A sample of 504 students was obtained, 208 men (41.3%) and 296 women (58.7%), with an age range of 18-22 years and an average of 19.0 years (SD = 1.5), who presented a mean consumption of 20.3 servings / week (SD = 14.0) and a caloric intake provided from sugar of SSBs of 1794.3 kcal / week (SD = 1248.0). Since the SSBs consumption showed different amounts between men and women, it was decided to carry out separate analyzes.
A higher consumption of practically all groups is clearly observed in men, the total consumption was almost 2 liters higher per week (Table 1). In men and women the SSBs groups mainly consumed was whole milk, followed by cola soft drink and industrialized juice.
Table 1 Difference in SSBs groups consumption according to sex in young students population. Cross-sectional analysis considering all the participants (men n = 208 and women n = 296).
|
Men (mL)
|
Women (mL)
|
*p value
|
Cola soft drink
|
884.09 ± 1025.54
|
528.28 ± 750.63
|
0.000
|
Other flavor soft drink
|
626.35 ± 810.95
|
306.35 ± 415.35
|
0.000
|
Industrialized juice
|
698.65 ± 893.13
|
457.84 ± 644.35
|
0.000
|
Industrialized tea
|
355.14 ± 554.26
|
353.41 ± 660.70
|
0.975
|
Whole milk
|
1357.38 ± 1482.77
|
1033.50 ± 1253.55
|
0.008
|
Drinkable yogurt
|
333.73 ± 516.84
|
351.70 ± 552.40
|
0.712
|
Sport drinks
|
370.99 ± 624.11
|
130.35 ± 365.15
|
0.000
|
Energy drinks
|
76.97 ± 250.114
|
22.11 ± 99.24
|
0.001
|
Home-made drinks
|
1479.45 ± 1831.52
|
1147.28 ± 1343.54
|
0.019
|
Total SSBs
|
6182.64 ± 3851.74
|
4330.82 ± 3026.10
|
0.000
|
*t Student test. The values are presented as the mean ± standard deviation.
According to the values proposed by the WHO for metabolic syndrome diagnosis, it was found in men 35.0% have low HDL-C, 14.3% high TG, and 3.4% high fasting glucose, in women it was found 59.9% have low HDL-C, 7.0% high TG, and 1.4% high fasting glucose. Additionally, 20% of men and 18.2% of women have abdominal obesity (waist circumference greater than 94 and 88 cm respectively), 35.4% of men and 32.6% of women have BMI ≥ 25 kg / m2. The average values found in the metabolic and anthropometric examination are reported in Table 2. A positive association (p <0.05) was found between SSBs consumption and the concentrations of triglycerides (TG), low-density lipoprotein cholesterol (LDL-C) and total cholesterol (TC) in men, while women presented a positive association with visceral fat percentage (VF%) and LDL-C.
Table 2 Anthropometric and metabolic characteristics in young students population according to sex. Cross-sectional analysis, considering all the participants (men n=208 and women n= 296).
Variable
|
Men
|
Women
|
Waist (cm)
|
84.74 ± 12.84
|
79.38 ± 10.94
|
Hip (cm)
|
98.48 ± 8.88
|
98.66 ± 8.50
|
Weight (kg)
|
72.11 ± 15.12
|
60.56 ± 13.85
|
BMI (kg / m2)
|
24.29 ± 4.86
|
23.64 ± 4.46
|
TBF%
|
21.71 ± 8.44
|
32.26 ± 7.41
|
VF%
|
1.91 ± 1.44
|
1.28 ± 0.77
|
Glucose (mg / dL)
|
86.07 ± 6.93
|
84.37 ± 6.70
|
TG (mg / dL)
|
97.09 ± 52.96
|
83.22 ± 38.26
|
TC (mg / dL)
|
154.93 ± 29.48
|
152.35 ± 29.48
|
HDL-C (mg / dL)
|
44.50 ± 19.02
|
48.64 ± 22.14
|
VLDL-C (mg / dL)
|
20.62 ± 15.63
|
17.61 ± 11.64
|
LDL-C (mg / dL)
|
89.72 ± 27.56
|
87.23 ± 21.45
|
Abbreviations: BMI, body mass index; TBF%, total body fat percentage; VF%, visceral fat percentage; TG, triglycerides; TC, total cholesterol; HDL-C, high-density lipoprotein cholesterol; VLDL-C, very low-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol. The values are presented as the mean ± standard deviation.
