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Commentary
How Sweet It Is: Sugar-Sweetened Beverage Consumption, Obesity, and Cardiovascular Risk in Childhood

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Dietary Added Sugars and Obesity

Although cardiologists have long been concerned about dietary fat, concern about dietary added sugars dates from the onset of the obesity epidemic. Epidemiologic studies show that from 1970 to 2000 in adults, the prevalence of obesity tripled while intake of energy from fat significantly decreased. During roughly that same time period, intake of sugar-sweetened beverages increased dramatically. In children and adolescents, analysis of the 1989-1991 Continuing Survey of Food Intakes by

Development of Taste Preferences

Taste preference is a powerful contributor to high intake of sugars, including sugar-sweetened beverages. The development of food preferences in childhood is important because early preference patterns have long-term influence on dietary intake later in life (17). Children's food preferences develop from a complex interplay of innate, familial, and environmental factors. There are innate preferences for sweet tastes demonstrated from early infancy (18). High concentrations of glucose have even

Added Sugars and Cardiovascular Risk

High added sugar consumption in the form of sugar-sweetened beverages is associated with a constellation of cardiovascular risk factors, both independently and through the development of obesity. In terms of obesity, a prevailing theory is that liquid energy is associated with decreased satiety and incomplete compensatory reduction in subsequent energy intake (35, 36, 37). Obesity is strongly associated with the development of hypertension, dyslipidemia, type 2 diabetes, and the metabolic

Interventions to Lower Intake of Added Sugars

A small number of interventions have directly targeted consumption of added sugars with a focus on sugar-sweetened beverages in children and adolescents. A trial of 103 adolescents who regularly consumed sugar-sweetened beverages randomly assigned subjects to non–energy-containing beverage consumption via home delivery vs control (50). Sugar-sweetened beverage consumption decreased 82% in the intervention group with no change in controls. Change in BMI was 0.07±0.14 for the intervention group

Conclusions

The article by Reedy and Krebs-Smith in this issue of the Journal (8) reports high consumption of empty calories in contemporary American children with added sugars as a major contributor in that category. High added sugar consumption, which occurs most commonly in the form of sugar-sweetened beverages, is associated with a constellation of cardiovascular risk factors, both independently and through the development of obesity. Multiple studies have shown that presence of these risk factors in

R.-E. W. Kavey is a professor, Department of Pediatrics, Division of Cardiology, University of Rochester Medical Center, Rochester, NY.

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    R.-E. W. Kavey is a professor, Department of Pediatrics, Division of Cardiology, University of Rochester Medical Center, Rochester, NY.

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