2025 / 02 Professor Chien-Hung Lee (Department of Public Health)

Many people wonder whether frequent consumption of sugar-sweetened beverages, especially hand-shaken teas high in fructose, may worsen metabolic health in adolescents. Is this effect related to elevated uric acid or insulin resistance? This study involved 1,454 adolescents in southern Taiwan and analyzed their beverage intake, changes in uric acid and insulin resistance, and overall metabolic health risk using questionnaire and health examination data. The results showed that higher intake of sugar-sweetened beverages was associated with higher uric acid and insulin resistance levels, and higher levels of these biomarkers were linked to a higher risk of metabolic syndrome. In terms of drinking amount, adolescents who habitually consumed more than 500 mL of high-fructose tea daily tended to have worse overall metabolic health scores. Part of this difference could be explained by the observation that “sugar-sweetened tea increases uric acid” and “sugar-sweetened tea worsens insulin resistance,” with the uric acid pathway playing a particularly prominent role. Interestingly, after removing the negative effects of uric acid and insulin resistance, tea consumption itself may still have some positive effects on metabolic health. Overall, the findings suggest that tea beverages without fructose or added sugar may be more beneficial for adolescents’ metabolic health than high-fructose drinks. However, as this was a cross-sectional observational study, the results only show associations and cannot establish causal relationships.

Application and Highlights:

• The practical value of this research lies in linking the health advice of “drinking fewer sugar-sweetened beverages” to measurable and trackable physiological changes. Uric acid and insulin resistance can serve as useful indicators in school or community health promotion programs to identify adolescents at higher metabolic risk and to evaluate whether sugar-reduction interventions lead to improvements.
• The study also provides feasible alternatives for beverage choices. The key issue may be the sugar and fructose content rather than the beverage itself, supporting the substitution of high-fructose drinks with unsweetened or low-sugar teas that contain less fructose as part of daily dietary adjustments for adolescents.

More Information:
Wu PW, Chin YT, Lin WT, Tsai S, Lee CY, Tsai WC, Seal DW, Lee CH*. Fructose intake, endogenous biomarkers and latent metabolic construct in adolescents: Exploring path associations and mediating effects. Pediatr Obes. 2025 Jan;20(1):e13176.(SCIE, IF₂₀₂₄: 2.7, 33/191=17.28% in PEDIATRICS)

Team Member: 
Pei-Wen Wu, Yu-Ting Chin, Wei-Ting Lin, Sharon Tsai, Chun-Ying Lee, Wei-Chung Tsai, David W. Seal, Chien-Hung Lee

Introduction of Research Team:
The research team has long focused on cardiometabolic health issues among adolescents in southern Taiwan. The team includes epidemiology PhD researchers and postdoctoral fellows with expertise in study design and data analysis, as well as cardiology and family medicine physicians who provide clinical expertise and integrated health care experience.