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Life expectancy can increase by up to 10 years following sustained shifts towards healthier diets in the United Kingdom.
Fadnes, LT, Celis-Morales, C, Økland, JM, Parra-Soto, S, Livingstone, KM, Ho, FK, Pell, JP, Balakrishna, R, Javadi Arjmand, E, Johansson, KA, et al
Nature food. 2023;4(11):961-965
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The mortality rate is rising in the United Kingdom (UK) due to the poor quality dietary patterns among the general population. Public Health England and the UK government recommend the population eat a healthy balanced diet based on the Eatwell Guide. Adherence to the Eatwell Guide dietary pattern could reduce the mortality rate among the general population in the UK. This research estimated the benefits of sustainably changing the unhealthy dietary pattern to the Eatwell Guide or longevity-associated dietary pattern on life expectancy in the UK. Longevity-associated dietary pattern is based on a moderate consumption of whole grains, fruit, fish and white meat; a substantial consumption of dairy, vegetables, nuts and legumes; a comparatively low consumption of eggs, red meat and sugar-sweetened beverages; and a low consumption of refined grains and processed meat. The unhealthy dietary pattern included limited amounts of whole grains, vegetables, fruits, nuts, legumes, fish, milk and dairy, and white meat and high consumption of processed meat, eggs, refined grains and sugar-sweetened beverages. This peer-reviewed review used prospective population-based cohort data from the UK Biobank. In UK adults aged 40 years, the change from an unhealthy dietary pattern to the Eatwell guide added 8.9 years in males and 8.6 years in females to their life expectancy. Furthermore, sustained adherence to the Eatwell guide increased life expectancy up to 10.8 years in males and 10.4 years in females. Further robust studies are required to evaluate the correlation between life expectancy and different food groups due to the limitations of the current research. However, healthcare professionals can use the results of this research to develop health policies and to understand the beneficial effect of following the Eatwell Guide or longevity dietary pattern in increasing life expectancy in middle-aged men and women in the UK.
Abstract
Adherence to healthy dietary patterns can prevent the development of non-communicable diseases and affect life expectancy. Here, using a prospective population-based cohort data from the UK Biobank, we show that sustained dietary change from unhealthy dietary patterns to the Eatwell Guide dietary recommendations is associated with 8.9 and 8.6 years gain in life expectancy for 40-year-old males and females, respectively. In the same population, sustained dietary change from unhealthy to longevity-associated dietary patterns is associated with 10.8 and 10.4 years gain in life expectancy in males and females, respectively. The largest gains are obtained from consuming more whole grains, nuts and fruits and less sugar-sweetened beverages and processed meats. Understanding the contribution of sustained dietary changes to life expectancy can provide guidance for the development of health policies.
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Lifestyle risk behaviours among adolescents: a two-year longitudinal study of the impact of the COVID-19 pandemic.
Gardner, LA, Debenham, J, Newton, NC, Chapman, C, Wylie, FE, Osman, B, Teesson, M, Champion, KE
BMJ open. 2022;12(6):e060309
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The global spread of COVID-19 and subsequent lockdown measures have presented challenges worldwide. Previous research has highlighted the importance of six key lifestyle behaviours, including diet, physical activity, sleep, sedentary behaviour (including recreational screen time), alcohol use and smoking—collectively referred to as the ‘Big 6’—for the short-term and long-term health of adolescents. The aim of this study was to examine changes in the prevalence of six key chronic disease risk factors from before to during the COVID-19 pandemic, and also to explore whether differences over time are associated with gender and lockdown status. This study is a prospective cohort study among a large and geographically diverse sample of adolescents. The sample included 983 students (girls = 54.8%) from 22 schools. Results show that: - over the 2-year period, the prevalence of excessive recreational screen time, insufficient fruit intake and alcohol and tobacco use increased. - alcohol use increased more among girls compared to boys. - the prevalence of insufficient sleep reduced in the overall sample; yet, increased among girls. - being in lockdown was associated with improvements in sugar-sweetened beverages consumption and discretionary food intake. Authors conclude that supporting young people to improve or maintain their health behaviours, regardless of the course of the pandemic, is important, alongside targeted research and intervention efforts to support groups that may be disproportionately impacted, such as adolescent girls.
