Associations between sugar-sweetened beverage intake and emotional and behavioral problems in preschoolers

ZHOU Xin; WANG Lei; PENG Lei; CHEN Jia; ZHANG Lei; TAO Fangbiao; JIN Wu; YAO Qingbing; SUN Lei

doi:10.16835/j.cnki.1000-9817.2022.01.015

Volume 43 Issue 1

Jan. 2022

Turn off MathJax

Article Contents

Article Navigation > CHINESE JOURNAL OF SCHOOL HEALTH > 2022 > 43(1): 67-71

ZHOU Xin, WANG Lei, PENG Lei, CHEN Jia, ZHANG Lei, TAO Fangbiao, JIN Wu, YAO Qingbing, SUN Lei. Associations between sugar-sweetened beverage intake and emotional and behavioral problems in preschoolers[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2022, 43(1): 67-71. doi: 10.16835/j.cnki.1000-9817.2022.01.015

Citation:

ZHOU Xin, WANG Lei, PENG Lei, CHEN Jia, ZHANG Lei, TAO Fangbiao, JIN Wu, YAO Qingbing, SUN Lei. Associations between sugar-sweetened beverage intake and emotional and behavioral problems in preschoolers[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2022, 43(1): 67-71. doi: 10.16835/j.cnki.1000-9817.2022.01.015

Citation:

ZHOU Xin, WANG Lei, PENG Lei, CHEN Jia, ZHANG Lei, TAO Fangbiao, JIN Wu, YAO Qingbing, SUN Lei. Associations between sugar-sweetened beverage intake and emotional and behavioral problems in preschoolers[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2022, 43(1): 67-71. doi: 10.16835/j.cnki.1000-9817.2022.01.015

PDF( 399 KB)

Associations between sugar-sweetened beverage intake and emotional and behavioral problems in preschoolers

doi: 10.16835/j.cnki.1000-9817.2022.01.015

1.
Yangzhou Center for Disease Control and Prevention, Yangzhou (225100), Jiangsu Province, China

Received Date: 2021-08-09
Rev Recd Date: 2021-10-14
Publish Date: 2022-01-25

Abstract

Abstract

Objective To explore the consumption of sugar-sweetened beverages (SSBs) and its association with behavioral problems in Chinese preschool children, and to provide a scientific basis for the prevention of behavioral problems of children. Methods A total of 7 634 children aged 3-6 years were chosen from kindergartens in 3 cities (Yangzhou, Xuzhou, Zhenjiang) in the lower reaches of Yangtze River using method of cluster sampling during October to November in 2017. Parental or guardian questionnaires were used to obtain information regarding child consumption of SSBs. The Strengths and Difficulties Questionnaire (SDQ) was used to assess children's emotional and behavioral problems. Multivariate Logistic regression model was used to explore the association between different SSBs intake frequency and children's behavioral problems. Results A total of 5 509(72.2%) consumed SSBs less than once a day, 830(10.9%) reported SSBs consumption once a day, and 1 295(16.9%) had 2 times or more intake of sugar-sweetened beverages per day. After adjusting for confounding factors including age, sex, BMI, family financial status, parental education, screen time, sleep duration, and physical activities duration, multiple Logistic regression model revealed that intake of SSBs once a day was associated with an increased risk of hyperactivity disorder (OR=1.26, 95%CI=1.01-1.57) and SDQ total difficulties (OR=1.44, 95%CI=1.14-1.82) in boys and with an increased risk of emotional symptoms (OR=1.34, 95%CI=1.02-1.76), conduct problems (OR=1.53, 95%CI=1.18-2.00), hyperactivity disorder (OR=1.79, 95%CI=1.42-2.27) and prosocial behavior (OR=1.48, 95%CI=1.14-1.91) in girls. Intake of SSBs≥2 times per day was associated with an increased risk of emotional symptoms (OR=1.28, 95%CI=1.02-1.59) and SDQ difficulties (OR=1.30, 95%CI=1.07-1.58) in boys and not with behavioral problems in girls. Conclusion Sex differences are observed with respect to the association between SSBs intake and behavioral problems in preschoolers, but no significant dose-response relationship was observed. More longitudinal studies are needed to further explore the association between SSBs intake and behavioral problems in preschool children as well as the underlying physiological mechanisms in future.
- Carbohydrates,
- Beverages,
- Feeding behavior,
- Emotions,
- Behavior,
- Child, preschool

FullText(HTML)

References(32)

