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Table 4 Unadjusted Risk of Incident Asthma according to Beverage Consumption, The National Children’s Study

From: Excess free fructose, apple juice, high fructose corn syrup and childhood asthma risk – the National Children’s Study

Incident Asthmaa

Cox Proportional Hazards

Hazard Ratio

95% CI

p-value

ttlEFFb(any combination of soda/sports/fruit drinks and 100% juice)

n = 2118, # of obs = 4236

  ≤ 2.5 /wk

Reference -------

 3 /wk

1.43

0.65–3.14

0.375

 4–7 /wk

2.04

1.15–3.63

0.015*

  > 1 & 2 /day

3.08

1.77–5.36

0.0000***

  > 2 /day

3.89

2.27–6.67

0.000000***

100% Juicec

n = 2114, # of obs = 4228

  ≤ 2.5 /wk

Reference -------

 3–7 /wk

1.52

0.99–2.32

0.057∞

  > once /day

2.33

1.54–3.53

0.00000***

Soda/sports/fruit drinks

n = 2118, # of obs = 4236

  ≤ 2.5 /wk

Reference -------

 3–7 /wk

2.22

1.35–3.67

0.002**

  > once /day

3.33

1.92–5.75

0.0000***

  1. Cox regression hazard ratios (HR), their 95% confidence intervals and p values are shown. Significant associations are denoted with asterisks. Multiple asterisks denote highly significant associations. Associations that approached significance are denoted by the ∞ symbol. a Asthma refers to the first incidence of asthma as self-reported during the 18- and 24-month exams. b ttlEFF refers to intake frequency of any combination of high fructose corn syrup sweetened soft drinks/sports/fruit drinks and 100% juice. c Juice types were not distinguished. The most consumed juice by children < 5 years of age is apple juice, and apple juice is widely used as a main ingredient/sweetener in 100% juice blends marketed to children [42, 43]. Per capita apple juice consumption doubled from 1980 to 2010 [44]. During the study period, HFCS was the main sweetener in US soda [30]. Many varieties of fruit drinks are sweetened with HFCS and apple juice. The fructose to glucose ratio in apple juice is ≥2:1.[32]In HFCS sweetened soft drinks the ratio has been measured as 1.5:1 for HFCS with 60% fructose [34] and 1.9:1 for HFCS with 65% fructose [33] – higher than the 1.2:1 ratio that is generally recognized as safe [35]