complications and false claims arise when interpreting epidemiological and interventional studies on fructose or SSDs. The first is a notion that high-fructose corn syrup (HFCS) differs from sucrose owing to its name “high fructose,” which places the focus on fructose; however, the composition and short-term metabolic effects of these sugars are similar (Stanhope and Havel, 200821. Stanhope , K. L. and Havel , P. J. 2008. Fructose consumption: potential mechanisms for its effects to increase visceral adiposity and induce dyslipidemia and insulin resistance. Curr. Opin. Lipidol., 19: 16–24. [CrossRef], [PubMed], [Web of Science ®]View all references). Second, fructose can be a surrogate marker for added sugars, for which some adverse effect is relatable to their glycemic load (Livesey and Taylor, 200814. Livesey , G. and Taylor , R. 2008. Fructose consumption and consequences for glycation, plasma triacylglycerol, and body weight: meta-analyses and meta-regression models of intervention studies. Am. J. Clin. Nutr., 88: 1419–1437. [PubMed], [Web of Science ®]View all references; Livesey et al., 200814. Livesey , G. and Taylor , R. 2008. Fructose consumption and consequences for glycation, plasma triacylglycerol, and body weight: meta-analyses and meta-regression models of intervention studies. Am. J. Clin. Nutr., 88: 1419–1437. [PubMed], [Web of Science ®]View all references). Third, dietary fructose may surrogate SSD consumption or an ill lifestyle, whether fructose is a problem or not (Livesey, 200913. Livesey , G. 2009. Dose-dependent responses to fructose ingestion in health research. J. Nutr., 139: 1246S–1252S. [CrossRef], [PubMed], [Web of Science ®]View all references). Fourth, fructose has been proposed to underlie the adverse effects of high-glycemic-index diets; however, this fails to explain the literature on blood glucose control by diet (Livesey and Taylor, 200814. Livesey , G. and Taylor , R. 2008. Fructose consumption and consequences for glycation, plasma triacylglycerol, and body weight: meta-analyses and meta-regression models of intervention studies. Am. J. Clin. Nutr., 88: 1419–1437. [PubMed], [Web of Science ®]View all references), and fructose has a low glycemic index. Fifth, short- and long-term effects of diet may differ—those of very high or excessive doses of fructose on fasting plasma triglycerides seem as such (Livesey and Taylor, 200814. Livesey , G. and Taylor , R. 2008. Fructose consumption and consequences for glycation, plasma triacylglycerol, and body weight: meta-analyses and meta-regression models of intervention studies. Am. J. Clin. Nutr., 88: 1419–1437. [PubMed], [Web of Science ®]View all references). Sixth, regarding interventional and not epidemiological studies, doses of fructose studied are often very high or excessive and relevant to only <1% of the US population (Livesey and Taylor, 200814. Livesey , G. and Taylor , R. 2008. Fructose consumption and consequences for glycation, plasma triacylglycerol, and body weight: meta-analyses and meta-regression models of intervention studies. Am. J. Clin. Nutr., 88: 1419–1437. [PubMed], [Web of Science ®]View all references; Livesey, 200913. Livesey , G. 2009. Dose-dependent responses to fructose ingestion in health research. J. Nutr., 139: 1246S–1252S. [CrossRef], [PubMed], [Web of Science ®]View all references). Seventh, data analyses in epidemiology generally fail to distinguish between (1) a linear trend involving only adverse effects and (2) a benefit of a nutrient at a moderate dose that diminishes when counterbalanced by an adverse effect as overconsumption approaches, as noted for fructose (Livesey and Taylor, 200814. Livesey , G. and Taylor , R. 2008. Fructose consumption and consequences for glycation, plasma triacylglycerol, and body weight: meta-analyses and meta-regression models of intervention studies. Am. J. Clin. Nutr., 88: 1419–1437. [PubMed], [Web of Science ®]View all references). Finally, discussions, invited commentaries, and editorials are usually narrative, and are thus at high risk of bias—those on fructose are no exception. Ecological studies. An ecological link between fructose supply and obesity prevalence has been proposed (Bray et al., 20044. Bray , G. A. , Nielsen , S. J. and Popkin , B. M. 