References

[1]	POLANCZYK G V, SALUM G A, SUGAYA L S, et al. Annual research review: a meta-analysis of the worldwide prevalence of mental disorders in children and adolescents[J]. J Child Psychol Psychiatry, 2015, 56(3): 345-365. doi: 10.1111/jcpp.12381
[2]	SALUM G A, GADELHA A, PAN P M, et al. High risk cohort study for psychiatric disorders in childhood: rationale, design, methods and preliminary results[J]. Int J Methods Psychiatr Res, 2015, 24(1): 58-73. doi: 10.1002/mpr.1459
[3]	MARTINEZ N T, TIEMEIER H, LUIJK M P C M, et al. Aggressive behavior, emotional, and attention problems across childhood and academic attainment at the end of primary school[J]. Soc Psychiatry Psychiatr Epidemiol, 2021, 56(5): 837-846. doi: 10.1007/s00127-021-02039-3
[4]	BEVILACQUA L, HALE D, BARKER E D, et al. Conduct problems trajectories and psychosocial outcomes: a systematic review and Meta-analysis[J]. Eur Child Adolesc Psychiatry, 2018, 27(10): 1239-1260. doi: 10.1007/s00787-017-1053-4
[5]	XU H, WU X, WAN Y, et al. Interaction effects of co-consumption of fast food and sugar-sweetened beverages on psychological symptoms: evidence from a nationwide survey among Chinese adolescents[J]. J Affect Disord, 2020, 276: 104-111. doi: 10.1016/j.jad.2020.07.030
[6]	KENDIG M D. Cognitive and behavioural effects of sugar consumption in rodents: a review[J]. Appetite, 2014, 80: 41-54. doi: 10.1016/j.appet.2014.04.028
[7]	SANCHEZ-VILLEGAS A, ZAZPE T, SANTIAGO S, et al. Added sugars and sugar-sweetened beverage consumption, dietary carbohydrate index and depression risk in the Seguimiento Universidad de Navarra (SUN) Project[J]. Br J Nutr, 2018, 119(2): 211-221. doi: 10.1017/S0007114517003361
[8]	FREIJE S L, SENTER C C, AVERY S D, et al. Association between consumption of sugar-sweetened beverages and 100% fruit juice with poor mental health among US adults in 11 US States and the district of columbia[J]. Prev Chronic Dis, 2021, 18: E51.
[9]	WINPENNY E M, VAN HARMELEN A, WHITE M, et al. Diet quality and depressive symptoms in adolescence: no cross-sectional or prospective associations following adjustment for covariates[J]. Public Health Nutr, 2018, 21(13): 2376-2384. doi: 10.1017/S1368980018001179
[10]	WELSH J A, COGSWELL M E, ROGERS S, et al. Overweight among low-income preschool children associated with the consumption of sweet drinks: missouri, 1999-2002[J]. Pediatrics, 2005, 115(2): e223-229. doi: 10.1542/peds.2004-1148
[11]	GOODMAN R, RENFREW D, MULLICK M. Predicting type of psychiatric disorder from Strengths and Difficulties Questionnaire (SDQ) scores in child mental health clinics in London and Dhaka[J]. Eur Child Adolesc Psychiatry, 2000, 9(2): 129-134. doi: 10.1007/s007870050008
[12]	HIRSHKOWITZ M, WHITON K, ALBERT S M, et al. National Sleep Foundation's updated sleep duration recommendations: final report[J]. Sleep Health, 2015, 1(4): 233-243. doi: 10.1016/j.sleh.2015.10.004
[13]	PARUTHI S, BROOKS L J, D'AMBROSIO C, et al. Consensus statement of the American Academy of Sleep Medicine on the recommended amount of sleep for healthy children: methodology and discussion[J]. J Clin Sleep Med, 2016, 12(11): 1549-1561. doi: 10.5664/jcsm.6288
[14]	American Academy of Pediatrics, Committee on Public Education. American academy of pediatrics: children, adolescents, and television[J]. Pediatrics, 2001, 107(2): 423-426. doi: 10.1542/peds.107.2.423
[15]	WHO. Global recommendations on physical activity for health[EB/OL]. (2010-01-01)[2021-09-07]. https://www.who.int/dietphysicalactivity/factsheet_recommendations/en/.
