Mediation of BMI on 25-Hydroxyvitamin D Levels in U.S. Adults with Sugar-Sweetened Beverages Consumption

Wei-Ting Lin, Tulane University
Gabrielle V. Gonzalez, LSU Health Sciences Center - New Orleans
Yu-Hsiang Kao, LSU Health Sciences Center - New Orleans
Hui-Yi Lin, LSU Health Sciences Center - New Orleans
Mirandy S. Li, LSU Health Sciences Center - New Orleans
David W. Seal, Tulane University
Chien-Hung Lee, Kaohsiung Medical University
Chih-Yang Hu, LSU Health Sciences Center - New Orleans
Lei-Shih Chen, Texas A&M University, College Station
Tung-Sung Tseng, LSU Health Sciences Center - New Orleans

Abstract

Body mass index (BMI) as well as sugar-sweetened beverages (SSB) has been suggested to independently decrease 25-hydroxyvitamin D (25(OH)D). However, the relationship between SSB, BMI, and 25(OH)D is uncertain. This study aimed to investigate the potential mediating role of BMI in the association between SSB intake and 25(OH)D. A total of 4505 representative U.S. adults aged above 20 years and without liver conditions were selected from the 2013-2014 NHANES. All analyses were performed under survey modules with appropriate sampling weights. The prevalence of 25(OH)D insufficiency and deficiency was 37.8% and 24.1% in U.S. adults, respectively. Compared with non-SSB consumers, an increased risk of vitamin D deficiency was found in either heavy SSB consumers or soda consumers, respectively (aOR = 2.10, 95% CI = 1.25-3.54 in heavy SSB consumers; aOR = 1.61, 95% CI = 1.06-2.44 in soda consumers). Around 21.3% of the total effect of sugar intake from SSB on decreased 25(OH)D was explained by BMI. In conclusion, high total sugar intake from SSB and BMI independently contribute to lower 25(OH)D, and BMI mediates the inverse association between total sugar intake from SSB intake and 25(OH)D. Furthermore, an increased risk of having vitamin D deficiency was found in the population who consumed higher levels of sugar from SSB or soda drinks.