Changes in Total Energy, Nutrients and Food Group Intake among Children and Adolescents during the COVID-19 Pandemic—Results of the DONALD Study

The COVID-19 pandemic may have changed the habitual lifestyles of children and adolescents, in particular, due to the closure of kindergartens and schools. To investigate the impact of the pandemic on nutrients and food intake of children and adolescents in Germany, we analyzed repeated 3-day weighed dietary records from 108 participants (3–18 years; females: n = 45, males: n = 63) of the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study. Polynomial mixed-effects regression models were used to identify prospective changes in dietary intake (total energy (TEI), carbohydrates, fat, protein, free sugar, ultra-processed foods, fruits and vegetables, sugar sweetened beverages and juices) before and during the first months of the COVID-19 pandemic. For the current analysis, we have chosen the first months of the pandemic (March 2020–August 2020), as this was the period with the most restrictions in Germany so far (kindergarten, school and restaurant closures; contact and outdoor activity restrictions). No significant changes in either the selected nutrients or food groups were observed. However, children and adolescents recorded a significantly lower TEI during the pandemic (β = −109.65, p = 0.0062). Results remained significant after the exclusion of participants with under-reported records (β = −95.77, p = 0.0063). While macronutrient intake did not change, descriptive data indicate a non-significant decrease in sugar sweetened beverages and ultra-processed foods intake. We suggest that children and adolescents from high socioeconomic families may have adapted lifestyle changes during the pandemic.

The Association between Fasting Glucose and Sugar Sweetened Beverages Intake Is Greater in Latin Americans with a High Polygenic Risk Score for Type 2 Diabetes Mellitus

Chile has the highest per capita intake of sugar-sweetened beverages (SSB) world-wide. However, it is unknown whether the effects from this highly industrialized food will mimic those reported in industrialized countries or whether they will be modified by local lifestyle or population genetics. Our goal was to evaluate the association between SSB intake and fasting glucose in the Chilean population. We calculated a weighted genetic risk score (GRSw) based on 16 T2D risk SNPs in 2828 non-diabetic participants of the MAUCO cohort. SSB intake was categorized in four levels using a food frequency questionnaire. Log-fasting glucose was regressed on SSB and GRSw tertiles while accounting for socio-demography, lifestyle, obesity, and Amerindian ancestry. Fasting glucose increased systematically per unit of GRSw (β = 0.02 ± 0.006, p = 0.00002) and by SSB intake (β[cat4] = 0.04 ± 0.009, p = 0.0001), showing a significant interaction, where the strongest effect was observed in the highest GRSw-tertile and in the highest SSB consumption category (β = 0.05 ± 0.02, p = 0.02). SNP-wise, SSB interacted with additive effects of rs7903146 (TCF7L2) (β = 0.05 ± 0.01, p = 0.002) and with the G/G genotype of rs10830963 (MTNRB1B) (β = 0.19 ± 0.05, p = 0.001). Conclusions: The association between SSB intake and fasting glucose in the Chilean population without diabetes is modified by T2D genetic susceptibility.

Anxiety, Depression, Perceived Executive Function and Sugar Sweetened Beverages: A Causal Mediation Analysis in Mexican Young Adults

Background: There is the notion that dysregulation of executive function (EF), which disrupts behavior and cognitive processes, may explain the emotional impairment which leads to increasing sugar sweetened beverages (SSBs) intake. We aimed to test whether anxiety and depression mediate the association between self-reported problems in EF and sugar sweetened beverage intake in Mexican adults between 18-40 years. Methods: An open survey advertised as a “mental health and sugar sweetened beverages study” was conducted, participants were recruited through Facebook ads Males and females, between 18-40 years, able to read and write, and currently residing in Mexico were included. We analyzed data using causal mediation analysis with latent variables using a structural equation modelling framework. Results: Significant indirect effects were found for somatic symptoms of depression (β = 6.601, SE = 2.657, p<.05) and anxiety (β = .679, SE = .334, p<.05). In depression model no significant direct effects of EF were found in the depression model, however they were found in the anxiety model (β = 1.335 SE = .566, p<.05). Conclusions: Somatic symptoms of depression were a total mediator, and anxiety a partial mediator. The results suggests that EF increased the probability of emotional symptoms, which led to a higher consumption of SBBs

Students’ perceptions of school sugar-free, food and exercise environments enhance healthy eating and physical activity

Objective: The objective of this study was to examine the relationships between students’ perceptions of their school policies and environments (i.e., sugar-sweetened beverages (SSBs) free policy, plain water drinking, vegetables and fruit eating campaign, outdoor physical activity initiative, and the SH150 program (exercise 150 min/week at school)) and their dietary behaviors and physical activity. Design: Cross-sectional study. Setting: Primary, middle, and high schools in Taiwan. Participants: A nationally representative sample of 2,433 primary school (5th-6th grade) students, 3,212 middle school students, and 2,829 high school students completed the online survey in 2018. Results: Multivariate analysis results showed that after controlling for school level, gender, and age, the students’ perceptions of school sugar-free policies were negatively associated with the consumption of sugar-sweetened beverages (SSBs) and positively associated with consumption of plain water. Schools’ campaigns promoting the eating of vegetables and fruit were positively associated with students’ consumption of vegetables. In addition, schools’ initiatives promoting outdoor physical activity and the SH150 program were positively associated with students’ engagement in outdoor physical activities and daily moderate-to-vigorous physical activity. Conclusions: Students’ perceptions of healthy school policies and environments promote healthy eating and an increase in physical activity for students.