2004. Consumption of high-fructose corn syrup in beverages may play a role in the epidemic of obesity. Am. J. Clin. Nutr., 79: 537–543. [PubMed], [Web of Science ®], [CSA]View all references); however, data on obesity are too scant to make a formal (Gross et al., 20048. Gross , L. S. , Li , L. , Ford , E. S. and Liu , S. 2004. Increased consumption of refined carbohydrates and the epidemic of type 2 diabetes in the United States: An ecologic assessment. Am. J. Clin. Nutr., 79: 774–779. [PubMed], [Web of Science ®], [CSA]View all references) or statistically significant link (Livesey, 200913. Livesey , G. 2009. Dose-dependent responses to fructose ingestion in health research. J. Nutr., 139: 1246S–1252S. [CrossRef], [PubMed], [Web of Science ®]View all references), especially given that other confounders have also changed (Anderson, 20071. Anderson , G. H. 2007. Much ado about high-fructose corn syrup in beverages: the meat of the matter. Am. J. Clin. Nutr., 86: 1577–1578. [PubMed], [Web of Science ®]View all references). Cross-sectional studies. Among such studies, no relationship exists between total fructose intake and BMI in adults (Livesey, 200913. Livesey , G. 2009. Dose-dependent responses to fructose ingestion in health research. J. Nutr., 139: 1246S–1252S. [CrossRef], [PubMed], [Web of Science ®]View all references), whereas studies of SSDs and body weight in children and adolescents are inconsistent (Malik et al., 200616. Malik , V. S. , Schulze , M. B. and Hu , F. B. 2006. Intake of sugar-sweetened beverages and weight gain: a systematic review. Am. J. Clin. Nutr., 84: 274–288. [PubMed], [Web of Science ®]View all references). Prospective cohort studies. A meta-analysis by Forshee et al. (2008)7. Forshee , R. A. , Anderson , P. A. and Storey , M. L. 2008. Sugar-sweetened beverages and body mass index in children and adolescents: a meta-analysis. Am. J. Clin. Nutr., 87: 1662–1671. [PubMed], [Web of Science ®]View all references of combined longitudinal studies in children and adolescents linked one SSD per day with a possible steady-state rise in BMI of 0.02 kg/m2. If not a steady state, the duration of such studies from one to 10 years, implies that obesity would generally take longer than a lifetime to develop (Livesey, 200913. Livesey , G. 2009. Dose-dependent responses to fructose ingestion in health research. J. Nutr., 139: 1246S–1252S. [CrossRef], [PubMed], [Web of Science ®]View all references). Limitations to the Forshee et al. meta-analysis have been examined (INLogic Ltd, unpublished, 2008). The examination revealed that (1) studies less than one year in duration associate SSD consumption with incomplete caloric compensation and weight gain, whereas those of longer duration yield effects that are too small to explain the recent obesity epidemic. (2) Such effects of SSDs in preschool-age children, adolescents, and adults are not significantly different. (3) Effects in obese persons are not consistently higher than in normal-weight persons. (4) Across all studies, caloric compensation to SSDs is >98%, except in studies of less than one year in duration. Finally, studies published to date (2009) since the meta-analysis by Forshee et al. (2008)7. Forshee , R. A. , Anderson , P. A. and Storey , M. L. 2008. Sugar-sweetened beverages and body mass index in children and adolescents: a meta-analysis. Am. J. Clin. Nutr., 87: 1662–1671. [PubMed], [Web of Science ®]View all references are of inadequate weight to affect their findings, as expected (Storey, 200822. Storey , M. 2008. Reply to M Bes-Rastrollo and MA Martinez-Gonzalez. Am. J. Clin. Nutr., 88: 1451–1452. View all references).The implication for SSDs and related fructose consumption in the long term, therefore, is caloric dilution of dietary nutrient density (see below) rather than obesity. Marginal micronutrient deficiency could then replace marginal adequacy (Institute of Medicine, 20039. Institute of Medicine. 