While some studies have indicated a relationship between sugar-sweetened beverage (SSB) intake and hypertension among children and adolescents, others have not. The purpose of this study was to examine the evidence of a dose-response relationship between SSB intake and blood pressure among children and adolescents through a systemic review and meta-analysis. Inclusion criteria for relevant studies were 1) observational design, 2) original research, 3) SSB intake reported as exposure variable and blood pressure (i.e., hypertension, systolic blood pressure, and diastolic blood pressure) reported as outcome variable,  4) participants less than 19 years-old, and 5) mean and standard deviation or odds ratio of blood pressure were reported in subjects of highest verses lowest SSB category. Fourteen studies between the years of 2009 and 2020 were included with a total of 93,873 participants. Comparison of SSB categories and blood pressure was calculated by measuring the unstandardized mean difference. Results showed that high SSB intake was associated with an increase of systolic blood pressure by 1.67 mmHg (p<.001), and that high SSB consumers were 1.36 times more likely to develop hypertension compared to low SSB consumers. There was no association between SSB intake and diastolic blood pressure.

Study strengths: This is the first meta-analysis to study a dose-response relationship between SSB intake and blood pressure among children and adolescents. Additionally, this is the first study to indicate that a higher SSB intake is associated with an increased risk of hypertension and systolic blood pressure.

Study limitations: Studies included in this meta-analysis were observational; therefore, larger prospective and intervention studies are needed to confirm this study’s findings. Additionally, different measures of SSB intake were utilized in each study analyzed which may have caused error in the estimation of SSB intake. Finally, in each of the studies analyzed, different confounding variables were used in the analysis, which may affect results.

What this means for your practice: This study adds to the evidence that early interventions are warranted to reduce SSB intake among children and adolescents.  In addition to reducing the risk of obesity and dental caries, this study suggests reducing SSB may also improve their blood pressure.  Practitioners may find the Dietary Approaches to Stop Hypertension (DASH) tools and resources helpful for both children and adults.

Original citation: Farhangi, M. A., Nikniaz, L., & Khodarahmi, M. (2020). Sugar-sweetened beverages increases the risk of hypertension among children and adolescence: a systematic review and dose–response meta-analysis. Journal of Translational Medicine, 18(1), 1-18.

About the Author:  Chenin Treftz, Ph.D., R.D.N., is a member of the research faculty at the University of Nevada, Reno.  Dr. Treftz has expertise in research, community nutrition, and higher education. Dr. Treftz has been a member of the Rethink Your Drink team since 2012.

The goal of Rethink Your Drink Nevada is to promote healthy beverages and reduce sugary drinks. To support this goal, free educational resources are available to eligible medical and dental care practices in Nevada.  For more information, please visit www.rethinkyourdrinknevada.com/healthpros or e-mail rethinkyourdrinknevada@cabnr.unr.edu.

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