Estimating sex-specific population-level effects of limiting sugar-sweetened beverages or 100% fruit juices during childhood on insulin resistance, central adiposity, and glycemic outcomes in late adolescence

We estimated sex-specific population effects of hypothetical interventions to limit sugar sweetened-beverages (SSBs) and 100% fruit juice throughout childhood on central adiposity, insulin resistance, and glycemic outcomes in adolescence in Project Viva prebirth cohort. Among 481 females and 491 males, mothers reported beverage intake from 3 to 10 years from a food frequency questionnaire. The primary outcome was the homeostatic model assessment for insulin resistance (HOMA-IR), and secondary outcomes were waist circumference, truncal fat mass, fasting glucose, and glycated hemoglobin in late adolescence. We applied inverse probability weighting of longitudinal marginal structural models to account for baseline and time-varying confounding, and censoring. We estimated that limiting SSBs to 1 serving weekly across childhood would reduce HOMA-IR by 0.28 units (95% confidence interval [CI], -0.61 to 0.02), waist circumference by 1.91 cm (95% CI, -3.79 to -0.05), truncal fat mass by 0.64 kg (95% CI, -1.33 to 0.05), and fasting glucose by 1.02 mg/dL (95% CI, -2.40 to 0.35) in males compared to no intervention. In females, effect estimates were near 0 and less precise than males. Effect estimates for 100% fruit juice were small, with imprecise CI in both sexes. Overall, limiting SSBs in childhood may have small effects on insulin resistance, central adiposity, and glycemia in males in this population of low consumers. Trial registration: NCT02820402; https://clinicaltrials.gov/study/NCT02820402.