Abstract
OBJECTIVE To examine changes in the prevalence of six key chronic disease risk factors (the "Big 6"), from before (2019) to during (2021) the COVID-19 pandemic, among a large and geographically diverse sample of adolescents, and whether differences over time are associated with lockdown status and gender. DESIGN Prospective cohort study. SETTING Three Australian states (New South Wales, Queensland and Western Australia) spanning over 3000 km. PARTICIPANTS 983 adolescents (baseline Mage=12.6, SD=0.5, 54.8% girl) drawn from the control group of the Health4Life Study. PRIMARY OUTCOMES The prevalence of physical inactivity, poor diet (insufficient fruit and vegetable intake, high sugar-sweetened beverage intake, high discretionary food intake), poor sleep, excessive recreational screen time, alcohol use and tobacco use. RESULTS The prevalence of excessive recreational screen time (prevalence ratios (PR)=1.06, 95% CI=1.03 to 1.11), insufficient fruit intake (PR=1.50, 95% CI=1.26 to 1.79), and alcohol (PR=4.34, 95% CI=2.82 to 6.67) and tobacco use (PR=4.05 95% CI=1.86 to 8.84) increased over the 2-year period, with alcohol use increasing more among girls (PR=2.34, 95% CI=1.19 to 4.62). The prevalence of insufficient sleep declined across the full sample (PR=0.74, 95% CI=0.68 to 0.81); however, increased among girls (PR=1.24, 95% CI=1.10 to 1.41). The prevalence of high sugar-sweetened beverage (PR=0.61, 95% CI=0.64 to 0.83) and discretionary food consumption (PR=0.73, 95% CI=0.64 to 0.83) reduced among those subjected to stay-at-home orders, compared with those not in lockdown. CONCLUSION Lifestyle risk behaviours, particularly excessive recreational screen time, poor diet, physical inactivity and poor sleep, are prevalent among adolescents. Young people must be supported to find ways to improve or maintain their health, regardless of the course of the pandemic. Targeted approaches to support groups that may be disproportionately impacted, such as adolescent girls, are needed. TRIAL REGISTRATION NUMBER Australian New Zealand Clinical Trials Registry (ACTRN12619000431123).
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The Dose-Response Associations of Sugar-Sweetened Beverage Intake with the Risk of Stroke, Depression, Cancer, and Cause-Specific Mortality: A Systematic Review and Meta-Analysis of Prospective Studies.
Wang, Y, Zhao, R, Wang, B, Zhao, C, Zhu, B, Tian, X
Nutrients. 2022;14(4)
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The consumption of sugar-sweetened beverages is high in today's society, which may lead to weight gain, inflammation, and a number of obesity-associated diseases. The objective of this systematic review and meta-analysis was to investigate the associations and causal links between the consumption of sugar-sweetened beverages and cancer, stroke, depression, and cause-specific mortality. Consumption of sugar-sweetened beverages significantly increased the risk of cancer, strokes, depression, and cause-specific mortality when compared with the consumption of low or no-sugar-sweetened beverages. As little as a 250ml increment of sugar-sweetened beverages was associated with an increase in risk. Consumption of sugar-sweetened beverages increases the risk of ischemic stroke by 10%, CVD-caused mortality by 13%, and cancer-caused mortality by 6.0% compared to those who consume less or no sugar-sweetened beverages. These findings can be used by healthcare professionals to understand the clinical significance of intervention strategies that reduce the consumption of sugar-sweetened beverages. It is imperative to conduct additional robust studies as there is an insufficient amount of evidence at present to establish a causal connection between the consumption of sugary beverages and the risk of depression, stroke, cancer, and cause-specific mortality.
