78 - Association of Sodium and Sugar Sweetened Beverage Intake with Cardiovascular Disease Risk Factors in Obese and Overweight Youth

Poster Number: 78
Publication Number: 78.324

Jason Ong, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Jennifer Roem, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Kirstie Ducharme-Smith, Johns Hopkins All Children's Hospital, San Diego, CA, United States; Diane Vizthum, University of Delaware, Baltimore, MD, United States; Pranjal Agrawal, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Elaine M. Urbina, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Tammy M. Brady, Johns Hopkins University, Baltimore, MD, United States

Background: Cardiovascular disease (CVD) risk factors in children such as obesity and hypertension have increased in prevalence over the past decades. Dietary intake is a potential modifiable risk factor.

Objective: To determine the individual and combined association of sodium (Na) and sugar sweetened beverage (SSB) intake on adiposity, blood pressure (BP) and cardiac target organ damage (TOD) among youth with overweight/obesity.

Design/Methods: Secondary analysis of data that was collected from a randomized trial testing the effect of a behavioral intervention on adiposity, BP, and left ventricular mass index (LVMI; EMPower study). Participants with baseline and 6-month diet data and realistic caloric intake (500-3500 Kcal/d) were included (Nf69). Adiposity (BMI z-score and waist circumference z-score), BP (indices and hypertensive status) and echo (TOD including LVMI, LVH and abnormal LV geometry) measures were obtained from the 6-month visit.

ANOVA, Kruskal-Wallis, Chi-squared, and Fisher’s exact tests were used to compare characteristics between low ( < 2.5g), medium (2.5-3.5g) and high (≥3.5 g) Na intake and between low ( < 4oz), medium (4-12oz) and high (≥12oz) SSB intake. Multivariable regression determined the independent associations of Na and SSB (low, < 4oz vs medium and high, ≥4oz) with measures of (1) adiposity, (2) BP and (3) TOD, adjusting for covariates (Table 2). For combined association of Na and SSB on outcomes, an interaction term (Na*SSB) was added.

Results: The study population was a median age of 19 years (IRQ 16, 21), 32% (Nf22) male, 55% (Nf38) white, 55% in the intervention arm, mean Na intake of 3.1g (SD 1.0), median SSB intake of 6.6oz (IQR 2, 13.8) and mean caloric intake of 1813 Kcal (SD 423; Table 1). Prevalence of hypertensive BP and raw BMI z-score increased from low to high Na and SSB groups, respectfully (Figure 1). High Na had 12.8 times greater odds of hypertensive BP than low Na (95% CI 1.35, 120.9; p=0.027) after adjustment for age, sex, race, study arm and income, but was no longer associated when further adjusted for BMI z-score and total calories. High SSB was independently associated with higher BMI z-score (+0.34; 95% CI: 0.02, 0.65) and waist circumference z-score (+0.49; 95% CI: 0.07, 0.91) in fully adjusted models (Table 2). There was no effect modification between Na and SSB on outcomes.Conclusion(s): Higher Na intake was associated with greater prevalence of hypertensive BP and higher SSB was independently associated with adiposity among youth with overweight/obesity. These dietary factors hold promise as targets for intervention to decrease CVD risk in at-risk youth.
Jason_Ong_CVJason_Ong CV.pdf
Table 2: Association of measures of adiposity with sugar sweetened beverage (SSB) intake, adjusting for confounders
<img src=https://www.abstractscorecard.com/uploads/Tasks/upload/16020/FGOVBGGC-1157071-2-IMG.png width=440 hheight=98.4734799482536 border=0 style=border-style: none;>CI, confidence interval; BMI, body mass index; High SSB, ≥4oz/day; SES, socioeconomic status; SBP, systolic blood pressure
Model 1: unadjusted.
Model 2: adjusted for age, sex, race, study arm, SES. SES measured as reported income >75k/year or ≤75k/year.
Model 3: Model 2 covariates + total daily calories.
Model 4: Model 3 covariates + SBP index.