ARS | Publication request: Association of candy consumption with body weight measures, other health risk factors for cardiovascular disease, and diet quality in US children and adolescents: NHANES 1999-2004

Submitted to: Food and Nutrition Research
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: May 17, 2011
Publication Date: June 14, 2011
Citation: O'Neil, C.E., Fulgoni Iii, V.L., Nicklas, T.A. 2011. Association of candy consumption with body weight measures, other health risk factors for cardiovascular disease, and diet quality in US children and adolescents: NHANES 1999-2004. Food and Nutrition Research. 55.

Interpretive Summary: This study showed that approximately one-third of children and adolescents consumed candy the day of the recall and that candy consumption was associated with higher intakes of energy and added sugars; chocolate candy consumption was also associated with higher total and SFA intake. Total, chocolate, and sugar candy consumption was not associated with weight/adiposity variables and candy consumers were less likely to be overweight or obese than non-candy consumers. Only chocolate candy consumers had a lower diet quality than non-consumers, but all individuals had poor diet quality regardless of whether they consumed candy. Current levels of candy consumption were not associated with adverse health parameters in children or adolescents.

Technical Abstract: The purpose of this study was to determine the effects of total, chocolate, or sugar candy consumption on intakes of total energy, fat, and added sugars; diet quality; weight/adiposity parameters; and risk factors for cardiovascular disease in children 2–13 years of age (n=7,049) and adolescents 14–18 years (n=4,132) participating in the 1999–2004 National Health and Nutrition Examination Survey. Twenty-four hour dietary recalls were used to determine intake. Diet quality was determined using the Healthy Eating Index-2005 (HEI-2005). Covariate-adjusted means, standard errors, and prevalence rates were determined for each candy consumption group. Odds ratios were used to determine the likelihood of associations with weight status and diet quality. In younger children, total, chocolate, and sugar candy consumption was 11.4 g +/- 1.61, 4.8 g +/- 0.35, and 6.6 g +/- 0.46, respectively. In adolescents, total, chocolate, and sugar candy consumption was 13.0 g +/- 0.87, 7.0 g +/- 0.56, and 5.9 g +/- 0.56, respectively. Total candy consumers had higher intakes of total energy (2248.9 kcals +/- 26.8 vs 1993.1 kcals±15.1, p<0.0001) and added sugars (27.7 g +/- 0.44 vs 23.4 g +/- 0.38, p<0.0001) than non-consumers. Mean HEI-2005 score was not different in total candy and sugar candy consumers as compared to non-consumers, but was significantly lower in chocolate candy consumers (46.7 +/- 0.8 vs 48.3 +/- 0.4, p=0.0337). Weight, body mass index (BMI), waist circumference, percentiles/z-score for weight-for-age and BMI-for-age were lower for candy consumers as compared to non-consumers. Candy consumers were 22 and 26%, respectively, less likely to be overweight and obese than non-candy consumers. Blood pressure, blood lipid levels, and cardiovascular risk factors were not different between total, chocolate, and sugar candy consumers and non-consumers (except that sugar candy consumers had lower C-reactive protein levels than non-consumers). This study suggests that candy consumption did not adversely affect health risk markers in children and adolescents.