Early Introduction of Sugar-Sweetened Beverages and Caries Trajectories from Age 12 to 48 Months

Abstract

Early exposure to sweet tastes predicts similar food preferences and eating behavior in later life and is associated with childhood obesity. The aim of this study was to explore the associations of early (during the first year of life) and subsequent intake of sugar-sweetened beverages (SSBs) with 4-y caries trajectories among Scottish young children. We used data from 1,111 Scottish children who were followed annually from age 12 to 48 mo (4 sweeps in total). SSB intake was reported by parents in every sweep. SSB intake was broken down into 2 components, the initial SSB intake and the deviation over time from that initial value. Childhood dental caries was clinically determined (including noncavitated and cavitated lesions) every year. The association of SSB intake with baseline decayed, missing, and filled tooth surfaces (dmfs) (intercept) and rate of change in dmfs over time (slope) was examined in 2-level linear mixed-effects models, with repeated observations nested within children. Both the initial SSB intake and the deviation from the initial SSB intake were positively associated with steeper caries trajectories. By sweep 4, the predicted mean dmfs difference was 1.73 between children with low and high initial SSB intake (1 standard deviation below and above the mean) and 1.17 between children with low and high deviation from their initial SSB intake (1 SD below and above the mean). The findings of this prospective study among Scottish young children provide evidence that the introduction of SSBs during the first year of life can put children in a trajectory of high levels of dental caries. They support current recommendations to avoid sugars for very young children and interventions targeting early feeding practices for caries prevention.