Published online February 1, 2005
PEDIATRICS Vol. 115 No. 2 February 2005, pp. e223-e229 (doi:10.1542/10.1542/peds.2004-1148)
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ELECTRONIC ARTICLE

Overweight Among Low-Income Preschool Children Associated With the Consumption of Sweet Drinks: Missouri, 1999–2002

Jean A. Welsh, MPH, BA, RN*, Mary E. Cogswell, DrPH, RN*, Sharmini Rogers, MBBS, MPH{ddagger}, Helaine Rockett, MS, RD§, Zuguo Mei, MD, MPH* and Laurence M. Grummer-Strawn, PhD*

* Division of Nutrition and Physical Activity, Centers for Disease Control and Prevention, Atlanta, Georgia
{ddagger} Division of Community Health, Missouri Department of Health and Senior Services, Jefferson City, Missouri
§ Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts

Objective. To examine the association between sweet drink consumption and overweight among preschool children.

Methods. A retrospective cohort design was used to examine the association between sweet drink consumption and overweight at follow-up among 10904 children who were aged 2 and 3 years and had height, weight, and Harvard Service Food Frequency Questionnaire data collected between January 1999 and December 2001 and height and weight data collected 1 year later. Sweet drinks included vitamin C-containing juices, other juices, fruit drinks, and sodas as listed on the Harvard Service Food Frequency Questionnaire. Logistic regression was used to adjust for age; gender; race/ethnicity; birth weight; and intake of high-fat foods, sweet foods, and total calories. Results were stratified by baseline BMI.

Results. Among children who were normal or underweight at baseline (BMI <85th percentile), the association between sweet drink consumption and development of overweight was positive but not statistically significant. Children who were at risk for overweight at baseline (BMI 85th–<95th percentile) and consumed 1 to <2 drinks/day, 2 to <3 drinks/day, and ≥3 drinks/day were, respectively, 2.0 (95% confidence interval [CI]: 1.3–3.2), 2.0 (95% CI: 1.2–3.2), and 1.8 (95% CI: 1.1–2.8) times as likely to become overweight as the referent (<1 drink/day). Children who were overweight at baseline (BMI ≥95th percentile) and consumed 1 to <2 drinks/day, 2 to <3 drinks/day, and ≥3 drinks/day were, respectively, 2.1, 2.2, and 1.8 times as likely to remain overweight as the referent.

Conclusions. Reducing sweet drink consumption might be 1 strategy to manage the weight of preschool children. Additional studies are needed to understand the mechanism by which such consumption contributes to overweight.


Key Words: child nutrition • children's growth • obesity • weight control • fruit juice • beverages • diet

Abbreviations: PedNSS, Pediatric Nutrition Surveillance System • WIC, Special Supplemental Nutrition Program for Woman, Infants, and Children • HFFQ, Harvard Service Food Frequency Questionnaire • AOR, adjusted odds ratio • CI, confidence interval


Accepted Oct 6, 2004.


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