Joint association of physical activity and sugar-sweetened beverages with obesity in young U.S. adults: A cross-sectional analysis of NHANES 2007-2020.

Objective: This study aimed to investigate the independent and joint association of sugar-sweetened beverages (SSBs) and physical activity with obesity among young U.S. adults. Methods: We selected 11,318 U.S. young adults aged 20-44 years from the National Health and Nutrition Examination Survey (2007-2020). Physical activity was self-reported using the Global Physical Activity Questionnaire, while SSBs consumption was calculated from a single day of twenty-four-hour dietary recall. Multivariable logistic regression models, and sensitivity analyses were used to estimate the associations between SSBs, physical activity, and obesity. Results: There were 4216 cases of obesity (35.5 %). A positive relationship between the consumption of SSBs and the prevalence of obesity was observed, while physical activity was negatively associated with the prevalence of obesity. Relative to the moderate SSBs consumption + inactive participants, those who were insufficiently active [adjusted odds ratio (AOR) = 0.75, 95 % CI: 0.58, 0.97] and physically active (AOR = 0.72, 95 % CI: 0.62, 0.85) had a lower likelihood of obesity among moderate SSBs consumers (1-499 kcal/day). However, this pattern was not found in the heavy SSBs consumers (≥ 500 kcal/day) ( Conclusions: In conclusion, physical activity was associated with a lower prevalence of obesity among moderate SSBs consumers, while this pattern did not observe in heavy SSBs consumers. Further studies are needed to validate these results and determine causality.