Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Carbohydrates, glycemic index and diabetes mellitus

Associations of sugar-containing beverages with asthma prevalence in 11-year-old children: the PIAMA birth cohort

European Journal of Clinical Nutrition volume 69, pages 303–308 (2015)Cite this article

Subjects

Abstract

Background/objectives:

Recently, a few studies have linked soft drink consumption to increased asthma risk, but the contribution of different types of soft drinks is unknown. We investigated cross-sectional associations between six different types of soft drinks and asthma in 11-year-old children.

Subjects/methods:

We analyzed data of 2406 children participating in the Dutch Prevention and Incidence of Asthma and Mite Allergy birth cohort. At age 11, children self-reported consumption of sugar-added drinks, diet drinks, sweetened milk drinks, 100% fruit juice, energy drinks and sport drinks. The definition of asthma was based on parental reports of wheezing, prescription of inhaled corticosteroids and doctor’s diagnosis of asthma.

Results:

The prevalence of asthma in this study was 5.8%. In adjusted logistic regression analyses, asthma risk was increased for high (⩾10 glasses/week (gl/wk) versus low (<4 gl/wk) consumption of 100% fruit juice (odds ratio (OR): 2.09, 95% confidence interval (CI): 1.21–3.60), sugar-added drinks (OR: 1.56, 95%CI: 0.95–2.56) and for very high (>21.5 gl/wk) versus low (<12.5 gl/wk) total sugar-containing beverage (SCB) consumption (OR: 1.91, 95%CI: 1.04–3.48). Consumption of other beverages and consumption of fruit were not associated with increased asthma risk. No evidence for mediation of the observed associations by body mass index was found.

Conclusions:

This study indicates that high consumption of 100% fruit juice and total SCBs is associated with increased asthma risk in children. The positive association between consumption of 100% fruit juice and asthma is an unexpected finding that needs confirmation in future studies.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Masoli M, Fabian D, Holt S, Beasley R . The global burden of asthma: executive summary of the GINA Dissemination Committee report. Allergy 2004; 59: 469–478.

    Article  Google Scholar 

  2. de Cassia Ribeiro Silva R, Assis AM, Cruz AA, Fiaccone RL, Dinnocenzo S, Barreto ML et al. Dietary patterns and wheezing in the midst of nutritional transition: a study in Brazil. Pediatr Allergy Immunol Pulmonol 2013; 26: 18–24.

    Article  Google Scholar 

  3. Wood LG, Gibson PG . Dietary factors lead to innate immune activation in asthma. Pharmacol Ther 2009; 123: 37–53.

    Article  CAS  Google Scholar 

  4. Nurmatov U, Devereux G, Sheikh A . Nutrients and foods for the primary prevention of asthma and allergy: systematic review and meta-analysis. J Allergy Clin Immunol 2011; 127: 724–733 e721-730.

    Article  Google Scholar 

  5. Stensson M, Wendt LK, Koch G, Nilsson M, Oldaeus G, Birkhed D . Oral health in pre-school children with asthma—followed from 3 to 6 years. Int J Paediatr Dent 2010; 20: 165–172.

    Article  Google Scholar 

  6. Park S, Blanck HM, Sherry B, Jones SE, Pan L . Regular-soda intake independent of weight status is associated with asthma among US high school students. J Acad Nutr Diet 2013; 113: 106–111.

    Article  Google Scholar 

  7. Shi Z, Dal Grande E, Taylor AW, Gill TK, Adams R, Wittert GA . Association between soft drink consumption and asthma and chronic obstructive pulmonary disease among adults in Australia. Respirology 2012; 17: 363–369.

    Article  Google Scholar 

  8. Aeberli I, Gerber PA, Hochuli M, Kohler S, Haile SR, Gouni-Berthold I et al. Low to moderate sugar-sweetened beverage consumption impairs glucose and lipid metabolism and promotes inflammation in healthy young men: a randomized controlled trial. Am J Clin Nutr 2011; 94: 479–485.

    Article  CAS  Google Scholar 

  9. Steinman HA, Weinberg EG . The effects of soft-drink preservatives on asthmatic children. S Afr Med J 1986; 70: 404–406.

    CAS  PubMed  Google Scholar 

  10. Brunekreef B, Smit J, de Jongste J, Neijens H, Gerritsen J, Postma D et al. The prevention and incidence of asthma and mite allergy (PIAMA) birth cohort study: design and first results. Pediatr Allergy Immunol 2002; 13 (Suppl 15): 55–60.

    Article  Google Scholar 

  11. Wijga AH, Kerkhof M, Gehring U, de Jongste JC, Postma DS, Aalberse RC et al. Cohort profile: The Prevention and Incidence of Asthma and Mite Allergy (PIAMA) birth cohort. Int J Epidemiol 2013; 43: 527–535.

    Article  Google Scholar 

  12. Keil T, Kulig M, Simpson A, Custovic A, Wickman M, Kull I et al. European birth cohort studies on asthma and atopic diseases: II. Comparison of outcomes and exposures—a GA2LEN initiative. Allergy 2006; 61: 1104–1111.

    Article  CAS  Google Scholar 

  13. Subar AF, Thompson FE, Kipnis V, Midthune D, Hurwitz P, McNutt S et al. Comparative validation of the Block, Willett, and National Cancer Institute food frequency questionnaires: the Eating at America's Table Study. Am J Epidemiol 2001; 154: 1089–1099.

    Article  CAS  Google Scholar 

  14. Fredriks AM, van Buuren S, Burgmeijer RJ, Meulmeester JF, Beuker RJ, Brugman E et al. Continuing positive secular growth change in The Netherlands 1955-1997. Pediatr Res 2000; 47: 316–323.

