1. Hayman, Laura L. PhD, RN, FAAN
  2. Callister, Lynn Clark PhD, RN, FAAN

Article Content

Welsh, J. A., Cogswell, M. E., Rogers, S., Rockett, H., Mei, Z., & Grummer-Strawn, L. M. (2005).Pediatrics, 115(2), e223-e229.


The prevalence of overweight among preschool children has increased substantially in the past 3 decades. Among 2- to 5-year-olds, overweight doubled from 5% in the early 1970s to greater than 10% in 2000 (Ogden, Flegal, Carroll, & Johnson, 2002). Studies suggest that the consumption of sweet drinks may be a major contributor to the current epidemic of overweight and obesity in the United States. This retrospective cohort study was designed to examine the association between sweet drink consumption (soda, fruit drink, vitamin C juice, other juice) and overweight (body mass index [BMI] >= 95th percentile for age and gender) among preschool children. Data for this study were part of the Missouri Pediatric Nutrition Surveillance System (PedNSS) and the Missouri Demonstration Project through the federally funded program for Women, Infants and Children (WIC). The PedNSS is a national program-based surveillance system to monitor the nutrition status of low-income children enrolled in public health nutrition programs. The sample (n = 10,904) included children who were aged 2 and 3 years, enrolled in the Missouri WIC program between January 1999 and December 2001, had at least one clinic visit with height and weight measurements and Harvard Service Food Frequency Questionnaire data (HFFQ), and had one-year follow-up measurements of height and weight.


Logistic regression was used to adjust for age, gender, race/ethnicity, birth weight, and intake of high-fat foods, sweet foods, and total calories. Among children who were normal or underweight at baseline (BMI <85th percentile), the association between sweet drink consumption and development of overweight was positive but not statistically significant. Children who were at risk for overweight at baseline (BMI 85th to <95th percentile) and consumed one to less than two drinks per day, two to less than three drinks per day, and three or more drinks per day were, respectively, 2.0, 2.0, and 1.8 times as likely to become overweight as the referent (less than one drink per day). A similar threshold effect was observed for children who were overweight at baseline and consumed sweets drinks.


Placed in the context of recent research, the results suggest that reducing sweet drink consumption may be one viable strategy for weight management in preschool children. While the mechanisms remain to be clarified, sufficient evidence exists to support both individual and population-based efforts designed to promote healthy patterns of dietary intake early in life-including reduced consumption of sweet drinks.


Comment by Laura L. Hayman




Ogden, C. L., Flegal, K. M., Carroll, M. D., & Johnson, C. L. (2002). Prevalence and trends in overweight among US children and adolescents. JAMA, 288, 1728-1732. [Context Link]