The trajectories of free sugar intake and its main sources during childhood and cardiometabolic clusters at 13 years of age.

BACKGROUND AND AIM: The effect of free sugar (FS) intake trajectories in early life on later cardiometabolic health is unclear. To evaluate the association of FS intake trajectories (both total FS and primary food sources) on cardiometabolic risk clusters from childhood into adolescence.

METHODS AND

RESULTS

Participants (n = 3616) from the Generation XXI birth-cohort were assessed at ages 4, 7, 10, and 13. FS intake was assessed using food frequency questionnaires. Cardiometabolic outcomes (BMI, waist circumference, HOMA, lipids, blood pressure) were objectively measured. Gaussian mixture models identified FS trajectories and cardiometabolic risk clusters at 13y, and logistic regression models estimated their associations, adjusting for confounders and energy intake. Six FS intake trajectories were identified. Compared with the lowest FS trajectory, higher intake trajectories were positively associated with a less favorable cardiometabolic profile, with this association attenuated after adjustment for energy. Children with the highest FS intake at 4-years of age had significantly increased odds of a less favorable profile (Cluster 1, OR = 2.11,95%CI:1.04-4.22). The later the age peaks the maximum FS intake from sugar-sweetened beverages (SSBs), the lower the cardiometabolic risk (OR = 0.94,95%CI:0.87-1.02). For sweets, both a later trend reversal of minimum intake (OR = 1.09,95%CI:1.00-1.18) and a higher minimum intake (OR = 1.15,95%CI:1.05-1.25) were associated with a less favorable cardiometabolic profile, even after adjustments.

CONCLUSION

Higher FS intake in early life and persistent intake during childhood, particularly from SSBs and sweets, is associated with a less favorable cardiometabolic profile in adolescence. This association was attenuated after adjustment for energy intake, suggesting that energy intake may partly explain the observed associations.