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Using doubly labeled water to validate associations between sugar-sweetened beverage intake and body mass among White and African-American adults

Abstract

Background:

Evidence is mixed regarding sugar-sweetened beverage (SSB) intake and adiposity among adults, perhaps because of reporting bias.

Objective:

The objective of this study is to determine the impact of reporting bias on any associations between increased SSB intake and overweight/obesity.

Design:

Beverage intake and overweight/obese status (body mass index 25 kg m−2) were examined among adults from a dietary assessment and doubly labeled water study (n=250). Four web-based, 24-h recalls assessed dietary intake. SSB intake was categorized as no intake, 1–99 kcals per day and >99 kcals per day. Logistic regression models adjusted for total caloric intake, age, race, education and diet quality compared SSB intake with overweight/obese status. To investigate dietary self-reporting bias, analyses were replicated in a subset of ‘true reporters’: those with self-reported total caloric intake within 25% of total energy expenditure per doubly labeled water assessments (n=108).

Results:

One-half of participants were overweight/obese; more overweight/obese participants consumed SSB than normal-weight participants (69% vs 47%; P<0.001). Intake of other beverages did not differ by adiposity. Less number of White participants (48%) consumed SSB compared with African-American participants (68%; P=0.002). Compared with no intake, SSB intake up to the median intake doubled the risk of being overweight/obese (odds ratio: 2.1, 95% confidence interval: 1.0–4.3; P=0.046) and SSB intake over the median more than doubled the risk (odds ratio: 2.6, 95% confidence interval: 1.2–6.0; P=0.018). When limited to true reporters, SSB intake significantly increased the risk of being overweight/obese by nearly fourfold.

Conclusion:

Underreporting of SSB intake may be attenuating true associations of SSB intake and the risk of being overweight/obese.

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Acknowledgements

This project was funded by the National Institutes of Health grant R01CA105048 and a T32 training grant 3T3236GM084896-0251 under the National Institute of General Medical Sciences of the National Institutes of Health.

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Correspondence to J A Emond.

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Supplementary Information accompanies this paper on International Journal of Obesity website

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Emond, J., Patterson, R., Jardack, P. et al. Using doubly labeled water to validate associations between sugar-sweetened beverage intake and body mass among White and African-American adults. Int J Obes 38, 603–609 (2014). https://doi.org/10.1038/ijo.2013.130

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Keywords

  • sugar-sweetened beverages
  • African American
  • high-fructose corn syrup

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