Table 2.
Cardiometabolic Indicators Among Adolescents by Level of Added Sugars Intake, NHANES 1999–2004*
| % total energy from added sugars |
|||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 0 – <10% (referent) (n=318) |
10 – <15% (n=377) |
15 – <20% (n=440) |
20 – < 25% (n=380) |
25 – <30% (n=320) |
≥30% (n=417) |
p- trend |
|||||||
| Indicator | mean | (95% CI) | mean | (95% CI) | mean | (95% CI) | mean | (95% CI) | mean | (95% CI) | mean | (95% CI) | |
| Lipid measures (mmol/L) | |||||||||||||
| HDL cholesterol | 1.38 | (1.32, 1.43) | 1.33 | (1.27, 1.39) | 1.31 f | (1.27, 1.35) | 1.32 § | (1.27, 1.37) | 1.24 † | (1.19, 1.28) | 1.28 ‡ | (1.23, 1.33) | 0.007 |
| LDL cholesterol | 2.26 | (2.12, 2.39) | 2.28 | (2.16, 2.39) | 2.38 f | (2.30, 1.34) | 2.49 § | (2.35, 2.63) | 2.40 | (2.28, 2.52) | 2.40 | (2.27, 2.52) | 0.10 |
| Triglycerides‖ | 0.79 | −(0.32, 0.86) | 0.82 | −(0.27, 0.88) | 0.82 | (0.78, 0.87) | 0.86 | (0.80, 0.92) | 0.90 | (0.84, 0.96) | 0.89 | (0.83, 0.96) | 0.03 |
| Total cholesterol | 4.04 | (4.03, 4.20) | 4.03 | (3.91, 4.14) | 4.11 | (4.02, 4.20) | 4.25 § | (4.09, 4.40) | 4.09 | (3.97, 4.22) | 4.12 | (3.99, 4.26) | 0.29 |
| TG/HDL (mg/dL) | 1.56 | (1.75, 4.98) | 1.75 | (1.51, 1.99) | 1.73 | (1.50, 1.96) | 1.89 § | (1.61, 2.17) | 2.13 § | (1.74, 2.53) | 1.99 § | (1.68, 2.30) | 0.02 |
| Blood pressure (mmHg) | |||||||||||||
| systolic | 109 | (107, 111) | 111 | (108, 113) | 111 | (109, 112) | 111 | (109, 113) | 113 ‡ | (111, 114) | 112 | (110, 114) | 0.07 |
| diastolic | 62.7 | (60.3, 65.1) | 63.7 | (62.3, 65.1) | 61.6 | (60.0, 63.2) | 62.4 | (60.8, 64.0) | 66.2 § | (64.7, 67.8) | 63.1 | (61.1, 65.1) | 0.54 |
| Glucose (fasting) (mmol/L) | 4.95 | (4.87 5.04) | 4.94 | (4.85 5.04) | 5.02 | (4.94 5.11) | 5.02 | (4.91 5.12) | 5.08 | (4.99 5.16) | 5.00 | (4.91 5.10) | 0.05 |
| Insulin (fasting) (pmol/L) | |||||||||||||
| underweight# | 57.1 | (31.5, 82.8) | 45.7 | (18.4, 73.2) | 64.1 | (57.6, 70.5) | 68.8 | (61.3, 76.3) | 50.2 | (38.7, 61.7) | 21.5 | −(1.8, 44.8) | 0.58 |
| normal weight# | 59.7 | (52.7, 66.7) | 59.3 | (52.0, 66.6) | 60.3 | (55.6, 65.0) | 62.3 | (57.6, 67.1) | 59.5 | (58.8, 60.2) | 61.7 | (53.3, 70.2) | 0.84 |
| overweight/obese# | 79.0 | (62.6, 95.4) | 90.5 | (69.9, 111) | 101 e | (90.3, 113) | 130 † | (110, 151) | 111 ‡ | (94.5, 128) | 139 † | (120, 157) | <0.001 |
| HOMA-IR | |||||||||||||
| underweight | 2.13 | (1.88, 2.38) | 1.62 | (1.58, 1.66) | 1.77 | (1.52, 2.03) | 2.36 | (2.29, 2.42) | 1.81 | (1.74, 1.88) | 0.80 | (0.71, 0.90) | <0.001 |
| normal weight | 2.01 | (1.74, 2.27) | 2.03 | (1.81, 2.26) | 2.00 | (1.79, 2.21) | 1.99 | (1.79, 2.18) | 2.13 | (1.93, 2.33) | 2.00 | (1.76, 2.24) | 0.85 |