Serving consumption
A categorization was carried out based on the servings consumed (< 10, 10-20 and >20) weekly to evaluate differences of the variables between categories, the values are reported in Table 3 and 4 for men and women. The values are presented as the mean ± standard deviation. The mean of consumed servings by category are the following: 5.5 servings / week (SD = 2.8), 15.0 servings / week (SD = 3.0) and 35.7 servings / week (SD = 12.3) for men, and for women: 5.4 servings / week (SD = 3.0), 14.4 servings / week (SD = 2.9) and 31.4 servings / week (SD = 8.9) for the categories < 10 servings, 10-20 servings and >20 servings respectively.
Table 3 Change in metabolic and anthropometric variables in young men according to SSBs serving consumption category (servings < 10, 10-20 servings and servings > 20).
Variable
|
< 10
|
CI 95%
|
10-20
|
CI 95%
|
> 20
|
CI 95%
|
*P
|
Waist (cm)
|
85.4 ± 10.8
|
81.8, 89.0
|
83.4 ± 9.9
|
76.0, 79.8
|
81.4 ± 12.2
|
78.7, 84.0
|
0.099
|
Hip (cm)
|
99.4 ± 6.9
|
96.5, 102.3
|
97.6 ± 7.1
|
96.3, 99.4
|
99.3 ± 9.8
|
97.4, 101.3
|
0.614
|
Weight (kg)
|
74.8 ± 13.1
|
70.3, 79.3
|
71.0 ± 14.0
|
55.6, 61.0
|
62.6 ± 12.4
|
59.3, 65.9
|
0.363
|
BMI (kg / m2)
|
25.0 ± 4.6
|
23.5, 26.4
|
23.7 ± 4.1
|
22.2, 23.9
|
24.2 ± 3.2
|
23.1, 25.4
|
0.317
|
TBF%
|
22.1 ± 7.4
|
19.4, 24.8
|
21.3 ± 7.9
|
30.4, 33.3
|
32.7 ± 7.1
|
30.9, 34.5
|
0.586
|
VF%
|
1.8 ± 0.9
|
1.4, 2.2
|
1.8 ± 1.1
|
1.0, 1.2
|
1.5 ± 1.0
|
1.3, 1.7
|
0.001
|
Glucose (mg / dL)
|
87.6 ± 8.4
|
84.7, 90.4
|
85.5 ± 7.8
|
83.3, 85.9
|
84.8 ± 7.9
|
83.4, 86.2
|
0.206
|
TG (mg / dL)
|
82.2 ± 6.7
|
67.2, 97.2
|
88.5 ± 8.2
|
73.3, 87.6
|
87.6 ± 55.2
|
79.0, 96.2
|
0.281
|
TC (mg / dL)
|
143.9 ± 33.4
|
136.0, 151.8
|
155.6 ± 29.7
|
145.9, 155.6
|
154.1 ± 24.7
|
149.1, 159.1
|
0.581
|
HDL-C (mg / dL)
|
43.8 ± 13.2
|
39.6, 49.0
|
42.6 ± 12.9
|
44.9, 49.7
|
51.4 ± 15.9
|
44.4, 58.4
|
0.183
|
VLDL-C (mg / dL)
|
19.3 ± 12.6
|
13.5, 25,1
|
20.2 ± 12.5
|
14.8, 18.6
|
19.8 ± 10.8
|
16.5, 23.0
|
0.040
|
LDL-C (mg / dL)
|
78.3 ± 25.9
|
68.5, 88.1
|
89.0 ± 22.5
|
82.9, 91.2
|
86.7 ± 25.5
|
81.8, 91.7
|
0.735
|
Abbreviations: BMI, body mass index; TBF%, total body fat percentage; VF%, visceral fat percentage; TG, triglycerides; TC, total cholesterol; HDL-C, high-density lipoprotein cholesterol; VLDL-C, very low-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol. *Test for lineal trend. The values are presented as the mean ± standard deviation.