Abstract
The associations between sugar-sweetened beverage (SSB) consumption and the risk of stroke, depression, cancer, and cause-specific mortality have not been determined, and the quantitative aspects of this link remain unclear. This meta-analysis therefore conducted a systematic review and dose-response analysis to determine their causal links. The database searches were conducted in PubMed, Cochrane library, Embase, Web of Science up to 10 November 2021. The intervention effects were evaluated by relative risk (RR) with 95% confidences (CI). Thirty-two articles met the inclusion criteria. Higher levels of SSB consumption significantly increased the risk of stroke (RR 1.12, 95% CI 1.03-1.23), depression (1.25, 1.11-1.41), cancer (1.10, 1.03-1.17), and all-cause mortality (1.08, 1.05-1.11) compared with none or lower SSB intake. The associations were dose-dependent, with per 250 mL increment of SSB intake daily increasing the risk of stroke, depression, cancer, and all-cause mortality by RR 1.09 (1.03-1.15), 1.08 (1.06-1.10), 1.17 (1.04-1.32), and 1.07 (1.03-1.11), respectively. The link was curved for depression and cancer risk (pnon-linear < 0.05). Subgroup analysis suggested that higher SSB intake increased ischemic stroke by 10%, CVD-caused mortality by 13%, and cancer-caused mortality by 6.0% than none or lower SSB consumption. It is suggested that SSB accounts for a leading risk factor of stroke, depression, cancer, and mortality, and that the risk rises in parallel with the increment of SSB intake (and is affected by participant characteristics).
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Anxiety, anhedonia and food consumption during the COVID-19 quarantine in Chile.
Landaeta-Díaz, L, González-Medina, G, Agüero, SD
Appetite. 2021;164:105259
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It has been recognised that mechanisms to cope with stress and the inability to feel pleasure can include eating foods high in sugar, carbohydrates, and fat, resulting in obesity. The current Covid-19 pandemic could be causing stress and anxiety to many individuals. This cross-sectional study aimed to determine the role of anxiety and reduced feelings of pleasure on diet and weight during the covid-19 pandemic in 1725 individuals in Chile. The results showed that anxiety levels were related to an increased consumption of sugar-sweetened drinks, fast food, and pastries. However, there was no relationship between lockdown measures due to Covid-19 and feelings of anxiety or reduced feelings of pleasure. Increased portion sizes were also related to anxiety levels. It was concluded that high levels of anxiety were related to increased consumption of unhealthy foods. This study could be used by healthcare professionals to recognise the need to recommend healthy eating habits for the wellbeing of patients who are suffering from anxiety.
Abstract
The current epidemic of COVID-19 has gained attention and highlighted the need for a better understanding of the population's mental health. Diet has been identified as an environmental determinant of mental health. In this regard, it has been suggested that the consumption of palatable foods represents a strategy to mitigate negative emotions, such as anxiety. This study aimed to evaluate the association between symptoms of anxiety and/or anhedonia to food consumption patterns during the period of COVID-19 quarantine in Chile. We conducted a cross-sectional study with non-randomized sampling via an online survey. A total of 1725 responses were collected. Each person self-answered the Beck Anxiety Inventory, Snaith-Hamilton Pleasure Scale for anhedonia, the Food Intake Questionnaire, and questions regarding type and duration of lockdown, as well as body weight and food serving variation. Significant correlations were observed between fried food consumption and self-reported body weight. The subjects who consumed fried food three times a week, had higher weight (63.5%) (χ2 = 48.5 and p < 0.001). Those who ate one and two or more pastries on a week had 1.41 and 1.49, respectively higher odds of reporting increased body weight. We found a relationship anxiety level and sugar-sweetened beverages level (χ2 = 25.5; p 0.013), fast food intake (χ2 = 63.4; p < 0.001), and pastry consumption (χ2 = 37.7; p < 0.001). In conclusion, it is important to monitor the evolution of these findings since they could represent a risk of increased health problems in the future post-lockdown period.
