[Association of beverage consumption patterns with different types of obesity among children and adolescents in Renhuai City, Guizhou Province].

Objective

To investigate the associations between different beverage consumption patterns and general obesity, abdominal obesity, and their coexistence in children and adolescents, and to analyze the differences across gender, age groups, and residential areas, so as to provide scientific evidence for precise prevention and control of childhood obesity.

Methods

This was a cross-sectional study conducted in Renhuai City, Guizhou Province, involving 11 646 children and adolescents. Principal component analysis was employed to extract beverage consumption patterns. General obesity (BMI ≥95th percentile for age and sex) and abdominal obesity (waist circumference ≥90th percentile for age and sex) were defined according to the Screening for Overweight and Obesity in School-age Children and Adolescents (WS/T 586-2018) and the Screening Thresholds for High Waist Circumference in Children and Adolescents Aged 7-18 Years (WS/T 611-2018), respectively. Multivariate logistic regression was used to analyze the associations between beverage patterns and three types of obesity (general obesity, abdominal obesity, and their coexistence), with subgroup analyses stratified by gender, age group, and residential area.

Results

Among 11 646 children and adolescents, two beverage patterns were extracted, named the carbonated-stimulant-sweetener beverage group and the dairy-juice group. Analysis of population distribution characteristics showed that the carbonated-stimulant-sweetener beverage group had a higher proportion of males (χ²=32.327, P<0.001), adolescents (χ²=110.242, P<0.001), boarders (χ²=18.053, P<0.001), and urban residents (χ²=83.999, P<0.001). Regarding lifestyle factors, the carbonated-stimulant-sweetener beverage group had a higher proportion of individuals who did not meet the screen time recommendation (χ²=22.955, P<0.001) and did not meet the moderate-to-vigorous physical activity recommendation (χ²=6.622, P=0.010). The Food Diversity Score[M(Q1, Q3)] for the carbonated-stimulant-sweetener beverage group was 3(1, 6), while that for the dairy-juice group was 4 (2, 7) (Z=-12.233, P<0.001). Sleep duration[M(Q1, Q3)] for the carbonated-stimulant-sweetener beverage group was 8.5 (7.5, 9.3) h/d, whereas for the dairy-juice group it was 8.9 (8.1, 9.5) h/d (Z=-10.505, P<0.001). Both the Food Diversity Score and sleep duration were lower in the carbonated-stimulant-sweetener beverage group than in the dairy-juice group. Multivariate logistic regression showed that, using the dairy-juice group as the reference, the carbonated-stimulant-sweetener beverage group was positively associated with general obesity (OR=1.154, 95%CI: 1.021-1.304, P=0.021), abdominal obesity (OR=1.195, 95%CI: 1.078-1.324, P<0.001), and the coexistence of both obesity types (OR=1.175, 95%CI: 1.024-1.347, P=0.021). These associations remained significant after correction using the MEff method (α=0.022). In subgroup analyses, the carbonated-stimulant-sweetener beverage group was positively associated with the three obesity phenotypes in adolescents (P<0.01), with abdominal obesity in males (OR=1.224, 95%CI: 1.083-1.383, P=0.001), and with abdominal obesity in urban students (OR=1.163, 95%CI: 1.041-1.298, P=0.007). These associations also remained significant after correction using the MEff method.

Conclusions

The carbonated-stimulant-sweetener beverage pattern was significantly positively associated with all obesity indicators in children and adolescents. Further subgroup analyses showed that these positive associations were more pronounced among adolescents, males, and urban residents.