Table 4 Change in metabolic and anthropometric variables in young women according to SSBs serving consumption category (servings < 10, 10-20 servings and servings > 20).
Variable
|
< 10
|
CI 95%
|
10-20
|
CI 95%
|
> 20
|
CI 95%
|
*P
|
Waist (cm)
|
78.8 ± 11.0
|
76.9, 80.6
|
77.9 ± 11.7
|
76.0, 79.8
|
85.2 ± 10.1
|
82.6, 87.9
|
.957
|
Hip (cm)
|
98.7 ± 8.9
|
97.2, 100.3
|
97.8 ± 9.2
|
96.3, 99.4
|
98.6 ± 7.5
|
96.8, 100.4
|
.685
|
Weight (kg)
|
60.8 ± 11.9
|
58.4, 66.2
|
58.3 ± 13.7
|
55.6, 61.0
|
71.9 ± 13.4
|
68.8, 75.0
|
.348
|
BMI (kg / m2)
|
23.6 ± 4.1
|
22.8, 24.3
|
23.1 ± 3.9
|
22.2, 23.9
|
24.3 ± 3.9
|
23.3, 25.4
|
.537
|
TBF%
|
32.1 ± 7.7
|
30.8, 33.4
|
31.9 ± 6.8
|
30.4, 33.3
|
21.8 ± 8.5
|
20.0, 23.5
|
.852
|
VF%
|
1.1 ± 1.2
|
1.0, 1.2
|
1.1 ± 0.9
|
1.0, 1.2
|
1.9 ± 1.2
|
1.6, 2.3
|
.580
|
Glucose (mg / dL)
|
83.6 ± 6.4
|
82.2, 84.9
|
84.6 ± 6.2
|
83.3, 85.9
|
85.9 ± 7.7
|
84.5, 87.3
|
.230
|
TG (mg / dL)
|
81.6 ± 55.3
|
74.0, 89.1
|
80.4 ± 51.9
|
73.3, 87.6
|
105.8 ± 8.3
|
95.3, 116.4
|
.029
|
TC (mg / dL)
|
152.2 ± 29.8
|
147.6, 156.8
|
150.7 ± 22.5
|
145.9, 155.6
|
157.6 ± 30.0
|
151.5, 163.6
|
.022
|
HDL-C (mg / dL)
|
47.1 ± 16.1
|
44.5, 49.7
|
47.3 ± 16.0
|
44.9, 49.7
|
45.7 ± 13.1
|
41.3, 50.0
|
.629
|
VLDL-C (mg / dL)
|
16.3 ± 11.8
|
14.8, 17.8
|
16.7 ± 10.5
|
14.8, 18.6
|
21.6 ± 12.9
|
19.0, 23.2
|
.566
|
LDL-C (mg / dL)
|
87.5 ± 25.4
|
83.9, 91.7
|
87.0 ± 26.2
|
82.9, 91.2
|
93.2 ± 26.8
|
87.9, 98.5
|
.008
|
Abbreviations: BMI, body mass index; TBF%, total body fat percentage; VF%, visceral fat percentage; TG, triglycerides; TC, total cholesterol; HDL-C, high-density lipoprotein cholesterol; VLDL-C, very low-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol. *Test for lineal trend. The values are presented as the mean ± standard deviation.
Calorie intake
Men consume more calories from SSBs compare to women with means of 2174.9 kcal / week (SD = 1380.0) and 1526.9 kcal / week (SD = 1070.3) p <0.01. The analysis by serving category, showed men consume 479.0 kcal / week (SD = 268.1), 1311.4 kcal / week (SD = 318.9) and 3152.8 kcal / week (SD = 1117.8) while women consume 483.0 kcal / week (SD = 281.9), 1342.5 kcal / week (SD = 297.1) and 2732.7 kcal / week (SD = 861.4) in the categories < 10, 10-20 and > 20 respectively. A significant difference between sex was found when comparing the groups of >20 (p <0.05). The description of calories consumed by each SSBs group are specified in Figure 1.