Low Healthy Diet Self-Efficacy and Intentions Associated with High Sweet Snacks and Sugar Sweetened Beverages Consumption among African American Adolescents Recruited from Low-Income Neighborhoods in Baltimore

Psychosocial factors may influence consumption patterns of sweet snacks and sugar sweetened beverages (SSB), which are potential risk factors for obesity among African American (AA) adolescents. We used multivariable linear and logistic regression models to examine cross-sectional associations among psychosocial factors, sweet snacks and SSB consumption, and BMI z-scores in 437 AA adolescents aged 9–14 years living in low-income neighborhoods in Baltimore City, U.S.A. Mean caloric intake from sugar was 130.64 ± 88.37 kcal. Higher sweet snacks consumption was significantly associated with lower self-efficacy (adjusted Odds Ratio (aOR) = 0.81; 95% CI = 0.71 to 0.93) and lower food intentions scores (0.43; 0.30 to 0.61). Higher SSB consumption was associated with lower outcome expectancies (aOR = 0.98; 95% CI = 0.96–0.99), lower self-efficacy (0.98; 0.96 to 0.99), and lower food intentions (0.91; 0.87 to 0.95). No significant association was found between SSB and sweet snacks consumption and weight status. Psychosocial factors may play a role in sugar consumption behaviors among AA adolescents in low-income neighborhoods. Further studies are needed to improve our understanding of causal mechanisms of this association.

Energy-dense dietary patterns high in free sugars and saturated fat and associations with obesity in young adults

Purpose To derive dietary patterns based on dietary energy density (DED), free sugars, SFA, and fiber and investigate association with odds of overweight/obesity in young adults. Methods Cross-sectional data from 625 young Australian adults (18–30 years) were used. Dietary patterns were derived using reduced rank regression based on dietary data from a smartphone food diary using DED, free sugars, SFA, and fiber density as response variables. Multivariable logistic regression was used to investigate associations between dietary patterns and odds of self-reported overweight/obesity (BMI ≥ 25 kg/m2). Results Two dietary patterns were identified (DP1 and DP2). DP-1 was positively correlated with DED, free sugars, and SFA, and inversely correlated with fiber density. It was characterized by higher sugar-sweetened beverages intake and lower vegetable intake, and associated with higher odds of overweight/obesity (OR: 1.22; 95% CI 1.05, 1.42). DP-2 was positively correlated with fiber density and free sugars, and inversely correlated with DED and SFA. It was characterized by higher sugar-sweetened beverages intake and lower non-lean red meat intake, and was not significantly associated with overweight/obesity. Conclusion An energy-dense dietary pattern high in free sugars and SFA and low in fiber was associated with higher odds of obesity in young adults. These findings support dietary interventions that target reductions in energy-dense foods and sugar-sweetened beverages.

Sugar Sweetened Beverages Intake and Risk of Non-Communicable Chronic Diseases in Longitudinal Studies: A Systematic Review and Meta-Analysis with 1.5 Million Individuals

This study aimed to examine longitudinal associations between sugar-sweetened beverages (SSB) intake and type 2 diabetes, obesity, coronary heart disease and stroke in adults. We performed a systematic review and meta-analysis searching for articles in the Pubmed, Lilacs, Web of Science, Cochrane, Embase, and Scopus databases. After screening of titles and abstracts, 27 longitudinal studies were included for the narrative synthesis with all of them presenting medium or high methodological quality. None of the selected studies were from low-income countries and only three were conducted in middle-income countries. Type 2 diabetes was the most investigated disease – outcome in 15 out of 27 studies. Around 80% of the studies enrolled more than 10,000 individuals in the sample, and almost half of them followed the subjects for less than 10 years. A total of 1.5 million individuals were included in the pooled analyses, and results indicated that SSB intake increased the risk of type 2 diabetes (RR = 1.20; 95%C.I. 1.13 – 1.28), obesity (RR = 1.17; 95%C.I. 1.10 – 1.25), coronary heart disease (RR = 1.15; 95%C.I. 1.06 – 1.25), and stroke (RR = 1.10; 95%C.I. 1.01 – 1.19) in adults after adjustment for all potential confounders. Our systematic review and meta-analysis demonstrated that consumption of SSB intake appears to increase the risk non-communicable chronic disease, being the strongest evidence for type 2 diabetes. Actions are needed to be taken to reduce the SSB intake and its consequences worldwide.