Sugar-sweetened beverages increases the risk of hypertension among children and adolescence: a systematic review and dos
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(2020) 18:344 Farhangi et al. J Transl Med https://doi.org/10.1186/s12967-020-02511-9
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REVIEW
Sugar‑sweetened beverages increases the risk of hypertension among children and adolescence: a systematic review and dose– response meta‑analysis Mahdieh Abbasalizad Farhangi1*, Leila Nikniaz2 and Mahdieh Khodarahmi3
Abstract Background: In the current systematic review and meta-analysis, we summarized the studies that evaluated the effects of sugar-sweetened beverages (SSBs) intake on blood pressure among children and adolescents. Methods: In a systematic search from PubMed, Scopus, Embase and Cochrane electronic databases up to 20 April 2020, the observational studies that evaluated the association between sugar-sweetened beverages intake and hypertension, systolic or diastolic blood pressure (SBP, DBP) were retrieved. Results: A total of 14 studies with 93873 participants were included in the current meta-analysis. High SSB consumption was associated with 1.67 mmHg increase in SBP in children and adolescents (WMD: 1.67; CI 1.021–2.321; P 50% large heterogeneity [34]. The heterogeneity was considered significant if either the Q statistic had P value 50%. Sensitivity analysis by exclusion of one study at a time was applied to test the influence of each individual study on overall pooled estimates and heterogeneity [35]. Begg’s funnel plots was assessed to evaluate the publication bias followed by the Egger’s regression asymmetry test and Begg’s adjusted rank correlation for formal statistical assessment of funnel plot asymmetry. The data were analyzed using STATA version 13 (STATA Corp, College Station, TX, USA), and P-values less than 0.05 were considered as statistically significant. Dose–response meta‑analysis of the association between SSB dose and change in SBP or DBP
For dose response meta-analysis, the eligible studies had been reported the mean (SD) of continuous variable (e.g. SBP, DBP) in at least three categories. The median point in each SSB category was also identified. If medians had not been reported in the manuscript, then approximate medians were estimated, using the midpoint of the lower and upper limits. If the highest study category
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was open-ended, its SSB dose was calculated by assuming that the interval was the same as the closest category. The lowest categories of SSB intake was considered as the reference dose for each study. Any potential non- linear associations of SSB intake were performed by fractional polynominal modelling (polynomials) to explore the nonlinear potential effects of SSB dosage (g/d) and the studyspecific parameter [36].
671 manuscripts were excluded because of their irrelevant subject, inappropriate design, being reviews including meta-analysis or systematic reviews, conferences and seminars, not relevant age groups, not evaluating the association of studied parameters. A final number of 14 manuscripts were included in the current meta-analysis (Fig. 1).
Results
The characteristics of included
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