Interactions
To verify the associations between metabolic alterations and the SSBs consumption an interactions analysis between all the anthropometric and metabolic variables was carried out, using the obesity diagnosis (by BMI) and body fat diagnosis (by TBF%) to evaluate possible interactions, the results are shown in table 5.
Table 5 Interactions between SSBs serving consumption category and lipid variables differentiated by obesity diagnosis (by BMI) and body fat diagnosis (by TBF%) in men and women.
Men
|
|
|
|
|
|
<10
|
10-20
|
>20
|
BMI diagnosis
|
<10
|
10-20
|
>20
|
TBF% diagnosis
|
TG (mg / dL)
|
81.2 ± 55.9
|
80.8 ± 49.7
|
81.1 ± 50.4
|
Normal
|
74.8 ± 50.7
|
73.9 ± 50.1
|
75.6 ± 55.4
|
Normal
|
|
82.1 ± 51.2
|
85.9 ± 50.3
|
140.1 ± 55.6
|
Overweight
|
98.1 ± 48.5
|
99.0 ± 51.7
|
138.9 ± 54.2
|
MH
|
|
71.7 ± 58.2
|
137.7 ± 71.4
|
158.2 ± 70.4
|
Obese
|
61.0 ± 59.5
|
115.6 ± 62.3
|
158.7 ± 70.3
|
High
|
TC (mg / dL)
|
143.2 ± 31.2
|
151.9 ± 35.7
|
149.1 ± 34.4
|
Normal
|
143.5 ± 33.2
|
151.4 ± 35.9
|
150.1 ± 37.2
|
Normal
|
|
149.1 ± 32.8
|
169.6 ± 33.4
|
170.8 ± 33,2
|
Overweight
|
144.9 ± 29.4
|
164.2 ± 28.4
|
170.7 ± 29.9
|
MH
|
|
137.3 ± 29.8
|
167.0 ± 30.1
|
173.9
|
Obese
|
127.5 ± 28.9
|
165.8 ± 29.7
|
175.6 ± 33.6
|
High
|
LDL-C (mg / dL)
|
72.8 ± 25.7
|
87.8 ± 26.7
|
87.2 ± 22.3
|
Normal
|
75.5 ± 26.9
|
86.0 ± 27.0
|
86.1 ±28.5
|
Normal
|
|
86.4 ± 26.9
|
94.6 ± 29.1
|
108.2 ± 30.7
|
Overweight
|
84.9 ± 28.0
|
90.5 ± 29.1
|
107.3 ± 30.7
|
MH
|
|
81.9 ± 26.7
|
105.9 ± 29.0
|
105.6 ± 26.9
|
Obese
|
76.2 ± 27.9
|
108.1 ± 29.5
|
106.0 ± 22.2
|
High
|
Women
|
|
|
|
|
|
|
|
|
VLDL-C (mg / dL)
|
14.5 ± 8.1
|
14.8 ± 7.1
|
16.5 ± 6.5
|
Normal
|
14.9 ± 5.9
|
15.6 ± 5.3
|
16.8 ± 5.0
|
Normal
|
|
20.8 ± 9.1
|
16.7 ± 11.9
|
16.9 ± 11.1
|
Overweight
|
19.9 ± 8.8
|
17.9 ± 7.8
|
22.8 ± 8.4
|
MH
|
|
18.5 ± 10.0
|
37.4 ± 14.9
|
35.2 ± 13.2
|
Obese
|
20.0 ± 11.6
|
30.8 ± 14.7
|
33.2 ± 15.2
|
High
|
Abbreviations: TG, triglycerides; TC, total cholesterol; VLDL-C, very low-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; MH moderately high. Interaction analysis. Only the variables that shown independence (no significant interaction using p <0.05) using both diagnostic criteria are shown. The values are presented as the mean ± standard deviation.