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Health behavior patterns of sugar-sweetened beverage consumption among Brazilian adolescents in a nationally representative school-based study.
Rocha, LL, Pessoa, MC, Gratão, LHA, Carmo, ASD, Cunha, CF, Oliveira, TRPR, Mendes, LL
PloS one. 2021;16(1):e0245203
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Sugar sweetened beverages (SSB) are ultra-processed foods containing several man-made chemicals, which heavily feature in the diets of adolescents in many developing countries. This cross-sectional study of 74,589 adolescents aimed to determine health behaviour patterns that affect SSB consumption to focus education and policy efforts to reduce consumption. The results showed that most adolescents who consumed SSB’s had higher consumption of processed foods, more screen time, more days of alcoholic beverage consumption, were more likely to purchase food from the school canteen, and a smoking habit. Those who had a higher consumption of water, minimally processed foods and frequent physical activity were less likely to consume SSB’s. It was concluded that healthy habits can aid implementation of other beneficial health behaviours. This study could be used by healthcare professionals to understand the importance of adopting healthy habits to decrease SSB and ultra-processed food consumption.
Abstract
Studies on sugar-sweetened beverage consumption patterns can help in the individual and population level management of chronic non-communicable diseases and other conditions. This study aimed to identify the association between health behavior patterns and the consumption of sugar-sweetened beverages among Brazilian adolescents from a nationally representative school-based study. A cross-sectional study analyzed data from 71,553 adolescents aged 12-17 years who attended public and private schools in Brazilian cities, from the Study of Cardiovascular Risk in Adolescents. Principal component analysis was performed to identify health behavior patterns, and ordered logistic regression was performed to identify the association between health behavior patterns and sugar-sweetened beverage consumption. Sugar-sweetened beverage consumption (mL/day) was used as the dependent variable. The analyses were performed using Stata software version 14.0 with a significance level of 0.05. Patterns 2 (alcoholic beverage and smoking habit) and 3 (ultra-processed food and screen time) of health behaviors and regularly purchasing snacks in the school cafeteria increased the odds of sugar-sweetened beverage consumption, while pattern 1 (water, unprocessed and minimally processed food and physical activity) decreased these odds. The adoption of healthy habits can indirectly stimulate the adoption of other habits beneficial to health. These results indicate the importance of adopting a set of regulatory measures to reduce sugar-sweetened beverage consumption.
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Ultra-Processed Foods and Nutritional Dietary Profile: A Meta-Analysis of Nationally Representative Samples.
Martini, D, Godos, J, Bonaccio, M, Vitaglione, P, Grosso, G
Nutrients. 2021;13(10)
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In addition to the nutrient content of foods, the production and formulation methods of processed foods may also play a role in their effect on human health. The aim of this study was to systematically review the existing data from nationally representative surveys regarding UPF consumption in relation to dietary nutritional profiles, and to perform a meta-analysis (of 14 studies) of the results in order to understand the similarities or discrepancies that exist between countries. Results indicate a significant consumption of UPFs in the countries investigated, accounting for up to almost 80% of total caloric intake with confectionery (categorized as “cookies, pastries, and sweet bread”) and sugar-sweetened beverages representing the most consumed UPF groups. In fact, when considered in relation to other food groups, UPFs were not sporadically consumed in an isolated manner, but instead characterized entire dietary patterns and were consumed at the expense of unprocessed foods. Authors conclude that there is a consistent correlation between the increased consumption of UPFs and the worsening nutritional quality of diet.
