Investigating the Beverage Patterns of Children and Youth with Obesity at the Time of Enrollment into Canadian Pediatric Weight Management Programs

Abstract

Introduction: Beverages influence diet quality, however, beverage intake among youth with obesity is not well-described in literature. Dietary pattern analysis can identify how beverages cluster together and enable exploration of population characteristics. Objectives: 1) Assess the frequency of children and youth with obesity who fail thresholds of: no sugar-sweet beverages (SSB), <1 serving/week of SSB, ≥2 servings/day of milk and factors influencing the likelihood of failing to meet these cut-offs. 2) Derive patterns of beverage intake and examine related social and behavioural factors and health outcomes at entry into Canadian pediatric weight management programs. Methods: Beverage intake of youth (2–17 years) enrolled in the CANPWR study (n=1425) was reported at baseline visits from 2013-2017. Beverage thresholds identified weekly SSB consumers and approximated Canadian recommendations. The relationship of sociodemographic (income, guardian education, race, household status) and behaviours (eating habits, physical activity, screen time) to the likelihood of failing cut-offs was explored using multivariable logistic regression. Beverage patterns were derived using Principal Component Analysis. Related sociodemographic, behavioural and health outcomes (lipid profile, fasting glucose, HbA1c, liver enzymes) were evaluated with multiple linear regression. Results: Nearly 80% of youth consumed ≥1 serving/week of SSB. This was more common in males, lower educated families and was related to eating habits and higher screen time. Two-thirds failed to drink ≥2 servings milk/day and were more likely female, demonstrated favourable eating habits and lower screen time. Five beverage patterns were identified: 1) SSB, 2) 1% Milk, 3) 2% Milk, 4) Alternatives, 5) Sports Drinks/Flavoured Milks. Patterns were related to social and lifestyle determinants; the only related health outcome was HDL. Conclusion: Many children and youth with obesity consumed SSB weekly. Fewer drank milk twice daily. Beverage intake was predicted by sex, socioeconomic status and other behaviours, however most beverage patterns were unrelated to health outcomes.