Childhood adiposity: measurement and effects of sugar-sweetened beverage and dairy intakes
Bigornia, Sherman Jesse
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Problem: The correlation between various adiposity measures has implications for studies examining abdominal fatness. We hypothesized that central and total fat measures would be strongly correlated during childhood, resulting in similarly sized associations with intakes of sugar-sweetened beverages (SSBs) and dairy. Methods: Participants of the Avon Longitudinal Study of Parents and Children were examined at ages 9, 11 , 13, and 15 (n=3,796 to 6,495) where anthropometry and dual-energy X-ray absorptiometry (DXA) data were collected. Diet was assessed at 10 and 13 (n=2,455). Correlations between adiposity measures were determined cross-sectionally at each age. Linear and logistic regression were used to examine the effects of SSB and dairy intakes, respectively, on adiposity at 13 y. Excess total body fat mass (TBFM) and waist circumference (WC) were defined as the top quintile of participants for the respective adiposity measure. Results: TBFM, BMI, and WC were strongly correlated (r=0.85-0.95) and these associations generally weakened after age 11. BMI and we explained similar amounts of variation in TBFM. In dietary analyses, change in SSB consumption from 10 to 13 was positively associated with BMI (standardized β=0.07, P<0.001), TBFM (β=0.07, P=0.003), and WC (β=0.10, P<0.001) at 13. Adjustment for BMI attenuated SSB and we associations by 56% (β=0.042, P=0.02). Children in the top quartile of full-fat dairy intake at 10 were at reduced risk of excess TBFM (OR=0.63: 0.41-0.99), overweight (OR=0.65: 0.40, 1.06), and excess WC (OR=0.58, 0.38-0.90) at 13 compared to those in the bottom quartile. In general, results for total and reduced-fat dairy were directionally similar, but weakened compared to full-fat dairy fmdings. Conclusions: We demonstrated that we and total fat measures (BMI and TBFM) were highly correlated, suggesting that WC can be a proxy for total adiposity. In support of this, the effect sizes of dairy and to a lesser extent SSB consumption on we and total adiposity measures were comparable. Further, adjustment for BMI attenuated the effect of SSB intakes on WC. These results indicate that dietary exposures should be examined independently and in a standardized fashion to compare effect sizes between adiposity measures as associations may be very similar during childhood.
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