Original article
Sugar-Sweetened Beverages, Serum Uric Acid, and Blood Pressure in Adolescents

https://doi.org/10.1016/j.jpeds.2009.01.015Get rights and content

Objective

To evaluate whether sugar-sweetened beverage consumption, a significant source of dietary fructose, is associated with higher serum uric acid levels and blood pressure in adolescents.

Study design

We analyzed cross-sectional data from 4867 adolescents aged 12 to 18 years in the National Health and Nutrition Examination Survey, 1999-2004. Dietary data were assessed from 24-hour dietary recall interviews. Sugar-sweetened beverages included fruit drinks, sports drinks, soda, and sweetened coffee or tea. We used multivariate linear regression to evaluate the association of sugar-sweetened beverage consumption with serum uric acid and with blood pressure.

Results

Adolescents who drank more sugar-sweetened beverages tended to be older and male. In the adjusted model, serum uric acid increased by 0.18 mg/dL and systolic blood pressure z-score increased by 0.17 from the lowest to the highest category of sugar-sweetened beverage consumption (P for trend, .01 and .03, respectively).

Conclusions

These results from a nationally representative sample of US adolescents indicate that higher sugar-sweetened beverage consumption is associated with higher serum uric acid levels and systolic blood pressure, which may lead to downstream adverse health outcomes.

Section snippets

Methods

This is a cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES) 1999-2004, a complex sample survey designed to collect data on the health and nutrition from a representative household population in the United States.18 Certain populations, such as adolescents and racial/ethnic minorities, were oversampled to improve estimates in these groups.

The NHANES protocol was reviewed and approved by the National Center for Health Statistic's Institutional

Results

Demographic and clinical characteristics of the study population are shown in Table I. Drinking any amount of sugar-sweetened beverages in a day was reported by 82.5% of adolescents. Adolescents who drank more sugar-sweetened beverages tended to be older and male. Sugar-sweetened beverage consumption did not differ according to race/ethnicity, BMI z-score, height z-score, or dietary fiber intake. Sugar-sweetened beverage consumption was associated with higher intake of total calories, sodium,

Discussion

Adult studies have shown serum uric acid levels to be predictive of major outcomes even when values are within the normal range.8

It should be noted that the adjusted difference in serum uric acid between the lowest and highest category of sugar-sweetened beverage consumption was relatively small. In adult studies, the risk associated with serum uric acid varies with the outcome. The observed serum uric acid difference between extreme categories, 0.18 mg/dL, in the NHANES III, was associated

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    S.N. was supported by the American Heart Association (0725258Y) and the Department of Pediatrics, University of California San Francisco. C-y.H. was supported by NIH DK70939 and DK67126.

    The authors disclose no conflicts of interest.

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