Added Sugar Consumption and HDL in Adolescent Girls: A Longitudinal Analysis Público

Lee, Alexandra Kathryn (2013)

Permanent URL: https://etd.library.emory.edu/concern/etds/rn3011916?locale=pt-BR
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Abstract

Background: Added sugar consumption has been linked to obesity, type 2 diabetes, and dyslipidemia. In the United States, added sugar consumption is highest among adolescents, accounting for over 22% of daily calories in the year 2000.

Objective: To determine if added sugar consumption is associated with change in HDL among adolescent girls, and whether race or obesity modify this relationship.

Methods and Participants: The National Heart Lung and Blood Institute's Growth and Health Study (NGHS) was a 10-year cohort study that recruited 2,379 9 and 10 year old girls in 1987 and 1988. Participants completed a three-day food record annually and lipids were assessed biennially. Participants' added sugar consumption was categorized for each year lipids were available and a longitudinal mixed model was fit.

Results: After controlling for obesity, race, physical activity, smoking, maturation stage, age, and other nutritional factors, consumption of 15-20% of calories from added sugar was significantly associated with a 0.30mg/dL annual decline in high-density lipoprotein (HDL) compared to consumption of <10% calories from added sugar (p=0.03). Consumption of ≥25% of calories from added sugar was marginally not significantly associated with a 0.27mg/dL annual decline in HDL compared to consumption of <10% calories from added sugar (p=0.06).

Conclusion: High consumption of added sugar has deleterious effects on HDL cholesterol among adolescent girls.

Table of Contents

Introduction.................................................1
Literature Review.........................................3
Sugars.........................................................3
History and Trends of Sugar Consumption..........4
Biological Mechanisms.....................................7
Sugar and Cholesterol.....................................9
Methods.....................................................14
Study Design and Participants..........................14
HDL............................................................14
Nutrition......................................................15
Other Covariates...........................................16
Exclusion from Analysis...................................19
Statistical Analysis.........................................19
Institutional Review Board...............................22
Results.......................................................23
Participant Characteristics..............................23
Graphical Evaluation.......................................25
Mixed Models.................................................25
Discussion...................................................28
Strengths.....................................................29
Limitations....................................................31
Implications and Future Directions.....................32
References..................................................36
Tables.........................................................41
Figures........................................................51
Appendix.....................................................55

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