    Article  CAS  Google Scholar 

  15. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH . Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000; 320: 1240–1243.

    Article  CAS  Google Scholar 

  16. Nurmatov U, Nwaru BI, Devereux G, Sheikh A . Confounding and effect modification in studies of diet and childhood asthma and allergies. Allergy 2012; 67: 1041–1059.

    Article  CAS  Google Scholar 

  17. Papoutsakis C, Priftis KN, Drakouli M, Prifti S, Konstantaki E, Chondronikola M et al. Childhood overweight/obesity and asthma: is there a link? A systematic review of recent epidemiologic evidence. J Acad Nutr Diet 2013; 113: 77–105.

    Article  Google Scholar 

  18. Morgan RE . Does consumption of high-fructose corn syrup beverages cause obesity in children? Pediatr Obes 2013; 8: 249–254.

    Article  CAS  Google Scholar 

  19. Wickens K, Barry D, Friezema A, Rhodius R, Bone N, Purdie G et al. Fast foods—are they a risk factor for asthma? Allergy 2005; 60: 1537–1541.

    Article  CAS  Google Scholar 

  20. Bueso AK, Berntsen S, Mowinckel P, Andersen LF, Lodrup Carlsen KC, Carlsen KH . Dietary intake in adolescents with asthma—potential for improvement. Pediatr Allergy Immunol 2011; 22 (Pt 1), 19–24.

    Article  Google Scholar 

  21. Thornley S, Stewart A, Marshall R, Jackson R . Per capita sugar consumption is associated with severe childhood asthma: an ecological study of 53 countries. Prim Care Respir J 2011; 20: 75–78.

    Article  Google Scholar 

  22. Schulze MB, Hoffmann K, Manson JE, Willett WC, Meigs JB, Weikert C et al. Dietary pattern, inflammation, and incidence of type 2 diabetes in women. Am J Clin Nutr 2005; 82: 675–684. quiz 714-675.

    Article  CAS  Google Scholar 

  23. Johnson RJ, Nakagawa T, Sanchez-Lozada LG, Shafiu M, Sundaram S, Le M et al. Sugar, uric acid, and the etiology of diabetes and obesity. Diabetes 2013; 62: 3307–3315.

    Article  CAS  Google Scholar 

  24. Li Lin, Wan Chun, Wen F . An unexpected role for serum uric acid as a biomarker for severity of asthma exacerbation. Asian Pac J Allergy Immunol 2014; 32: 93–99.

    PubMed  Google Scholar 

  25. Willart MA, Lambrecht BN . The danger within: endogenous danger signals, atopy and asthma. Clin Exp Allergy 2009; 39, 12–19.

    Article  CAS  Google Scholar 

  26. Kool M, Willart MA, van Nimwegen M, Bergen I, Pouliot P, Virchow JC et al. An unexpected role for uric acid as an inducer of T helper 2 cell immunity to inhaled antigens and inflammatory mediator of allergic asthma. Immunity 2011; 34: 527–540.

    Article  CAS  Google Scholar 

  27. Boeing H, Bechthold A, Bub A, Ellinger S, Haller D, Kroke A et al. Critical review: vegetables and fruit in the prevention of chronic diseases. Eur J Nutr 2012; 51: 637–663.

    Article  CAS  Google Scholar 

  28. Englyst KN, Englyst HN . Carbohydrate bioavailability. Br J Nutr 2005; 94: 1–11.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We gratefully acknowledge the contribution of all participating children and parents or caregivers of the Prevention and Incidence of Asthma and Mite Allergy (PIAMA) study. We thank Ada Wolse, Marjan Tewis and Marieke Oldenwening for their contribution to the data collection and data management. The PIAMA study was funded by grants from the Netherlands Organisation for Health Research and Development; the Netherlands Asthma Foundation; the Netherlands Ministry of Planning, Housing and the Environment; The Netherlands Ministry of Health, Welfare and Sport; and the Institute for Public Health and the Environment. Professor Dr GHK has received grants from the Dutch Lung Foundation, Biobanking and Biomolecular Resources Research Infrastructure and Stichting Astma Bestrijding. These organizations and study sponsors were not involved in the design or conduct of the current study.

Author information

Authors and Affiliations

  1. Center for Nutrition, Prevention, and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands

    N E Berentzen, V L van Stokkom & A H Wijga

  2. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands

    N E Berentzen & H A Smit

  3. Division of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands

    U Gehring

  4. Department of Pediatric Pulmonology and Pediatric Allergology, University of Groningen, University Medical Center Groningen, Beatrix Children’s Hospital, GRIAC Research Institute, Groningen, The Netherlands

    G H Koppelman

  5. Department of Health Sciences, Faculty of Earth and Life Sciences, VU University, Amsterdam, The Netherlands

    L A Schaap

Authors
  1. N E Berentzen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. V L van Stokkom
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. U Gehring
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. G H Koppelman
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. L A Schaap
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. H A Smit
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. A H Wijga
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to N E Berentzen.

Ethics declarations

Competing interests

GHK has received grants from the Dutch Lung Foundation, Biobanking and Biomolecular Resources Research Infrastructure and Stichting Astma Bestrijding. These organizations or study sponsors were not involved in the design or conduct of the current study. The remaining authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Berentzen, N., van Stokkom, V., Gehring, U. et al. Associations of sugar-containing beverages with asthma prevalence in 11-year-old children: the PIAMA birth cohort. Eur J Clin Nutr 69, 303–308 (2015). https://doi.org/10.1038/ejcn.2014.153

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ejcn.2014.153

This article is cited by

Search

Advanced search

Quick links