Abstract
Excessive consumption of ultra-processed foods (UPFs), as described by the NOVA classification system, represents a potential threat to human health. The nutritional composition of UPFs may explain their observed adverse effects. The present study aimed to provide a quantitative meta-analysis of nationally representative surveys on the consumption of UPFs and the dietary/nutrient composition of respondents' diets. A systematic search for relevant studies published prior to July 2021 was conducted via electronic databases. The studies that provided the dietary/nutrient composition of foods categorized according to the NOVA classification system were selected. The association between UPFs and other dietary variables was modelled using ordinary least squares linear regression based on aggregated data extracted from the selected articles. Consumption of UPFs represented up to 80% of total caloric intake in the US and Canada, with confectionery and sugar-sweetened beverages being the most consumed items. When considered in relation to other food groups, an inverse linear relation between UPFs and less-processed foods was evident. Increased UPF intake correlated with an increase in free sugars, total fats, and saturated fats, as well as a decrease in fiber, protein, potassium, zinc, and magnesium, and vitamins A, C, D, E, B12, and niacin. In conclusion, the data indicate that increased UPF consumption negatively affects the nutritional quality of diets.
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Association of Major Food Sources of Fructose-Containing Sugars With Incident Metabolic Syndrome: A Systematic Review and Meta-analysis.
Semnani-Azad, Z, Khan, TA, Blanco Mejia, S, de Souza, RJ, Leiter, LA, Kendall, CWC, Hanley, AJ, Sievenpiper, JL
JAMA network open. 2020;3(7):e209993
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Fructose is a type of sugar that has been implicated as a contributor to the development of metabolic syndrome (MetS), which is a condition where large waist circumference, high blood pressure and elevated blood lipid levels may all coexist. However, it remains unclear as to the role of fructose containing foods in the development of MetS. This systematic review and meta-analysis of 13 prospective cohort studies aimed to determine the association of several fructose containing foods and drinks with MetS. The results showed that sugary drinks containing fructose increased the risk of MetS, whereas no associations were found with mixed fruit juice, 100% fruit juice, honey, ice cream or confectionary. Interestingly fruit and yoghurt containing fructose decreased the risk of developing MetS. It was concluded that fructose containing food and drinks are not all equal in their biological effects. Sugary drinks increased the risk of developing MetS but yoghurt and fruit had a protective effect against development. Reasons for this could be due to a generally unhealthier lifestyle in those who consume sugary drinks or may be due to the increased protective effects associated with the vitamins and minerals in fruit and yoghurt. This study could be used by healthcare professionals to recommend a diet eliminating sugary drinks and containing regular fruit and yoghurt intake.
Abstract
Importance: Sugar-sweetened beverages (SSBs) are associated with increased risk of metabolic syndrome (MetS). However, the role of other important food sources of fructose-containing sugars in the development of MetS remains unclear. Objective: To examine the association of major food sources of fructose-containing sugars with incident MetS. Data Sources: MEDLINE, Embase, and Cochrane Library were searched from database inception to March 24, 2020, in addition to manual searches of reference lists from included studies using the following search terms: sugar-sweetened beverages, fruit drink, yogurt, metabolic syndrome, and prospective study. Study Selection: Inclusion criteria included prospective cohort studies of 1 year or longer that investigated the association of important food sources of fructose-containing sugars with incident MetS in participants free of MetS at the start of the study. Data Extraction and Synthesis: Study quality was assessed using the Newcastle-Ottawa Scale. Extreme quantile risk estimates for each food source with MetS incidence were pooled using a random-effects meta-analysis. Interstudy heterogeneity was assessed (Cochran Q statistic) and quantified (I2 statistic). Dose-response analyses were performed using a 1-stage linear mixed-effects model. The certainty of the evidence was assessed using GRADE (Grading of Recommendations, Assessment, Development, and Evaluation). Results were reported according to the Meta-analysis of Observational Studies in Epidemiology (MOOSE) and Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines. Main Outcomes and Measures: Pooled risk ratio (RR) of incident MetS (pairwise and dose response). Results: Thirteen prospective cohort studies (49 591 participants [median age, 51 years; range, 6-90 years]; 14 205 with MetS) that assessed 8 fructose-containing foods and MetS were included. An adverse linear dose-response association for SSBs (RR for 355 mL/d, 1.14; 95% CI, 1.05-1.23) and an L-shaped protective dose-response association for yogurt (RR for 85 g/d, 0.66; 95% CI, 0.58-0.76) and fruit (RR for 80 g/d, 0.82; 95% CI, 0.78-0.86) was found. Fruit juices (mixed and 100%) had a U-shaped dose-response association with protection at moderate doses (mixed fruit juice: RR for 125 mL/d, 0.58; 95% CI, 0.42-0.79; 100% fruit juice: RR for 125 mL/d, 0.77; 95% CI, 0.61-0.97). Honey, ice cream, and confectionary had no association with MetS incidence. The certainty of the evidence was moderate for SSBs, yogurt, fruit, mixed fruit juice, and 100% fruit juice and very low for all other food sources. Conclusions and Relevance: The findings of this meta-analysis suggest that the adverse association of SSBs with MetS does not extend to other food sources of fructose-containing sugars, with a protective association for yogurt and fruit throughout the dose range and for 100% fruit juice and mixed fruit juices at moderate doses. Therefore, current policies and guidelines on the need to limit sources of free sugars may need to be reexamined.
