Associations between beverage consumption patterns and adiposity and urinary biomarkers among young adults: a multicenter cross-sectional study in China.

BACKGROUND: Beverage consumption is a common dietary behavior that may be associated with adiposity and urinary biomarker profiles, yet population-based evidence in young adults remains limited. This study aimed to examine associations between beverage consumption patterns and adiposity indicators and urinary biomarkers among young adults in China. METHODS: This multicenter cross-sectional study included 3,198 university students aged 18-25 years from seven geographic regions in China. Daily fluid intake (DFI) was assessed using a validated 7-day fluid intake diary with calibrated cups. Body mass index (BMI) and waist circumference (WC) and urinary biomarkers (creatinine, uric acid, uric acid-to-creatinine ratio, and urea) were obtained. Multivariable regression models adjusted for predefined covariates were used to evaluate associations. RESULTS: Plain water contributed the largest proportion of DFI (83.9%), followed by sugar-sweetened beverages (SSBs), with substantial regional variation in beverage consumption patterns. Higher plain water intake was positively associated with BMI (β = 0.06, 95% CI: 0.02, 0.10, p = 0.009) and WC (β = 0.14, 95% CI: 0.02, 0.27, p = 0.022), but inversely associated with urinary creatinine (β = -148.05, 95% CI: -197.52, -98.59, p < 0.001), urinary uric acid (β = -9.90, 95% CI: -17.58, -2.22, p = 0.012), and urinary urea (β = -3.69, 95% CI: -4.74, -2.63, p < 0.001). In contrast, SSB intake was positively associated with WC (β = 1.00, 95% CI: 0.62, 1.38, p < 0.001), urinary uric acid (β = 45.15, 95% CI: 21.40, 68.89, p < 0.001), and urinary uric acid-to-creatinine ratio (p < 0.001). Coffee/tea (β = -1.12, 95% CI: -2.18, -0.06, p = 0.038), 100% fruit juice (β = -0.86, 95% CI: -1.70, -0.02, p = 0.046), and other beverages (β = -1.13, 95% CI: -2.19, -0.07, p = 0.037) were inversely associated with waist circumference. CONCLUSION: Beverage consumption patterns were associated with adiposity indicators and urinary biomarker profiles among Chinese university students, and these associations differed according to beverage type.