Cardiovascular
Family Dietary Environments, Sugar-Sweetened Beverage Use, and Metabolic Risk in Adolescents: A Parent–Adolescent Dyad Study Ying-Hua Liao* Ying-Hua Liao Liao Liao Liao Liao Liao Department of Public Health, College of Health Science, Kaohsiung Medical University, Kaohsiung, Taiwan
Background: Family dietary environments, including healthy food accessibility and household dietary rules, play a key role in shaping children’s dietary behaviors, especially sugar-sweetened beverage (SSB) intake, and may influence early cardiometabolic risk. From a family medicine perspective, these upstream factors may have lasting implications for cardiometabolic health. Using a parent–adolescent dyad design, this study aimed to construct latent factors and risk scores for family dietary environments and examine their associations with adolescents’ SSB intake and metabolic syndrome (MetS) risk.
Methods: We analyzed 1,438 parent–adolescent pairs randomly selected from 10 senior high schools in southern Taiwan (2020‒2022). Parents reported 6 and 7 family dietary items, which were used to construct latent factors for family food accessibility and dietary rules via confirmatory factor analysis. Adolescents’ SSB use disorder (SUD) severity was assessed using summed DSM-5–derived symptoms. MetS was defined according to Taiwan Pediatric Association criteria. Associations of latent factor scores with SUD severity and MetS were examined using linear and logistic regression models adjusted for covariates.
Results: Two factors—healthy and sweetened food accessibility (HFA and SFA)—and one factor, household dietary rule (HDR), were identified from family food accessibility and dietary rule items, respectively. Higher HFA and HDR scores were associated with fewer SUD symptoms (adjusted β=−0.06 and −0.03, p<0.05). Greater SUD severity was linked to higher waist circumference, diastolic blood pressure, triglycerides, and a 1.1-fold increased risk of MetS. Higher HFA scores were also associated with lower MetS risk, partially mediated by reduced SUD symptoms.
Conclusion: HFA and HDR were linked to lower adolescent SUD severity, and high HFA was linked to lower MetS risk, suggesting family dietary environments as modifiable targets for early cardiometabolic prevention.