Consumption of sugar-sweetened beverages and metabolic markers in children – a narrative review of the evidence

A healthy hydration habit is an important aspect of a healthy diet, but recommendations on beverage choices are still less detailed than food-based recommendations. It is our working hypothesis that frequent consumption of sugar-sweetened beverages (SSBs) may cause insulin resistance by inducing rapid increases in insulin concentration. Insulin resistance is central to the risk of developing type 2 diabetes and may also be linked to development of obesity. This narrative review aims to review the literature on SSB consumption in relation to adverse markers of glucose metabolism in children. Literature searches were conducted in Medline and Embase via Ovid^® on June 21^st and June 22^nd, 2020. From 8892 titles, abstracts were screened from 76 publications. This screening resulted in the inclusion of 13 publications, while reference screening of the 13 publications resulted in inclusion of an additional six publications. A total of 11 cross-sectional studies, two prospective studies, five experimental studies and one randomised controlled trial were reviewed. The majority of the reviewed studies reported significant, positive associations between SSB consumption and a broad range of adverse markers of glucose metabolism. Results suggested that the adverse effects of SSB consumption on metabolic health may not be limited to individuals with overweight. The results suggest that more frequent consumption of SSBs may be associated with adverse markers of glucose metabolic health among children. However, the evidence is limited by a paucity of prospective studies and randomised controlled trials, as well as by profound heterogeneity in definitions of exposures and outcomes.