Nutrition/Obesity
Sugar-Sweetened Beverage Intake and Uric Acid in Adolescents: Longitudinal Pathways Through Adiposity and Blood Pressure Pei-Wen Wu* Pei-Wen Wu Wu Wu Wu Wu Kaohsiung Medical University
Background: Uric acid (UA) dysregulation in adolescence is increasingly recognized as an early marker of cardiometabolic risk. Sugar-sweetened beverage (SSB) intake, a major source of dietary fructose, may elevate UA directly through hepatic metabolism and indirectly via effects on adiposity and blood pressure (BP). Because BMI and BP vary over time and reflect both stable between-individual differences and within-individual change, this study examined longitudinal associations between SSB intake and UA, with BMI and BP as potential mediators. Methods: A six-wave cohort of 909 adolescents (aged 12–13 years) in southern Taiwan was followed at 6-month intervals from 2015 to 2018. Between- and within-individual temporal dynamics of BMI and BP were analyzed using random-intercept (RI) cross-lagged panel models. Direct and indirect pathways from baseline SSB intake to follow-up UA through time-varying BMI and BP were estimated within a structural equation modeling framework, adjusting for covariates. Results: At the between-person level, BMI and BP were temporally stable. Within individuals, higher-than-usual BMI predicted higher subsequent systolic BP (adjusted sβ = 0.06–0.08, p < 0.05), and autoregressive paths for BMI and systolic BP were significant. Adolescents consuming ≥500 mL/day SSB had higher UA at wave 1, which was associated with higher RI-BMI, and RI-BMI in turn predicted higher UA at wave 6 (adjusted sβ = 0.11, 0.56, and 0.19; all p < 0.05). Mediation analysis showed that the pathways ≥500 mL/day canned SSB → wave 1 UA → wave 6 UA and ≥500 mL/day canned SSB → wave 1 UA → RI-BMI → wave 6 UA accounted for 78.8% and 16.7% of the total mediation effect, respectively. Conclusion: Excessive SSB intake in adolescence predicts elevated UA over time, primarily through direct metabolic pathways and secondarily through stable adiposity, underscoring early metabolic consequences of SSB consumption.