Added Sugar Intake and Cardiovascular Risk Factors in Children and Adolescents: A Cross-Sectional Analysis of NHANES 2017–March 2020 Data

Background: There are many factors that increase the risk of cardiovascular diseases (CVD) including dyslipidemia, elevated blood pressure, and obesity, and they are increasingly recognized in pediatric populations. Early detection of modifiable risk factors such as body mass index (BMI) and dietary sugar intake facilitates preventive interventions. The National Health and Nutrition Examination Survey (NHANES) provides a dataset well-suited for such analyses.
Objective: To examine the relationships between BMI, dietary sugar intake, total caloric intake, and cardiovascular risk markers including serum triglycerides, LDL cholesterol, HDL cholesterol, and systolic blood pressure in a sample of children and adolescents.
Methods: A cross-sectional analysis was conducted using the NHANES 2017–March 2020 pre-pandemic cohort. The study includes 119 participants aged 12 to 17 years with complete data across all analytic variables (55 males, 64 females; mean age 14.7 ± 1.6 years). BMI was classified using CDC Growth Chart BMI-for-age percentile cutoffs. Pearson correlation coefficients and multiple linear regression analyses were performed using Python 3.x.
Results: BMI demonstrated significant but weak-to-moderate negative correlation with HDL cholesterol (r = −0.389, p < 0.001) and significant positive correlations with triglycerides (r = 0.369, p < 0.001) and LDL cholesterol (r = 0.336, p < 0.001). Using CDC growth chart classification, 55.5% of participants were classified as healthy weight, 23.5% as obese, 19.3% as overweight, and 1.7% as underweight; combined, 42.9% had elevated BMI. Dietary sugar intake was positively associated with LDL cholesterol (r = 0.210, p = 0.022). In multiple linear regression, BMI was the dominant independent predictor of triglycerides (β = 2.118, p < 0.001) and HDL cholesterol (β = −0.686, p < 0.001), while sex was a significant predictor of systolic blood pressure (β = −7.633, p < 0.001).
Conclusion: BMI is a strong predictor of adverse cardiovascular markers in children and adolescents, particularly reduced HDL and elevated triglycerides and LDL cholesterol. The association between dietary sugar and LDL warrants further investigation. These findings emphasize the importance of early lifestyle intervention to reduce the long-term burden of cardiovascular disease.