| overweight/obese | 2.83 | (2.26, 3.40) | 3.45 | (2.75, 4.15) | 3.68 e | (3.20, 4.17) | 4.57 † | (3.76, 5.37) | 4.12 ‡ | (3.51, 4.74) | 5.04 † | (4.35, 5.73) | <0.001 |
| BMI (z-score) | |||||||||||||
| underweight | −1.67 | −(2.66, −0.68) | −1.71 | −(2.14, −1.28) | −1.96 | −(2.46, −1.45) | −1.94 | −(2.40, −1.47) | −2.46 | −(2.81, −2.12) | −2.47 | −(2.7, −2.24) | 0.12 |
| normal weight | 0.04 | −(0.16, 0.25) | 0.11 | −(0.08, 0.31) | −0.02 | −(0.21, 0.18) | 0.04 | −(0.14, 0.23) | −0.19 § | −(0.38, −0.01) | −0.03 | −(0.25, 0.18) | 0.11 |
| overweight | 1.63 | (1.49, 1.77) | 1.77 | (1.63, 1.91) | 1.64 | (1.53, 1.75) | 1.72 | (1.6, 1.84) | 1.72 | (1.60, 1.85) | 1.89 § | (1.7, 2.03) | 0.08 |
| Waist circumference (cm) | |||||||||||||
| underweight | 65.3 | (64.5 66.1) | 67.2 | (66.4 68.1) | 66.5 | (65.6 67.3) | 67.5 | (67.2 67.8) | 62.4 | (61.0 63.8) | 64.7 | (63.8 65.6) | 0.01 |
| normal weight | 75.1 | (73.4 76.8) | 76.4 | (75.4 77.5) | 75.4 | (74.3 76.5) | 75.1 | (74.1 76.1) | 73.7 | (72.4 75.0) | 74.9 | (73.5 76.3) | 0.19 |
| overweight | 95.3 | (91.6 98.9) | 99.6 | (95.7 104) | 95.3 | (92.8 97.9) | 99.0 | (95.5 103) | 98.4 | (95.2 102) | 101 § | (97.2 105) | 0.11 |
Abbreviations: NHANES=National Health and Nutrition Examination Survey; %=percent; HDL=high-density lipoprotein cholesterol; LDL=low-density lipoprotein cholesterol; TG=triglycerides; BP=blood pressure; HOMA-IR=homeostatis model assessment of insulin resistance;BMI=body-mass-index
All means are adjusted for age; sex; race; bmi percentile (excluding model with BMI as outcome); physical activity; total energy intake; nutrient residuals for intake of: fats (mono-unsaturated fatty acids, poly- PUFAs, and saturated), protein, fiber, cholesterol, and other carbohydrates (excluding fiber and added sugar). Results are weighted to represent the US population and adjusted to account for complex sampling methods used. To covert mmol/L to mg/dL, multiply by 39 for HDL and LDL; multiply by 89 for triglycerides; multiply by 38.67 for total cholesterol; and multiply by 18 for glucose.
†,‡,§Mean values significantly different from the referent (10% total energy from added sugars),
p<0.001;
p<0.01;
p<0.05.
Geometric mean triglycerides are presented.
Under weight=<5th age-and sex-adjusted BMI %ile (n=44). Sub-sample size by level of added sugar intake: 0–<10% n=3; 10–<15% n=5; 15–<20% n=10; 20–<25% n=13; 25–<30% n=5; ≥30% n=8; normal weight=5th–<85th age- and sex- adjusted BMI %ile (n=1348). Sub-sample size by level of added sugar intake: 0–<10% n=179; 10–<15% n=225; 15–<20% n=283; 20–<25% n=231; 25–<30% n=179; >30% n=251; overweight/obese–>=95th age-and sex-adjusted BMI %ile (n=844). Sub-sample size by level of added sugar intake: 0–<10% n=131; 10–<15% n=147; 15–<20% n=142; 20–<25% n=135; 25–<30% n=133; >30% n=156