The effect of sugar-sweetened beverages at 4 years of age on appetitive behaviours of 7-year-olds from the Generation XXI birth cohort

The consumption of energy-dense sugar-sweetened beverages (SSB) and its low satiating effects may influence the development of child eating behaviours. We aimed to investigate the association of SSB consumption at 4 years on appetitive behaviours at age 7 years. Children from the Generation XXI birth cohort were included (n 3880). SSB consumption was evaluated through a FFQ and appetitive behaviours were evaluated through the Children's Eating Behaviour Questionnaire, which includes eight subscales. Two composite factors, derived by principal component analysis (Appetite Restraint - related to Food Fussiness, Enjoyment of Food, Slowness in Eating and Satiety Responsiveness - and Appetite Disinhibition - related to Food Responsiveness, Emotional Under- and Overeating and Desire to Drink), were also investigated. The dose-response relationship between SSB consumption and appetitive behaviours was examined using multivariable linear regression (continuous eating behaviour scores) and multinomial logistic regression (tertile categories of eating behaviour scores). Child SSB consumption at 4 years was associated with higher Appetite Disinhibition and Desire to Drink and lower Food Fussiness and Slowness in Eating at 7 years. Consuming SSB ≥1 times/d (compared with a lower intake) was associated with 29 % increase in the odds of Desire to Drink (3rd v. 1st tertile). Pre-schoolers' SSB consumption was associated with higher food approach and less food avoidant behaviours later in childhood. Family characteristics, particularly maternal SSB consumption, explained part of these associations. It is essential to promote the intake of water, instead of sugary drinks, and make parents and caregivers aware of the importance of this exposure, since they have a pivotal role in shaping children's eating behaviours.