含糖饮料消费与儿童和成人的体重增加：前瞻性队列研究和随机对照试验的系统评价和荟萃分析。

Sugar-sweetened beverage consumption and weight gain in children and adults: a systematic review and meta-analysis of prospective cohort studies and randomized controlled trials.

机构信息

Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.

Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.

出版信息

Am J Clin Nutr. 2023 Jan;117(1):160-174. doi: 10.1016/j.ajcnut.2022.11.008. Epub 2022 Dec 20.

DOI:10.1016/j.ajcnut.2022.11.008

PMID:36789935

Abstract

BACKGROUND

Sugar-sweetened beverages (SSBs) have been implicated in fueling the obesity epidemic.

OBJECTIVES

This study aimed to update a synthesis of the evidence on SSBs and weight gain in children and adults.

METHODS

MEDLINE, Embase, and Cochrane databases were searched through September 8, 2022, for prospective cohort studies and randomized controlled trials (RCTs) that evaluated intake of SSBs in relation to BMI and body weight in children and adults, respectively. Eligible interventions were compared against a noncaloric control. Study-level estimates were pooled using random-effects meta-analysis and presented as β-coefficients with 95% CIs for cohorts and weighted mean differences (MDs) with 95% CIs for RCTs.

RESULTS

We identified 85 articles including 48 in children (40 cohorts, n = 91,713; 8 RCTs, n = 2783) and 37 in adults (21 cohorts, n = 448,661; 16 RCTs, n = 1343). Among cohort studies, each serving/day increase in SSB intake was associated with a 0.07-kg/m (95% CI: 0.04 kg/m, 0.10 kg/m) higher BMI in children and a 0.42-kg (95% CI: 0.26 kg, 0.58 kg) higher body weight in adults. RCTs in children indicated less BMI gain with SSB reduction interventions compared with control (MD: -0.21 kg/m; 95% CI: -0.40 kg/m, -0.01 kg/m). In adults, randomization to addition of SSBs to the diet led to greater body weight gain (MD: 0.83 kg; 95% CI: 0.47 kg, 1.19 kg), and subtraction of SSBs led to weight loss (MD: -0.49 kg; 95% CI: -0.66 kg, -0.32 kg) compared with the control groups. A positive linear dose-response association between SSB consumption and weight gain was found in all outcomes assessed.

CONCLUSIONS

Our updated systematic review and meta-analysis expands on prior evidence to confirm that SSB consumption promotes higher BMI and body weight in both children and adults, underscoring the importance of dietary guidance and public policy strategies to limit intake. This meta-analysis was registered at the International Prospective Register of Systematic Reviews as CRD42020209915.

摘要

背景

含糖饮料（SSBs）被认为是肥胖流行的罪魁祸首。

目的

本研究旨在更新 SSBs 与儿童和成人体重增加相关的证据综合分析。

方法

通过 2022 年 9 月 8 日对 MEDLINE、Embase 和 Cochrane 数据库进行检索，以评估 SSBs 摄入量与儿童和成人 BMI 和体重之间关系的前瞻性队列研究和随机对照试验（RCT）。合格的干预措施与非热量对照进行比较。使用随机效应荟萃分析汇总研究水平的估计值，并以队列的β系数（95%CI）和 RCT 的加权均数差值（95%CI）表示。

结果

我们确定了 85 篇文章，其中包括 48 篇儿童研究（40 个队列，n=91713；8 项 RCT，n=2783）和 37 篇成人研究（21 个队列，n=448661；16 项 RCT，n=1343）。在队列研究中，SSB 摄入量每增加一份/天，儿童的 BMI 就会增加 0.07-kg/m（95%CI：0.04kg/m，0.10kg/m），成年人的体重会增加 0.42-kg（95%CI：0.26kg，0.58kg）。儿童 RCT 表明，与对照组相比，减少 SSB 摄入的干预措施可使 BMI 增加幅度降低（MD：-0.21kg/m；95%CI：-0.40kg/m，-0.01kg/m）。在成年人中，将 SSBs 添加到饮食中会导致体重增加（MD：0.83kg；95%CI：0.47kg，1.19kg），而减去 SSBs 会导致体重减轻（MD：-0.49kg；95%CI：-0.66kg，-0.32kg），与对照组相比。在所有评估的结果中，均发现 SSB 消费与体重增加之间存在正线性剂量反应关系。