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Effect of nutritive and non-nutritive sweeteners on hemodynamic responses to acute stress: a randomized crossover trial in healthy women.
Cros, J, Bidlingmeyer, L, Rosset, R, Seyssel, K, Crézé, C, Stefanoni, N, Schneiter, P, Tappy, L
Nutrition & diabetes. 2020;10(1):1
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Stress may play a role in the development of non-communicable diseases such as insulin resistance and heart disease, possibly due to changed metabolism and hormone related eating behaviours. Consumption of sweet foods has been shown to decrease levels of stress hormones, but the effect of sweeteners remains controversial. This randomised control trial of 12 healthy women aimed to determine the effect of sweeteners and sugar on physiological measures related to stress. The results showed that following induced stress, there were no differences to blood pressure, heart rate, and amount of blood pumped by the heart. when consuming sugary or artificially sweetened beverages. It was concluded that the consumption of sugar and sweeteners does not affect physiological stress measures during a period of stress. However, this study does not rule out the possibility that sweeteners and sugar may contribute to non-communicable diseases in other ways. This study can be used by health care professionals to understand that certain aspects of physiological stress remain unaffected by the consumption of sugar and sweeteners.
Abstract
BACKGROUND The mechanisms by which chronic stress increases the risk of non-communicable diseases remain poorly understood. On one hand, chronic stress may increase systemic vascular resistance (SVR) and blood pressure, which may lead to blood vessels injury and altered myocardial perfusion. On the other hand, chronic stress may promote the overconsumption of sugar-containing foods and favor obesity. There is indeed evidence that sweet foods are preferentially consumed to alleviate stress responses. The effects of nutritive and non-nutritive sweeteners (NNS) on hemodynamic stress responses remain however largely unknown. OBJECTIVE/DESIGN This study aimed at comparing the effects of sucrose-containing and NNS-containing drinks, as compared to unsweetened water, on hemodynamic responses to acute stress in twelve healthy female subjects. Acute stress responses were elicited by a 30-min mental stress (5-min Stroop's test alternated with 5-min mental arithmetic) and a 3-min cold pressure test (CPT), each preceded by a resting baseline period. Hemodynamic stress responses were investigated by the repeated measurement of mean arterial pressure and the continuous monitoring of cardiac output by thoracic electrical bioimpedance measurement. SVR was selected as a primary outcome because it is a sensitive measure of hemodynamic responses to acute stress procedures. RESULTS With all three drinks, SVR were not changed with mental stress (P = 0.437), but were increased with CPT (P = 0.045). Both mental stress and CPT increased mean arterial pressure and heart rate (all P < 0.001). Cardiac output increased with mental stress (P < 0.001) and remained unchanged with CPT (P = 0.252). No significant differences in hemodynamic responses were observed between water, sucrose and NNS (stress × condition, all P > 0.05). CONCLUSIONS These results demonstrate that sucrose and NNS do not alter hemodynamic responses to two different standardized acute stress protocols.
