July 2007: Beverage Patterns, Diet Quality, and Body Mass Index of US Preschool and School-Aged Children

Significant concern in public health has shifted to focus on the childhood obesity epidemic which seems to have been rising dramatically during the last decade. Research has shown that overweight and/or obese children are more likely to become overweight and/or obese adults. Carrying excess weight increases an individual’s risk for certain co morbidities such as hypertension, heart disease, type 2 diabetes and respiratory diseases. According to the article, 14% of children aged 2-5 years and 19% of children aged 6-11 years are obese. Due to the rising rates of childhood obesity and life-long health implications for those children, researchers are actively looking towards modifiable risk factors for prevention, specifically diet.

Research has shown that total energy intake from beverages is increasing in children. Many adults do not even realize the amount of energy that they are receiving daily from sweetened beverages, let alone children. There are beliefs that the excess energy from sweetened beverages could be associated with the weight problem many children are currently facing. There are also beliefs that overall diet quality is decreasing due to the consumption of less nutritious beverages, such as soda and fruit drinks, instead of healthier options, like milk and 100% fruit juices.

A sample of children from the NHANES (2001-2002) study was taken. The researchers grouped children by age; 2-5 year olds comprised one group, followed by 6-11 year olds. Dietary intake was assessed using a 24-Hour Recall and beverages were separated into eight clusters. These clusters included: high-fat milk, reduced-fat milk, fruit juices, soda, diet soda, sweetened beverages, coffee/tea, and water. The researchers looked at the different drinking clusters and compared them in terms of many different variables such as age, sex, ethnicity, household income, birth weight, diet quality, BMI and physical activity. BMI did differ among beverage groups for the 6-11 year old group; however it was not significantly different among beverage groups for the 2-5 year old group. For all age groups, the diet quality varied significantly across beverage patterns. The article goes into specific details about how those different clusters varied in terms of diet and diet quality.

The additional article explores the effect that consuming sugar-sweetened beverages in between meal times has on children’s body weight. The results are staggering, showing that children who regularly consume sugar-sweetened beverages between meals are more than twice as likely to be overweight than those who don’t regularly consume sugar-sweetened beverages. This shows that high calorie beverages are making a large impact on the child’s overall energy intake and therefore are a compounding factor to the childhood obesity epidemic. Parents are instructed to limit the consumption of sugar-sweetened beverages due to the large effect it can have on a child’s likeliness to gain weight.
The second article may be helpful when working with overweight children and their families. It explores one approach, motivational interviewing, to solving the childhood weight problem. The article goes through previous research applications and results of motivational interviewing with weight loss in adults and children; at the end it gives specific suggestions for successfully applying the motivational interviewing approach to children.

JADA Continuing Education Article:

LaRowe, T.L., Moeller, S.M., Adams, A.K., (2007). Beverage Pattersn, Diet Quality, and Body Mass Index of US Preschool and School-Aged Children. Journal of the American Dietetic Association, 107(7), 1124-1133.

Additional Articles:

Dubois, L., Farmer, A., Girard, M., Peterson, K. (2007). Regular sugar-sweetened beverage consumption between meals increases risk of overweight among preschool-aged children. Journal of the American Dietetic Association, 107(6), 924-934.

Resnicow, K., Davis, R., Rollnick, S. (2006). Motivational interviewing for pediatric obesity; Conceptual issues and evidence review. Journal of the American Dietetic Association, 106 (12), 2024-2033.