2003. “Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids (macronutrients)”. In Macronutrients and healthful diets, 769–879. Washington, DC: National Academies Press. View all references). Unpublished or incompletely reported studies and inverse analyses. Two unpublished or incompletely published cohort studies (see Dubois et al., 20075. Dubois , L. , Farmer , A. , Girard , M. and Peterson , K. 2007. Regular sugar-sweetened beverage consumption between meals increases risk of overweight among preschool-aged children. J. Am. Diet Assoc., 107: 924–934. discussion 934–935 [CrossRef], [PubMed], [Web of Science ®]View all references; O’Connor et al., 200619. O’Connor , T. M. , Yang , S. J. and Nicklas , T. A. 2006. Beverage intake among preschool children and its effect on weight status. Pediatrics., 118: e1010–e1018. [CrossRef], [PubMed], [Web of Science ®]View all references) are said to demonstrate no link between overweight and SSD intake—because these studies provide insufficient data to enter into meta-analyses, they contribute further to the publication bias found by Forshee et al. (2008)7. Forshee , R. A. , Anderson , P. A. and Storey , M. L. 2008. Sugar-sweetened beverages and body mass index in children and adolescents: a meta-analysis. Am. J. Clin. Nutr., 87: 1662–1671. [PubMed], [Web of Science ®]View all references. Three reported cohort studies (Blum et al., 20053. Blum , J. W. , Jacobsen , D. J. and Donnelly , J. E. 2005. Beverage consumption patterns in elementary school aged children across a two-year period. J. Am. Coll. Nutr., 24: 93–98. [Taylor & Francis Online], [PubMed], [Web of Science ®]View all references; Libuda et al., 200812. Libuda , L. , Alexy , U. , Sichert-Hellert , W. , Stehle , P. , Karaolis-Danckert , N. , Buyken , A. E. and Kersting , M. 2008. Pattern of beverage consumption and long-term association with body-weight status in German adolescents–results from the DONALD study. Br. J. Nutr., 99: 1370–1379. View all references; Tam et al., 200623. Tam , C. S. , Garnett , S. P. , Cowell , C. T. , Campbell , K. , Cabrera , G. and Baur , L. A. 2006. Soft drink consumption and excess weight gain in Australian school students: results from the Nepean study. Int. J. Obes. (Lond)., 30: 1091–1093. View all references) were analyzed inversely, that is, they linked SSD intake to body weight as a determinant. These studies showed obese persons to consume more SSDs than average (not SSDs causing obesity). Such results could arise either because energy demand is higher in the obese and is being met by SSD intake or because persons succeeding to reduce body weight by a variety of means included in their strategy the replacement of SSDs with diet drinks. Such represents a response to control energy balance and cannot be interpreted as effects of fructose on obesity. Limited research. Some results are unexpected: Three studies(Dubois et al., 20075. Dubois , L. , Farmer , A. , Girard , M. and Peterson , K. 2007. Regular sugar-sweetened beverage consumption between meals increases risk of overweight among preschool-aged children. J. Am. Diet Assoc., 107: 924–934. discussion 934–935 [CrossRef], [PubMed], [Web of Science ®]View all references; Ebbeling et al., 20066. Ebbeling , C. B. , Feldman , H. A. , Osganian , S. K. , Chomitz , V. R. , Ellenbogen , S. J. and Ludwig , D. S. 2006. Effects of decreasing sugar-sweetened beverage consumption on body weight in adolescents: a randomized, controlled pilot study. Pediatrics., 117: 673–680. View all references; Schulze et al., 200420. Schulze , M. B. , Manson , J. E. , Ludwig , D. S. , Colditz , G. A. , Stampfer , M. J. , Willett , W. C. and Hu , F. B. 2004. Sugar-sweetened beverages, weight gain, and incidence of type 2 diabetes in young and middle-aged women. JAMA., 292: 927–934. [CrossRef], [PubMed], [Web of Science ®]View all references) have reported that SSD intake affects body weight by more than what is suggested by Forshee et al. (2008)7. Forshee , R. A. , Anderson , P. A. and Storey , M. L. 2008. Sugar-sweetened beverages and body mass index in children and adolescents: a meta-analysis. Am. J. Clin. Nutr., 87: 1662–1671. [PubMed], [Web of Science ®]View all references and our own meta-analyses would predict. In an additional study, the replacement of sucrose with aspartame did not affect weight loss over a period of 12 months in obese persons, but weight rebound was reduced in aspartame consumers (Blackburn et al., 19972. Blackburn , G. L. , Kanders , B. S. , Lavin , P. T. , Keller , S. D. and Whatley , J. 1997. The effect of aspartame as part of a multidisciplinary weight-control