Article Figures & Data
Figures
- Figure 1
Allergic symptoms in children and consumption of excess free fructose beverages.
Note: Allergic symptoms in children were significantly associated with total excess free fructose beverage intake (P = .035) and nondiet soft drink intake (P = .012), but not with consumption of apple juice and nondiet fruit drinks alone.
- Figure 2
Allergic sensitization in children and consumption of excess free fructose beverages.
Note: Allergic sensitization in children was significantly associated with nondiet fruit drink intake (P < .001).
- Figure 3
Allergic symptoms in adolescents and consumption of excess free fructose beverages.
Note: Allergic symptoms in adolescents were significantly associated with total excess free fructose beverage intake (P = .005).
- Figure 4
Allergic sensitization in adolescents and consumption of excess free fructose beverages.
Note: Allergic sensitization in adolescents was significantly associated with apple juice intake (P = .001).
Tables
- Table 1
Demographic and Basic Characteristics of Children and Adolescents From NHANES 2005-2006
Characteristic Children, 6-12 y
(n = 860)Adolescents, 13-19 y
(n = 1,142)P Value Demographic Age, weighted mean (SE), y 8.99
(0.08)15.82
(0.13)BMI, z score, weighted mean (SE)a 0.483
(0.114)0.533
(0.054).728 Sex, weighted % .208 Male 52.5 47.0 Female 47.5 53.0 Race, weighted % .381 Mexican American 14.2 11.1 Other Hispanic 2.4 2.5 White 59.6 65.8 Black 15.0 14.9 Other 8.7 5.8 Asthma history, weighted % .776 Yes 18.4 19.6 No 81.6 80.4 Current asthma, weighted % .544 Yes 14.3 12.6 No 85.7 87.4 Lifestyles Smoking, weighted % <.001b Smoking 0.3 27.7 Nonsmoking 99.7 72.3 Secondhand smoke exposure, weighted % .002b Yes 11.7 19.3 No 88.3 80.7 Number of smokers at home, .021b weighted % 0 88.8 80.8 1 5.5 7.6 2 5.1 9.8 3 0.6 1.8 MET score, weighted mean (SE)c … 3,863.78 (337.11) NA Dietary nutrients, weighted mean (SE) Sodium,mg 3,013.42 (61.66) 3,560.90 (96.82) <.001b Total sugar, g 133.09 (3.35) 150.61 (3.83) .003b Vitamin A, mg 612.00 (32.95) 576.77 (25.85) .257 Vitamin C, mg 76.49 (3.26) 88.69 (3.98) .027b Vitamin E, mg 5.72 (0.23) 6.70 (0.30) .017b Vitamin B6, mg 1.63 (0.05) 1.96 (0.06) <.001b Vitamin B12, mg 4.77 (0.22) 5.73 (0.26) .021b Fiber, g 13.41 (0.40) 13.76 (0.53) .383 Folate, mg 373.58 (10.65) 408.46 (13.21) .014b Laboratory measures C-reactive protein, weighted 0.29 (0.10) 0.17 (0.02) .219 mean (SE), mg/dL Serum vitamin D level, <.001c weighted %c Sufficiency 83.2 70.4 Insufficiency 15.9 23.1 Deficiency 0.9 6.5 Allergic symptom, weighted % .108 Yes 37.4 42.7 No 62.6 57.3 Allergic sensitization, weighted % .135 Yes 40.0 43.9 No 60.0 56.1 - Table 2
Intake of Excess Free Fructose Beverages for Children and Adolescents From NHANES 2005-2006
Characteristic Children, 6-12 y
(n = 860)
No. (%)aAdolescents, 13-19 y
(n = 1,142)
No. (%)aP Value Total EFF beverages 1-3/mo 43 (6.9) 62 (9.1) .117 1-4/wk 71 (9.6) 56 (4.9) ≥5/wk 746 (83.6) 1,024 (86.0) Apple juice 1-3/mo 437 (54.5) 611 (62.7) .130 1-4/wk 246 (28.5) 308 (23.8) ≥5/wk 171 (17.0) 220 (13.5) Nondiet fruit drinks 1-3/mo 315 (45.0) 448 (45.9) .279 1-4/wk 262 (32.2) 312 (26.3) ≥5/wk 251 (22.7) 340 (27.8) Nondiet soft drinks 1-3/mo 142 (20.6) 131 (13.7) .013b 1-4/wk 190 (21.7) 138 (13.1) ≥5/wk 481 (57.7) 826 (73.2) - Table 3
Associations Between Intake of Excess Free Fructose Beverages and Allergic Symptoms and Sensitization in Children
Excess Free Fructose Beverage Intake Allergic Symptoms Allergic Sensitization Univariate
Crude ORs (95% CI)Multivariatea
Adjusted ORs (95% CI)Univariate
Crude ORs (95% CI)Multivariatea
Adjusted ORs (95% CI)Total 1-4/wk vs 1-3/mo 3.933 (0.874-17.698) 3.676 (0.561-24.070) 1.750 (0.511-5.989) 1.344 (0.464-3.894) ≥5/wk vs 1-3/mo 3.589 (1.030-12.501)b 3.433 (0.725-16.246) 1.070 (0.440-2.602) 0.873 (0.371-2.057) Apple juice 1-4/wk vs 1-3/mo 0.899 (0.605-1.334) 0.914 (0.590-1.418) 0.748 (0.433-1.293) 0.697 (0.410-1.186) ≥5/wk vs 1-3/mo 1.752 (0.849-3.617) 2.060 (0.833-5.094) 1.163 (0.504-2.685) 0.994 (0.461-2.146) Nondiet fruit drinks 1-4/wk vs 1-3/mo 1.217 (0.862-1.718) 1.051 (0.621-1.782) 0.671 (0.381-1.182) 0.576 (0.300-1.105) ≥5/wk vs 1-3/mo 1.510 (0.699-3.264) 1.496 (0.554-4.041) 2.636 (1.709-4.067)b 2.446 (1.583-3.780)b Nondiet soft drinks 1-4/wk vs 1-3/mo 2.283 (1.157-4.505)b 2.272 (0.881-5.859) 1.269 (0.575-2.804) 1.204 (0.424-3.415) ≥5/wk vs 1-3/mo 1.960 (1.234-3.114)b 1.873 (0.968-3.622) 0.945 (0.484-1.847) 0.891 (0.378-2.100) BMI = body mass index; OR = odds ratio.