[16]	COSTA D, WARKENTIN S, OLIVEIRA A. The effect of sugar-sweetened beverages at 4 years of age on appetitive behaviours of 7-year-olds from the Generation XXI birth cohort[J]. Br J Nutr, 2021, 126(5): 790-800. doi: 10.1017/S000711452000447X
[17]	LAVERTY A A, MAGEE L, MONTEIRO A, et al. Sugar and artificially sweetened beverage consumption and adiposity changes: national longitudinal study[J]. Int J Behav Nutr Phys Act, 2015, 12: 137. doi: 10.1186/s12966-015-0297-y
[18]	PALAKSHAPPA D, LENOIR K, BROWN C L, et al. Identifying geographic differences in children's sugar-sweetened beverage and 100% fruit juice intake using health system data[J]. Pediatr Obes, 2020, 15(11): e12663.
[19]	ROSINGER A, HERRICK K, GAHCHE J, et al. Sugar-sweetened beverage consumption among U.S. youth, 2011-2014[J]. NCHS Data Brief, 2017 (271): 1-8.
[20]	SUGLIA S F, SOLNICK S, HEMENWAY D. Soft drinks consumption is associated with behavior problems in 5-year-olds[J]. J Pediatr, 2013, 163(5): 1323-1328. doi: 10.1016/j.jpeds.2013.06.023
[21]	YU C J, DU J C, CHIOU H C, et al. Sugar-sweetened beverage consumption is adversely associated with childhood attention deficit/hyperactivity disorder[J]. Int J Environ Res Public Health, 2016, 13(7): 678. doi: 10.3390/ijerph13070678
[22]	LIEN L, LIEN N, HEYERDAHL S, et al. Consumption of soft drinks and hyperactivity, mental distress, and conduct problems among adolescents in Oslo, Norway[J]. Am J Public Health, 2006, 96(10): 1815-1820. doi: 10.2105/AJPH.2004.059477
[23]	张曌华, 张柳, 李红娟. 中国儿童青少年体力活动现状的Meta分析[J]. 中国学校卫生, 2020, 41(2): 173-178. doi: 10.16835/j.cnki.1000-9817.2020.02.004 ZHANG Z H, ZHANG L, LI H J. A Meta-analysis of physical activity among Chinese children and adolescents with accelerometer data[J]. Chin J Sch Health, 2020, 41(2): 173-178. doi: 10.16835/j.cnki.1000-9817.2020.02.004
[24]	李兴凯. 小学生体力活动、执行功能与行为问题的关系研究[D]. 扬州: 扬州大学, 2015. LI X K. A study on the relationship among physical activity, executive function and behavior problems of primary school students. Yangzhou University[D]. Yangzhou: Yangzhou University, 2015.
[25]	GENG M, JIANG L, WU X, et al. Sugar-sweetened beverages consumption are associated with behavioral problems among preschoolers: a population based cross-sectional study in China[J]. J Affect Dis, 2020, 265: 519-525. doi: 10.1016/j.jad.2020.01.076
[26]	CURRAIS A, FARROKHI C, DARGUSCH R, et al. Dietary glycemic index modulates the behavioral and biochemical abnormalities associated with autism spectrum disorder[J]. Mol Psychiatry, 2016, 21(3): 426-436. doi: 10.1038/mp.2015.64
[27]	HAGHIGHATDOOST F, AZADBAKHT L, KESHTELI A H, et al. Glycemic index, glycemic load, and common psychological disorders[J]. Am J Clin Nutr, 2016, 103(1): 201-209. doi: 10.3945/ajcn.114.105445
[28]	MITCHELL R H B, GOLDSTEIN B I. Inflammation in children and adolescents with neuropsychiatric disorders: a systematic review[J]. J Am Acad Child Adolesc Psychiatry, 2014, 53(3): 274-296. doi: 10.1016/j.jaac.2013.11.013
[29]	THEOHARIDES T C, TSILIONI I, PATEL A B, et al. Atopic diseases and inflammation of the brain in the pathogenesis of autism spectrum disorders[J]. Transl Psychiatry, 2016, 6(6): e844. doi: 10.1038/tp.2016.77
[30]	WESENSTEN N J. Legitimacy of concerns about caffeine and energy drink consumption[J]. Nutr Rev, 2014, 72 (Suppl 1): 78-86.
[31]	YU Z M, PARKER L, DUMMER T J B. Associations of coffee, diet drinks, and non-nutritive sweetener use with depression among populations in eastern Canada[J]. Sci Rep, 2017, 7(1): 6255. doi: 10.1038/s41598-017-06529-w
[32]	VERBY N C, LILLEGAARD I T L, JOHANSSON L, et al. High intake of added sugar among Norwegian children and adolescents[J]. Public Health Nutr, 2004, 7(2): 285-293. doi: 10.1079/PHN2003515