Substance Use
Development and validation of the sugar-sweetened beverage addictive-like scale and its association with lipid profiles in adolescents Yun Chen* Yun Chen Pei-Wen Wu Yu-Ting Chin Chien-Hung Lee Pei-Tung Lin
The excessive consumption of sugar-sweetened beverages (SSBs) among adolescents is linked to an increased risk of obesity, type 2 diabetes, and cardiovascular disease. This underscores the importance of identifying and providing treatment for individuals with problematic drinking habits. Sugar has the ability to activate the brain’s dopamine system, similar to substance addiction, leading to cravings and potentially encouraging overconsumption. The aim of this study was to develop and validate a measurement scale to assess addictive-like behaviors associated with SSB intake and investigate its relationship with lipid profiles in adolescents. Using a representative sample of 231 adolescents, exploratory factor analysis (EFA) was employed to develop the measurement scale, following the DSM-5 diagnostic criteria for substance use disorders and incorporating food addiction scales. We validated the SSB addictive-like measure utilizing confirmatory factor analysis (CFA) on another representative sample of 366 adolescents obtained from a cohort study. The association between the developed SSB addictive-like constructs and lipid profiles was analyzed using structural equation modeling (SEM). In EFA, three constructive factors, namely social impairment, impaired control, and risky use, were identified and explained 74.5% of the total variance. In CFA, the 3-factor model exhibited satisfactory internal consistency, convergent validity, and discriminant validity. In SEM, impaired control of SSB intake was positively associated higher levels of triglyceride (standardized β (sβ), 0.22) and uric acid (sβ, 0.18) after controlling for covariates. Furthermore, risky use of SSB intake showed a positive correlation with apolipoprotein B/A1 ratio (sβ, 0.20) and a negative correlation with apolipoprotein A1 (sβ, -0.25). Our study presents compelling evidence linking high-risk behavior of SSB intake to adverse lipid profiles in adolescents.
