Southwest Center for Occupational and Environmental Health

SWCOEH’s Dr. George Delclos co-authors article on asthma and sugar-sweetened beverages in children

HOUSTON (May 10, 2022) – George Delclos, MD, MPH, PhD, Deputy Director of the Southwest Center for Occupational and Environmental Health (SWCOEH) at UTHealth School of Public Health, co-authored an article examining the association between sugar-sweetened beverage consumption and asthma in children and adolescents.

The article was led by Luyu (“Amber”) Xie, a doctoral candidate working under Dr. Sarah E. Messiah at UTHealthSchool of Public Health, Dallas Campus, who is also a coauthor, along with Dr. Folefac Atem. The article, “Association between asthma and sugar-sweetened beverage consumption in the United States pediatric population” was published in the Journal of Asthma in April.

The study included 9,938 children aged 2-to-17 years old who participated in the 2011-2016 National Health and Nutrition Examination Surveys. sugar-sweetened beverage consumption was categorized into 3 groups based on the caloric intake from 24-hour food recall data as follows: 1) no consumption (0 kcal/day); 2) moderate consumption (1-499 kcal/day); and 3) heavy consumption (≥ 500 kcal/day). The primary outcome of interest was self-reported current asthma condition.

For Dr. Delclos, an interesting aspect of the findings is that, while the study findings suggest a dose-response relationship between sugar-sweetened beverage intake and asthma diagnosis, the association is not plainly discernible.

“A direct relationship between consuming sugar-sweetened beverages and having asthma may not initially seem intuitive,” Dr. Delclos said. “Yet there are now several studies showing such an association. In the case of our study, we added to the literature by studying this question in a broader age group of children (2 to 17 years) and by doing a good job of controlling for other variables (what we call “confounders”). In this regard, it was important to control for obesity, since an association between obesity and asthma is well known, as is that increased caloric intake (like what can happen when kids get a lot of their calories from sugar-sweetened beverages) can lead to obesity. We found that the effect of high levels of sugar-sweetened beverage consumption on asthma persisted even after we took obesity into account.”

The study found that asthma prevalence estimates were significantly higher in heavy (16.4%) and moderate (11.0%) consumers versus non-consumers (7.5%). Children with heavy sugar-sweetened beverage consumption were twice as likely to have asthma than non-SSB consumers. The odds of asthma were higher among those who consumed fruit drinks, non-diet soft drinks and sweet tea, compared to nondrinkers. The effect did not change by obesity status.

“At this point, I think there are plenty of epidemiology studies that have demonstrated this association between sugar-sweetened beverage consumption and asthma, but the important questions are ‘why?’ and ‘how?’”, Dr. Delclos said. “In other words, we need to conduct studies that try to understand the mechanism and pathway by which this occurs.”

The SWCOEH provides a variety of graduate-level training opportunities for occupational and environmental health professionals through our industrial hygiene, occupational and environmental medicine, occupational epidemiology, and Total Worker Health^®.