Association Between Sugar-Sweetened Beverage Consumption and Executive Function Among Chinese Tibetan Adolescents at High Altitude

Zhang, Feng; Zhang, Feng; Yin, Xiaojian; Yin, Xiaojian; Yin, Xiaojian; Liu, Yuan; Liu, Yuan; Li, Ming; Li, Ming; Gui, Xiaoying; Bi, Cunjian; Bi, Cunjian · 2022 · DOAJ

DOI: 10.3389/fnut.2022.939256

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Summary

This study investigates the association between sugar-sweetened beverage (SSB) consumption and executive function (EF) among Chinese Tibetan adolescents living at high altitudes in Tibet, China. The research was motivated by the lack of data regarding EF in this specific population, who face environmental hypoxia that may affect brain development, and the rising prevalence of SSB consumption in low- and middle-income countries. While previous studies linked SSB intake to poorer cognitive outcomes in other populations, the impact on high-altitude Tibetan adolescents remained unexplored. The researchers conducted a cross-sectional study involving 1,427 recruited adolescents, with 1,231 providing valid data after exclusions for missing values. Participants were selected via stratified cluster sampling from three cities in Tibet. SSB consumption frequency was assessed via questionnaire and categorized into three groups: 0 times/week, 1 time/week, and ≥2 times/week. Executive function, comprising inhibition, working memory, and cognitive flexibility, was measured using computerized tasks: a modified Eriksen flanker task, N-back shift tasks, and a more-odd shifting task. Statistical analyses included general linear regression and logistic regression, adjusting for covariates such as age, sex, parental education, body mass index, physical activity, and dietary intake. The results indicated that 84.73% of participants consumed SSBs at least once per week. Adolescents consuming SSBs ≥2 times/week exhibited significantly poorer EF performance compared to non-consumers. Specifically, after adjusting for all covariates, those in the highest consumption group showed longer reaction times across all EF metrics. For instance, incongruent reaction time was higher by 21.33 ms, and the reaction time difference for cognitive flexibility was higher by 112.41 ms. Logistic regression further revealed that adolescents consuming SSBs ≥2 times/week had significantly higher odds of executive dysfunction, with odds ratios of 5.91 for inhibition, 2.98 for working memory, and 2.80 for cognitive flexibility compared to non-consumers. The study concludes that SSB consumption is significantly associated with poorer executive function in Chinese Tibetan adolescents at high altitude. The findings suggest that controlling SSB intake is crucial for the healthy brain development of this population. The authors highlight the need for targeted interventions, such as taxation and education, to reduce SSB consumption. They also note the necessity for longitudinal studies to clarify the causal relationship between SSB intake and cognitive decline, particularly in populations vulnerable to environmental stressors like hypoxia.

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• cognitive capacity variation