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Sugary Drinks Linked to Obesity in Kids
By Jeremy Appleton, ND

Healthnotes Newswire —Drinking sugar-sweetened beverages is associated with obesity in children, according to a study published Saturday in The Lancet.1 Although there are other contributing factors to childhood obesity, the new study provides the first tangible link between consumption of sugar-sweetened beverages (such as soda pop, Hawaiian punch®, lemonade, Kool-Aid®, and iced tea) and obesity in 11- to 12-year-old kids.

Participants in the study, which ran over two academic years, included 548 sixth and seventh graders in the Boston area from ethnically diverse backgrounds. The researchers predicted that, by observing how many sugar-sweetened beverages the children consumed, they would be able to predict a rise or fall in the children’s weight over the 19-month study period. They were right.

The odds of becoming obese among children in the study increased 60% for each additional can or glass of sugar-sweetened drink they consumed every day. Although the study’s design did not enable the researchers to prove that the sugary beverages caused the weight gains observed in the study, the chances are good that the beverages were a causative factor. Consider the background.

A Growing Trend

In the past 50 years, consumption of soft drinks has increased by almost 500%.2 Half of all Americans and most adolescents (65% of girls and 74% of boys) consume soft drinks daily.3 Most of these soft drinks are sweetened with sugar, rather than calorie-free, artificial sweeteners.4 Add to these facts the prevalence of obesity among children in the United States, which increased 100% between 1980 and 1994,5 and you have a recipe for weight gain.

All Calories Are Not Equal

It is not difficult to imagine links between trends in weight gain and trends in soft drink consumption. However, many studies have shown no relationship between carbohydrate (e.g., sugar) intake and fatness, and there is no clear evidence that eating sugar affects intake of other foods in a way that promotes weight gain.6 What, then, could account for the new association between drinking sugary beverages and weight gain in children?

One potential answer may lie in how the body compensates for calories consumed as liquid versus how it compensates for those consumed as solid food. In the short term, most people who eat excess calories in the form of solid food at one meal will automatically partially compensate by eating less at later meals. The same does not appear to be true when those excess calories are consumed in liquid form. An analysis of studies done over 25 years showed that the body does not completely compensate for excess calories when they are consumed in liquid forms, such as alcohol or soft drinks;7 in other words, people who consume sugar-laden beverages are likely to be less satisfied by those calories than they would be by calories from solid food. They may, therefore, eat more total calories each day because they do not eat less at a later meal to compensate for the energy (calories) they received earlier from beverages.

The authors of the current study suggest that excessive body weight is probably the most common pediatric medical problem in the United States. For obese children, weight loss programs and nutrition education are important to prevent increased risk of disease. However, fasting or extreme calorie restriction is not recommended for most children. These methods are psychologically stressful and may adversely affect growth and the child's perception of “normal” eating. Balanced diets with moderate restrictions, especially of saturated fat and junk foods and beverages that are high in sugar, have been used successfully in treating obesity.8 Diet management coupled with exercise is an effective treatment for childhood obesity.9

Sugar in beverages can go by many names, including glucose, fructose, sucrose, dextrose, maltose, levulose, corn syrup, high fructose corn syrup, and corn sweetener.

References
1. Ludwig DS, Peterson KE, Gortmaker SL. Relation between consumption of sugar-sweetened drinks and childhood obesity: a prospective, observational analysis. Lancet 2001;357:505–8.
2. Putnam JJ, Allshouse JE. Food consumption, prices and expenditures, 1970–97. Washington, DC: Food and Consumers Economics Division, Economic Research Service, US Department of Agriculture, 1999.
3. Borrud L, Enns CW, Mickle S. What we eat: USDA surveys food consumption changes. Commun Nutr Inst 1997;27:4–5.
4. Harnack L, Stang J, Story M. Soft drink consumption among US children and adolescents: nutritional consequences. J Am Diet Assoc 1999;99:436–41.
5. Koplan JP, Dietz WH. Caloric imbalance and public health policy. JAMA 1999;282:1579–81.
6. Hill JO, Prentice AM. Sugar and body weight regulation. Am J Clin Nutr 1995;62(1 Suppl):264S–273S; discussion 273S–274S.
7. Mattes RD. Dietary compensation by humans for supplemental energy provided as ethanol or carbohydrate in fluids. Physiol Behav 1996;59:179–87.
8. Dietz WH, Gortmaker SL. Do we fatten our children at the television set? Obesity and television viewing in children and adolescents. Pediatrics 1984;75:807–12.
9. Wolf MC, Cohen KR, Rosenfeld JG. School-based interventions for obesity: Current approaches and future prospects. Psychology in the Schools 1985; 22:187–200. EJ 318 072.

Jeremy Appleton, ND, is a licensed naturopathic physician, writer, and educator in the field of evidence-based complementary and alternative medicine. Dr. Appleton is Chair of Nutrition at the National College of Naturopathic Medicine and Senior Science Editor at Healthnotes.




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