Sugary Drinks Research: Weight Gain

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This is part of our Sugary Drinks & Latino Kids: A Research Review »

More sugary drinks is linked to higher body weight

Those who consume a greater amount of SSBs tend to have higher body weight than those who drink less.5

A recent systematic review and meta-analysis of 32 studies, including prospective cohort studies and randomized controlled trials, associated SSB intake with risk of weight gain in children and adults.22

Similarly, a meta-analysis of 88 studies found a clear association between soft drink consumption and weight.23

By contrast, a recent systematic review of papers focused on regular soda consumption among children and adolescents and published between 2004 and 2014 did not find an association between regular soda consumption and weight among all age groups. Through an analysis of the NPD Group’s 2006-2011 National Eating Trends survey, however, the same researchers found an association between more frequent soda consumption and obesity emerging between ages 6-8 and persisting through ages 9-12.24

Recent studies have more clearly demonstrated the causal role of SSB consumption.

For example, one recent prospective study of an intervention to reduce SSB consumption among adolescents found that BMI increase was smaller one year later in the intervention group than in the control group.25

Research indicates that calories from liquids are associated with higher overall total consumption because the body does not register liquid calories the same way it registers calories from solid food.26,27

One study estimated that each additional 8-ounce serving of SSB consumed among children and adolescents ages 2-19 corresponded to an additional 106 calories in total energy intake, suggesting little to no compensation for the SSB calories.13

However, one review had caveats related to the research design of some of the studies (although not necessarily the conclusions),28 and another questioned the hypothesis that calorie-containing liquids are less satiating and that their sugar content affects body weight differently than solid foods.29

Additionally, one study found greater ability among preschoolers to compensate for liquid calories consumed as long as one hour prior to sweet and savory snack foods.30

Finally, some research has found that children and adults who drink SSBs specifically consume more sweet and salty snacks and eat more calories overall compared to those who do not.31

This higher body weight is prevalent even in early childhood

While detailed data on SSB intake at very young ages is generally lacking, research has shown an association of SSB intake and weight gain in early childhood.

For example, a review of the literature (through September 2011) on the relationship between early weight gain, overweight, or obesity and genetic/biological, dietary, environmental, and behavioral factors concluded that SSB consumption was positively associated with adiposity or overweight in toddler and preschool age children.32

A recent analysis of IFPS II data found that prevalence of obesity at age 6 was twice as high (17.0% vs. 8.6%) among children who had consumed SSBs between ages 1-12 months compared to those who did not drink SSBs in infancy.5

After controlling for infants’ gender, birth weight, age of solid food introduction, maternal race, maternal education, and other covariates, children who had consumed SSBs between ages 1-12 months had 1.71 times the odds of being obese as those who had not.

Obesity prevalence was highest among children who consumed SSBs before 6 months and those who consumed SSBs at least three times per week between ages 10-12 months.5

One analysis of the Early Childhood Longitudinal Study Birth Cohort (ECLS-B) found that at ages 4 and 5, children drinking one or more servings of SSBs daily had higher odds of being overweight and obese compared to those not drinking SSBs. This association remained significant after adjusting for potential confounders (e.g., gender, race/ethnicity, SES, maternal BMI, TV viewing) at age 5 (AOR=1.43, p<0.01) but not at age 4.33

A separate analysis based on data from ECLS-B found through multivariate analyses that Latino race/ethnicity and drinking sugary beverages at kindergarten age at least once in the past week were both associated with 2.3 times the odds of severe obesity (BMI ≥ 99th percentile) in kindergarten.34

Finally, an analysis of 1988-94 NHANES data showed a positive association between soft drink consumption and overweight among children, contributing a greater percentage of total calories among overweight versus normal weight 2-5-year-olds (3.1% vs. 2.4%).35

This relationship greatly impacts Latino children

Specific to the young Latino population, a study involving low-income, Latino toddlers (ages 2-4) participating in the Los Angeles County Women, Infants, and Children (WIC) programs found that toddlers consuming no SSBs had 31 percent lower odds of being obese compared to those with high intakes (≥2 servings/day) of SSBs.36

Cultural adaptation also plays a role

Individuals with lower socioeconomic status and U.S. immigrants with a higher degree of acculturation are more likely to consume more SSBs.

A study based on 2007-2008 NHANES data found that low-income children ages 2-11 (and those in older age groups) were significantly more likely than their high-income counterparts to consume regular soda and sports/energy drinks.37

Low-income children were also significantly more likely to be heavy SSB consumers (>=500 calories/day) and to obtain more calories from fruit drinks compared to high-ncome children.37 Research has also pointed to an association between lower parental education and higher prevalence of SSB consumption among children ages 2-11.19,37,38

In a study in New York City, frequent soda consumption was more common among U.S.-born Puerto Ricans, Mexican/Mexican-Americans, and blacks, and individuals with less education and lower household incomes, mirroring disparities in obesity and other chronic diseases.39

Although focused on adults, this study, unlike most, segmented by Hispanic origin (e.g., Puerto Rican, Dominican, Mexican/Mexican-American, and “other”), as well as for U.S. born and non-U.S. born.

The authors concluded that economic resources, health literacy, and culture all play a role in soda consumption because the income-to-poverty ratio, educational attainment, and race/ethnicity/birthplace were all independent predictors of soda consumption.

While the level of Latinos’ acculturation—defined as a “process in which members of one cultural group adopt the beliefs and behaviors of another group”40—shows mixed results in terms of the effect on physical activity and the consumption of dietary fat and less healthful foods, the findings about added sugar consumption are consistent: Reviews of multiple studies concluded that more acculturated Latinos consume more added sugar41,42 than less acculturated Latinos.

