Sugar-sweetened beverages and body mass index in children and adolescents: a meta-analysis

Background: Rates of overweight and obesity have increased. Consumption of sugar-sweetened beverages (SBs) may play a role. Objective: The purpose of this meta-analysis was to determine whether the results of original research with the use of longitudinal and randomized controlled trials (RCTs) support the hypothesis that SB consumption is associated with weight gain among children and adolescents. Design: The MEDLINE database was used to retrieve all original studies of SBs and weight gain involving children and adolescents. Twelve (10 longitudinal and 2 RCT) studies were reviewed. Eight of the longitudinal studies and both RCT studies were incorporated into a quantitative meta-analysis. Forest plots and overall estimates and CIs for the association of the difference (Delta) in SB consumption with Delta body mass index (BMI; in kg/m(2)) were produced. Funnel plots were examined as a diagnostic test for publication bias. Databases of unpublished scientific studies were searched. Sensitivity tests were conducted to examine the robustness of the meta-analysis results. Results: The overall estimate of the association was a 0.004 (95% CI: -0.006,0.014) change in BMI during the time period defined by the study for each serving per day change in SB consumption with the fixed-effects model and 0.017 (95% CI: -0.009, 0.044) with the random-effects model. The funnel plot is consistent with publication bias against studies that do not report statistically significant findings. The sensitivity tests suggest that the results are robust to alternative assumptions and new studies. Conclusion: The quantitative meta-analysis and qualitative review found that the association between SB consumption and BMI was near zero, based on the current body of scientific evidence.