↵a Adjusted for age, sex, race, BMI z score, smoking, secondhand smoke, dietary intakes, including sodium, total sugars, vitamin A, vitamin C, vitamin E, vitamin B6, vitamin B12, fiber, folate, C-reactive protein, serum vitamin D level, asthma history, and current asthma.
↵b P <.05.
- Table 4
Associations Between Intakes of Excess Free Fructose Beverages and Allergic Symptoms and Allergic Sensitization in Adolescents
Excess Free Fructose Beverage Intake Allergic Symptoms Allergic Sensitization Univariate
Crude ORs (95% CI)Multivariatea
Adjusted ORs (95% CI)Univariate
Crude ORs (95% CI)Multivariatea
Adjusted ORs (95% CI)Total 1-4/wk vs 1-3/mo 2.071 (0.894-4.799) 4.112 (1.857-9.107)b 1.673 (0.445-6.287) 7.135 (0.901-56.529) ≥5/wk vs 1-3/mo 3.006 (1.356-6.664)b 5.164 (1.866-14.297)b 1.965 (0.312-12.364) 3.766 (0.977-14.513) Apple juice 1-4/wk vs 1-3/mo 1.370 (0.626-3.002) 1.520 (0.535-4.322) 1.664 (1.191-2.326)b 1.506 (0.969-2.338) ≥5/wk vs 1-3/mo 1.622 (0.920-2.862) 1.764 (0.896-3.473) 2.444 (1.433-4.170)b 2.215 (1.178-4.164)b Nondiet fruit drink 1-4/wk vs 1-3/mo 1.304 (0.841-2.021) 1.308 (0.955-1.792) 0.880 (0.511-1.514) 1.224 (0.717-2.092) ≥5/wk vs 1-3/mo 1.276 (0.763-2.131) 1.426 (0.741-2.747) 0.926 (0.598-1.435) 0.936 (0.421-2.080) Nondiet soft drink 1-4/wk vs 1-3/mo 1.569 (0.749-3.288) 2.053 (0.499-8.454) 1.010 (0.460-2.216) 1.406 (0.304-6.500) ≥5/wk vs 1-3/mo 1.664 (0.882-3.139) 1.893 (0.845-4.238) 0.852 (0.412-1.761) 1.011 (0.453-2.261) BMI = body mass index; OR = odds ratio.
↵a Adjusted for age, sex, race, BMI z-score, smoking, secondhand smoke, physical activity, dietary intakes, including sodium, total sugars, vitamin A, vitamin C, vitamin E, vitamin B6, vitamin B12, fiber, folate, C-reactive protein, vitamin D, asthma history, and current asthma
↵b P <.05.
The Article in Brief
Excess Free Fructose Beverages and Allergy in Children and Adolescents: Results From NHANES 2005-2006
Xueyan Wang , and colleagues
Background Children's intake of beverages high in free (i.e., added) fructose have been tied to an increased incidence of asthma. This study investigates possible associations between allergic sensitization and consumption of drinks high in free fructose by children and adolescents.
What This Study Found This study offers preliminary evidence of a possible link between beverages that are high in free (added) fructose and allergic symptoms or allergic sensitization in children and adolescents. Analyses of 860 children and 1,142 adolescents in the 2005-2006 National Health and Nutrition Examination Survey do not yield entirely consistent findings, but lend some support to an association between allergy and high intake of beverages with excess free fructose. After controlling for potential confounders, children who consumed non-diet fruit drinks at least five times per week had 2.5 times greater odds of allergic sensitization than children who consumed such beverages one to three times per month. The association was stronger among adolescents; those who consumed beverages with excess free fructose one to four times per week or at least five times per week were five times more likely to have allergic symptoms than those who seldom drank such beverages. Adolescents consuming apple juice at least five times per week were twice as likely to have allergic sensitization than those who seldom consumed such beverages.
Implications
- These findings provide some evidence for the hypothesis that there may be a link between intake of beverages high in free fructose and allergic symptoms or allergic sensitization in children and adolescents. Longitudinal studies are needed to confirm the causality and to clarify underlying mechanisms
