|dc.description.abstract||Introduction: Children of Kuwait have both a high obesity and dental caries prevalence, as well as excessive consumption of sugar-sweetened beverages (SSB). Obesity is a major risk factor for serious health conditions such as diabetes, cancer, and cardiovascular disease. Metabolic syndrome (SMets), the occurrence of 3 out 5 variables (obesity, hypertension, hyperglycemia, lowered high-density lipoprotein cholesterol (HDLC), and hypertriglyceridemia) is a risk factor that predicts future cardiovascular disease and type 2-diabetes. The aim of this analysis was to assess the impact of the consumption of three beverages (soda, milk, and juice) on the obesity and dental caries in Kuwaiti children. We also aim to investigate the changes overtime of the salivary biomarkers; insulin, CRP, phosphate, and uric acid. This study followed a group of children before having developed SMets and after its development, and compared them to children with no SMets characteristics.
Methods and Materials: Data were obtained from the Kuwait Healthy Life Study. For the impact of beverage consumption on the severity of dental caries, 8,317 children were included from the baseline visit in 2012-13 (age =10). For the obesity 6,305 children were included, from both baseline and follow-up visit in 2014-15 (age =12). A subset of 94 children were included in the study of the salivary biomarker change over time, all the children had no SMets at baseline, 51 became SMets positive and 43 remain healthy at follow-up. A multivariate logistic regression analysis was conducted to examine the relation between developing obesity as a dependent binary variable, and beverages consumption amount as a categorical independent variable. For the severity of dental caries, a multivariate logistic regression was used to evaluate this association between the severity of dental caries as a binary dependent variable (low and high), and the categorical consumption (amount and pattern) of the three beverages as independent variables. For the salivary biomarkers, the changes in the salivary biomarker measurements from baseline to follow-up for each group were tested using Wilcoxon matched-pairs signed-ranks test.
Results: A significant association between high soda and milk consumption with developing obesity (OR=1.68, P= 0.004, CI =1.19- 2.39) (OR=1.77, P=0.019, CI =1.10- 2.87), respectively. For the severity of dental caries, high soda consumption was significantly associated with severe dental caries (OR=1.20, P= 0.041, CI =1.01- 1.42). Moderate milk drinking showed a protective effect from having severe dental caries (OR=0.88, P= 0.007, CI =0.81- 0.97). The change in salivary biomarkers from baseline to follow-up, children in the healthy group had no significant change. Children who developed SMets had a significant increase in all salivary biomarkers; insulin became double the baseline levels (p =0.014), CRP were 120% higher (p =0.005), phosphate became 11% higher (p =0.030) and uric acid showed 17% elevation (p =0.009).
Conclusion: High soda consumption was significantly associated with obesity and dental caries. High milk consumption was significantly associated with obesity but not with dental caries. Moderate milk consumption was protective from having severe dental caries, even if it was occasional use of flavored milk. Children who developed SMets showed a significant elevation in all the four salivary biomarkers while there was no significant change noted in the levels for children who did not develop SMets.||