Consumption of Sugar Sweetened Beverage Is Associated With Incidence of Metabolic Syndrome in Tehranian Children and Adolescents

Parvin Mirmiran; Emad Yuzbashian; Golaleh Asghari; Somayeh Hosseinpour-Niazi; Fereidoun Azizi


Nutr Metab. 2015;12(25) 

In This Article

Abstract and Introduction


Background: Intakes of high sugar-sweetened beverages (SSBs) in adults can escalate risk of metabolic syndrome (MetS); however, data of longitudinal studies in children and adolescents are lacking. In this study we assessed consumption of SSBs in relation to incidence of MetS among children and adolescents during a 3.6 year follow-up.

Methods: This study was a population-based longitudinal study, in which 424 subjects, aged 6–18 years, from the Tehran Lipid and Glucose Study with complete data on dietary intake, blood pressure, anthropometry, and biochemical indices were followed for 3.6 years. Dietary intake was collected using a valid and reliable food frequency questionnaire. MetS was defined according to the Cook criteria. Sugar sweetened beverages included all kinds of sugar sweetened carbonated soft drinks (SSSDs) and fruit juice drinks.

Results: Average daily intakes of SSSD and fruit juice drinks were 38.5 ± 75.0 and 32.3 ± 60.1 g, respectively. After adjustment for confounders, compared to the first quartile, the odds ratio of incident MetS in the highest quartile of SSB and SSSD was 3.20 (95 % CI: 1.06–9.90) and 3.01 (95 % CI: 1.17–7.74), respectively. Regarding incidence of MetS components, compared with the lowest quartile, the highest quartile of SSSDs showed odds ratios of 2.49 (95 % CI: 1.00–6.53) for abdominal obesity and 2.79 (95 % CI: 1.02–7.64) for hypertension. No significant association was found between consumption of fruit juice drink and SSSD with other components of MetS.

Conclusions: Children and adolescents with high intakes of carbonated beverages could be at increased risk of MetS, abdominal obesity, and hypertension.


The rising prevalence of metabolic syndrome (MetS) during childhood and adolescence affectes over 3.3 % of the adolescent population worldwide,[1] and may be predictive of adult MetS, type 2 diabetes, and cardiovascular disease.[2,3] Although some studies have examined genetic predispositions, findings show that only 10 % of MetS cases can be explained by genetics.[4] Alternatively, many environmental factors have been identified,[5] e.g. food intakes play an important role in the pathogenesis of MetS through hepatic insulin resistance and/or increasing reactive oxygen species formation.[6]

Nowadays the consumption of sugar sweetened beverages (SSBs) has increased drastically particularly in children and adolescents.[7–9] Higher SSB intakes in adults may enhance risk of weight gain and of developing obesity and obesity-related disorders, such as MetS, type 2 diabetes, coronary heart disease, and stroke.[10,11] However, according to a recent evidence mapping study by Althuis et al.,[12] longitudinal studies in children and adolescents are lacking and limited to one cross-sectional investigation, which indicated that SSBs have been linked to increased risk of MetS, hypertension, and abdominal obesity.[13]

In the current study, we evaluated the association between SSB consumption with incident MetS and its components 3.6 years later among children and adolescents in Iran.