program on short- and long-term control of body weight. Am. J. Clin. Nutr., 65: 409–418. [PubMed], [Web of Science ®], [CSA]View all references). The reasons for these unpredicted effects are unclear. The replication of such effects has not been attempted, so there is a high risk of a false claim or inadequate interpretation (Ioannidis, 200510. Ioannidis , J. P. 2005. Why most published research findings are false. PLoS Med., 2: e124 [CrossRef], [PubMed], [Web of Science ®]View all references). None of these authors could assign the cause of effects they found to fructose versus co-ingested glucose or other carbohydrate, energy, or related ill-lifestyle choices. Beyond body weight: type-2 diabetes and lifestyle. Since more fructose has appeared in the US food supply, the rate of increase of type-2 diabetes has fallen (Livesey 200814. Livesey , G. and Taylor , R. 2008. Fructose consumption and consequences for glycation, plasma triacylglycerol, and body weight: meta-analyses and meta-regression models of intervention studies. Am. J. Clin. Nutr., 88: 1419–1437. [PubMed], [Web of Science ®]View all references, unpublished ecological observation). Among cross-sectional data, type-2 diabetes is most prevalent among low consumers of total fructose at all ages in adults (Livesey, 200913. Livesey , G. 2009. Dose-dependent responses to fructose ingestion in health research. J. Nutr., 139: 1246S–1252S. [CrossRef], [PubMed], [Web of Science ®]View all references). Furthermore, prospective association of type-2 diabetes with free fructose is found inconsistently, and when apparent it is no stronger than that for free glucose (Janket et al., 200311. Janket , S. J. , Manson , J. E. , Sesso , H. , Buring , J. E. and Liu , S. 2003. A prospective study of sugar intake and risk of type 2 diabetes in women. Diabetes Care., 26: 1008–1015. [CrossRef], [PubMed], [Web of Science ®], [CSA]View all references; Meyer et al., 200017. Meyer , K. A. , Kushi , L. H. , Jacobs , D. R. J. , Slavin , J. , Sellers , T. A. and Folsom , A. R. 2000. Carbohydrates, dietary fiber, and incident type 2 diabetes in older women. Am. J. Clin. Nutr., 71: 921–930. [PubMed], [Web of Science ®], [CSA]View all references; Montonen et al., 200718. Montonen , J. , Järvinen , R. , Knekt , P. , Heliövaara , M. and Reunanen , A. 2007. Consumption of sweetened beverages and intakes of fructose and glucose predict type 2 diabetes occurrence. J. Nutr., 137: 1447–1454. [PubMed], [Web of Science ®]View all references). Fructose in sucrose has been associated with a lower incidence of type-2 diabetes (Janket et al., 200311. Janket , S. J. , Manson , J. E. , Sesso , H. , Buring , J. E. and Liu , S. 2003. A prospective study of sugar intake and risk of type 2 diabetes in women. Diabetes Care., 26: 1008–1015. [CrossRef], [PubMed], [Web of Science ®], [CSA]View all references; Meyer et al., 200017. Meyer , K. A. , Kushi , L. H. , Jacobs , D. R. J. , Slavin , J. , Sellers , T. A. and Folsom , A. R. 2000. Carbohydrates, dietary fiber, and incident type 2 diabetes in older women. Am. J. Clin. Nutr., 71: 921–930. [PubMed], [Web of Science ®], [CSA]View all references; Montonen et al., 200718. Montonen , J. , Järvinen , R. , Knekt , P. , Heliövaara , M. and Reunanen , A. 2007. Consumption of sweetened beverages and intakes of fructose and glucose predict type 2 diabetes occurrence. J. Nutr., 137: 1447–1454. [PubMed], [Web of Science ®]View all references); statistical data have shown the meta-analytical relative risk of 0.85, with a 95% confidence interval of 0.73–0.97 (INLogic Ltd, unpublished, 2008). Frequent SSD intake and type-2 diabetes have also been associated prospectively (Schulze et al., 200420. Schulze , M. B. , Manson , J. E. , Ludwig , D. S. , Colditz , G. A. , Stampfer , M. J. , Willett , W. C. and Hu , F. B. 2004. Sugar-sweetened beverages, weight gain, and incidence of type 2 diabetes in young and middle-aged women. JAMA., 292: 927–934. [CrossRef], [PubMed], [Web of Science ®]View all references). However, caloric dilution of non-soda-related dietary energy by SSDs is approximately five times too small to explain an associated 50% to 60% lower nutrient density for magnesium and cereal fiber, and a 25% lower physical activity. Moreover, a simultaneous increase