Another study focused on Mexican Americans ages 12-19 in the NHANES 1999-2004 surveys found that second- and third-generation adolescents consumed more SSBs and had 2-4 times higher odds of being overweight or obese compared to first-generation adolescents.43

The effect of acculturation on SSB consumption may change over time, at least for those of Mexican origin—but that is because Mexicans who are just coming to the United States may already consume more SSBs, given that Mexico’s per capita sugary drink consumption is the highest in the world.44

One analysis shows that SSB consumption among Mexican adolescents more than doubled in less than a decade, from an average of 100 calories daily in 1999 to 225 calories daily in 2006.45

More from our Sugary Drinks & Latino Kids: A Research Review »

References for this section »

22. Malik, V. S., Pan, A., Willett, W. C. & Hu, F. B. Sugar-sweetened beverages and weight gain in children and adults: a systematic review and meta-analysis. Am J Clin Nutr 98, 1084–1102 (2013).

23. Vartanian, L. R., Schwartz, M. B. & Brownell, K. D. Effects of Soft Drink Consumption on Nutrition and Health: A Systematic Review and Meta-Analysis. Am J Public Health 97, 667–675 (2007).

24. Rao, G. et al. Consumption Patterns of Sugar-Sweetened Carbonated Beverages Among Children and Adolescents. 17 (2015).

25. Ebbeling, C. B. et al. A Randomized Trial of Sugar-Sweetened Beverages and Adolescent Body Weight. New England Journal of Medicine 367, 1407–1416 (2012).

26. Mourao, D. M., Bressan, J., Campbell, W. W. & Mattes, R. D. Effects of food form on appetite and energy intake in lean and obese young adults. Int J Obes 31, 1688–1695 (2007).

27. Wang, Y. Disparities in Pediatric Obesity in the United States. Adv Nutr 2, 23–31 (2011).

28. Weed, D. L., Althuis, M. D. & Mink, P. J. Quality of reviews on sugar-sweetened beverages and health outcomes: a systematic review. Am J Clin Nutr 94, 1340–1347 (2011).

29. Drewnowski, A. & Bellisle, F. Liquid calories, sugar, and body weight. Am J Clin Nutr 85, 651–661 (2007).

30. Birch, L. L., McPhee, L. & Sullivan, S. Children’s food intake following drinks sweetened with sucrose or aspartame: Time course effects. Physiology & Behavior 45, 387–395 (1989).

31. Bleich, S. N. & Wolfson, J. A. U.S. adults and child snacking patterns among sugar-sweetened beverage drinkers and non-drinkers. Preventive Medicine 72, 8–14 (2015).

32. Dattilo, A. M. et al. Need for Early Interventions in the Prevention of Pediatric Overweight: A Review and Upcoming Directions. Journal of Obesity 2012, e123023 (2012).

33. DeBoer, M. D., Scharf, R. J. & Demmer, R. T. Sugar-Sweetened Beverages and Weight Gain in 2- to 5-Year-Old Children. PEDIATRICS 132, 413–420 (2013).

34. Flores, G. & Lin, H. Factors predicting severe childhood obesity in kindergarteners. International journal of obesity 37, 31–39 (2013).

35. Troiano, R. P., Briefel, R., Carroll, M. D. & Bialostosky, K. Energy and Fat Intakes of Children and Adolescents in the United States Data from the National Health and Nutrition Examination Surveys. (Mathematica Policy Research, 2001).

36. Davis, J. N., Whaley, S. E. & Goran, M. I. Effects of breastfeeding and low sugar-sweetened beverage intake on obesity prevalence in Hispanic toddlers. Am J Clin Nutr 95, 3–8 (2012).

37. Han, E. & Powell, L. M. Consumption Patterns of Sugar-Sweetened Beverages in the United States. Journal of the Academy of Nutrition and Dietetics 113, 43–53 (2013).

38. Beck, A. L., Patel, A. & Madsen, K. Trends in Sugar-Sweetened Beverage and 100% Fruit Juice Consumption Among California Children. Academic Pediatrics 13, 364–370 (2013).

39. Rehm, C. D., Matte, T. D., Van Wye, G., Young, C. & Frieden, T. R. Demographic and Behavioral Factors Associated with Daily Sugar-sweetened Soda Consumption in New York City Adults. J Urban Health 85, 375–385 (2008).

40. University of Houston Clear Lake. Terms & Themes: Acculturation. Available at: http://coursesite.uhcl.edu/HSH/Whitec/terms/A/acculturation.htm. (Accessed: 11th October 2016)

41. Pérez-Escamilla, R. & Putnik, P. The Role of Acculturation in Nutrition, Lifestyle, and Incidence of Type 2 Diabetes among Latinos. J. Nutr. 137, 860–870 (2007).

42. Ayala, G. X., Baquero, B. & Klinger, S. A Systematic Review of the Relationship between Acculturation and Diet among Latinos in the United States: Implications for Future Research. J Am Diet Assoc 108, 1330–1344 (2008).

43. Liu, J.-H., Chu, Y. H., Frongillo, E. A. & Probst, J. C. Generation and acculturation status are associated with dietary intake and body weight in Mexican American adolescents. J. Nutr. 142, 298–305 (2012).

44. Fox New Latino. Mexico Leads World in Consumption of Sugary Drinks, Study Says | Fox News Latino.

45. Barquera, S. et al. Energy Intake from Beverages Is Increasing among Mexican Adolescents and Adults. J. Nutr. 138, 2454–2461 (2008).

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