Relationship Between Insulin Resistance-Associated Metabolic Parameters and Anthropometric Measurements With Sugar-Sweetened Beverage Intake and Physical Activity Levels in US Adolescents Findings From the 1999-2004 National Health and Nutrition Examination Survey

Objective: To evaluate the relationship between insulin resistance-associated metabolic parameters and anthropometric measurements with sugar-sweetened beverage intake and physical activity levels. Design: A cross-sectional analysis of the National Health and Nutrition Examination Survey data collected by the National Center for Health Statistics. Setting: Nationally representative samples of US adolescents participating in the National Health and Nutrition Examination Survey during the years 1999-2004. Participants: A total of 6967 adolescents aged 12 to 19 years. Main Exposure: Sugar-sweetened beverage consumption and physical activity levels. Outcome Measures: Glucose and insulin concentrations, a homeostasis model assessment of insulin resistance (HOMA-IR), total, high-density lipoprotein, and low-density lipoprotein cholesterol concentrations, triglyceride concentrations, systolic and diastolic blood pressure, waist circumference, and body mass index ( calculated as weight in kilograms divided by height in meters squared) percentile for age and sex. Results: Multivariate linear regression analyses showed that increased sugar-sweetened beverage intake was independently associated with increased HOMA-IR, systolic blood pressure, waist circumference, and body mass index percentile for age and sex and decreased HDL cholesterol concentrations; alternatively, increased physical activity levels were independently associated with decreased HOMA-IR, low-density lipoprotein cholesterol concentrations, and triglyceride concentrations and increased high-density lipoprotein cholesterol concentrations. Furthermore, low sugar-sweetened beverage intake and high physical activity levels appear to modify each others' effects of decreasing HOMA-IR and triglyceride concentrations and increasing high-density lipoprotein cholesterol concentrations. Conclusions: Sugar-sweetened beverage intake and physical activity levels are each independently associated with insulin resistance-associated metabolic parameters and anthropometric measurements in adolescents. Moreover, low sugar-sweetened beverage intake and high physical activity levels appear to modify each others' effects on several health-related outcome variables.