by 20% occurs in glycemic load. These and likely other lifestyle factors associate independently with type-2 diabetes and collectively would confound the interpretation ‘effect caused by SSDs’. Furthermore, meta-analyses of limited data have shown that fructose at doses consumed by the majority of persons in the United States will lower HbA1c and marginally, although not significantly, improve insulin sensitivity and fasting plasma triglycerides (Livesey and Taylor, 200814. Livesey , G. and Taylor , R. 2008. Fructose consumption and consequences for glycation, plasma triacylglycerol, and body weight: meta-analyses and meta-regression models of intervention studies. Am. J. Clin. Nutr., 88: 1419–1437. [PubMed], [Web of Science ®]View all references; Livesey, 200913. Livesey , G. 2009. Dose-dependent responses to fructose ingestion in health research. J. Nutr., 139: 1246S–1252S. [CrossRef], [PubMed], [Web of Science ®]View all references). With respect to type-2 diabetes, a causative role for fructose per se—or even a preventative role of moderate or possibly higher intake of pure fructose—remains to be established (Livesey and Taylor, 200814. Livesey , G. and Taylor , R. 2008. Fructose consumption and consequences for glycation, plasma triacylglycerol, and body weight: meta-analyses and meta-regression models of intervention studies. Am. J. Clin. Nutr., 88: 1419–1437. [PubMed], [Web of Science ®]View all references; Livesey, 200913. Livesey , G. 2009. Dose-dependent responses to fructose ingestion in health research. J. Nutr., 139: 1246S–1252S. [CrossRef], [PubMed], [Web of Science ®]View all references). The observations reported herein are consistent with a view that many claims in the scientific literature are false (Ioannidis, 200510. Ioannidis , J. P. 2005. Why most published research findings are false. PLoS Med., 2: e124 [CrossRef], [PubMed], [Web of Science ®]View all references) and that there is need for insightful meta-analyses.
    Full-text · Article · Nov 2010 · Critical Reviews in Food Science and Nutrition
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    • "Most of this research has focused on the effects of soft drinks and fruit drinks. There are fewer studies that found that fruit juice has the same effect.[26,27] Other metabolic effects are much less frequently studied.[28-30] "
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    ABSTRACT: Mexico has seen a very steep increase in child obesity level. Little is known about caloric beverage intake in this country as well as all other countries outside a few high income countries. This study examines overall patterns and trends in all caloric beverages from two nationally representative surveys from Mexico. The two nationally representative dietary intake surveys (1999 and 2006) from Mexico are used to study caloric beverage intake in 17, 215 children. The volume (ml) and caloric energy (kcal) contributed by all beverages consumed by the sample subjects were measured. Results are weighted to be nationally representative. The trends from the dietary intake surveys showed very large increases in caloric beverages among pre-school and school children. The contribution of whole milk and sugar-sweetened juices was an important finding. Mexican pre-school children consumed 27.8% of their energy from caloric beverages in 2006 and school children consumed 20.7% of their energy from caloric beverages during the same time. The three major categories of beverage intake are whole milk, fruit juice with various sugar and water combinations and carbonated and noncarbonated sugared-beverages. The Mexican government, greatly concerned about obesity, has identified the large increase in caloric beverages from whole milk, juices and soft drinks as a key target and is initiating major changes to address this problem. They have already used the data to shift 20 million persons in their welfare and feeding programs from whole to 1.5% fat milk and in a year will shift to nonfat milk. They are using these data to revise school beverage policies and national regulations and taxation policies related to an array of less healthful caloric beverages.
    Full-text · Article · Oct 2010 · Nutrition Journal
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