Sugar Sweetened Beverages Consumption in Preadolescent Children: 25-Hydroxy Vitamin D and Bone Mineral Density Affection

Objective: To study the effect of heavy consumption of sugar sweetened beverages on serum 25-hydroxy vitamin D (25OHD) level and bone mineral density (BMD) in preadolescents.
Study Design: Case-control.
Place and Duration of Study: Outpatient clinic in Children`s hospital, Ain Shams University, between September, 2009 and July, 2010.
Methods: A questionnaire to define the frequency of beverage consumption was filled by one thousand children within the age range of 8-12 years. Fifty children were selected from the heavy sugar sweetened beverages consumers and were compared to 50 clinically healthy age and sex matched children who gave no history of more than average sugar sweetened beverages intake. Each enrolled case filled a questionnaire that assesses duration of beverage intake, frequency and type as well as milk consumption. Questions concerning symptoms of pain, limitation of movement and fractures were also included. Anthropometric measurements were taken. Serum calcium and phosphorus were measured as well as the circulating 25OHD and dual-emission x-ray absorptiometry scan assessed their BMD Z-score.
Results: Children who heavily consumed the sugar sweetened beverages had significantly lower 25 (OH) vitamin D, and BMD Z-score as compared to the controls (t= 4.05, P<0.001 and t= 3.73, P<0.001, respectively). There was significant negative correlations between duration of beverage intake and both BMD Z-score and 25OHD among heavy sugar sweetened beverage consumers(r=0.38, P=0.01 and r=0.4, P<0.001, respectively). A significant negative correlation was detected between duration of beverage intake and serum calcium among heavy sugar sweetened beverage consumers (r = -0.46 and P<0.001) and significant positive correlation between BMD Z-score and 25OHD among them (r = 0.69 and P<0.001).
Conclusion: Sugar sweetened beverages intake is associated with a decrease in 25OHD which contributes to low bone mineralization in preadolescents and the duration of intake is the most determinant factor for this association. Consumption of carbonated beverages had more hazardous effect on 25OHD and BMD than packed fruit juice while milk intake showed an opposite effect. We recommend more awareness programs for preadolescents and their parents whether at school or as a part of national campaigns to boost healthy trends in beverage consumption.