A systematic review and meta-analysis of the association of all types of beverages high in fructose with asthma in children and adolescents.

Background: Asthma has become the most common chronic condition among children in recent decades. Environmental factors, including food, drive its rise. Sweetened beverages are a staple of children's diets and cause various health issues. Therefore, this research aims to evaluate the association of all types of high fructose beverages with asthma in children.

Method: We assessed observational studies published before November 2023, obtained from PubMed, Scopus, and Web of Science. The quality of articles was assessed by using the Newcastle-Ottawa Scale. Studies with a pediatric population under 18 years that indicate the association between all kinds of beverages containing high fructose and asthma and evaluated risk estimates with 95% confidence intervals were included. We also followed Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA).

Results: In the final analysis, we included eleven studies with 164,118 individuals. Twenty-one effect sizes indicated a significant positive association between sugar-sweetened beverages (SSBs) consumption and odds of asthma (OR: 1.28; 95% CI: 1.15-1.42; P < 0.001). Three effect sizes showed that total excess free fructose (tEFF) intake increases children's asthma odds by 2.7 times (pooled OR: 2.73; 95% CI: 1.30-5.73; P =0.008). However, five effect sizes in 100% fruit juice failed to show statically association with asthma prevalence in children (pooled OR: 1.43; 95%CI: 0.91-2.23; P =0.12).

Conclusion: In summary, SSB and tEFF raised asthma probabilities. No relationship was found between fruit juice and asthma in children and adolescents. We need more cohort studies with correct age selection to identify the precise link.