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Relation of Total Sugars, Sucrose, Fructose, and Added Sugars With the Risk of Cardiovascular Disease: A Systematic Review and Dose-Response Meta-analysis of Prospective Cohort Studies.
Khan, TA, Tayyiba, M, Agarwal, A, Mejia, SB, de Souza, RJ, Wolever, TMS, Leiter, LA, Kendall, CWC, Jenkins, DJA, Sievenpiper, JL
Mayo Clinic proceedings. 2019;94(12):2399-2414
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Sugar-sweetened beverages have been associated with a risk for poor health outcomes, however risk for poor health outcomes with the fructose sugar they contain remains unclear. This systematic review and meta-analysis of 24 prospective cohort studies aimed to determine the role of total added fructose in the development of heart disease. Total sugars, sucrose and fructose were not associated with the incidence of heart disease, however total sugars and fructose increased the risk of death due to heart disease, the extent of which was dependent upon the amount consumed. Interestingly sucrose had a protective effect against death due to heart disease. It was concluded that consumption of fructose, total sugars and added sugars is associated with death due to heart disease, whereas sucrose is not. Although not all food stuffs containing fructose and added sugars were analysed, it is still indicative that healthcare professionals could recommend a low sugar and fructose diet to lower the risk of death due to heart disease.
Abstract
OBJECTIVE To determine the association of total and added fructose-containing sugars on cardiovascular (CVD) incidence and mortality. METHODS MEDLINE, EMBASE and Cochrane Library were searched from January 1, 1980, to July 31, 2018. Prospective cohort studies assessing the association of reported intakes of total, sucrose, fructose and added sugars with CVD incidence and mortality in individuals free from disease at baseline were included. Risk estimates were pooled using the inverse variance method, and dose-response analysis was modeled. RESULTS Eligibility criteria were met by 24 prospective cohort comparisons (624,128 unique individuals; 11,856 CVD incidence cases and 12,224 CVD mortality cases). Total sugars, sucrose, and fructose were not associated with CVD incidence. Total sugars (risk ratio, 1.09 [95% confidence interval, 1.02 to 1.17]) and fructose (1.08 [1.01 to 1.15]) showed a harmful association for CVD mortality, there was no association for added sugars and a beneficial association for sucrose (0.94 [0.89 to 0.99]). Dose-response analyses showed a beneficial linear dose-response gradient for sucrose and nonlinear dose-response thresholds for harm for total sugars (133 grams, 26% energy), fructose (58 grams, 11% energy) and added sugars (65 grams, 13% energy) in relation to CVD mortality (P<.05). The certainty of the evidence using GRADE was very low for CVD incidence and low for CVD mortality for all sugar types. CONCLUSION Current evidence supports a threshold of harm for intakes of total sugars, added sugars, and fructose at higher exposures and lack of harm for sucrose independent of food form for CVD mortality. Further research of different food sources of sugars is needed to define better the relationship between sugars and CVD. REGISTRATION clinicaltrials.gov, NCT01608620.
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Sugar-Sweetened Beverage Consumption in Relation to Obesity and Metabolic Syndrome among Korean Adults: A Cross-Sectional Study from the 2012⁻2016 Korean National Health and Nutrition Examination Survey (KNHANES).
Shin, S, Kim, SA, Ha, J, Lim, K
Nutrients. 2018;10(10)
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Obesity and Metabolic Syndrome (MetS) in Korea has increased significantly in the last decade and dietary factors, including the consumption of sugar sweetened drinks, is considered one of the key drivers. Soft drinks, soda coffee, fruit juices, sports drinks and sweetened rice drinks are popular beverages in Asia. Consumption of these is a major source of sugar intake for the Korean population. This study analysed data from over 12,112 participants of the Korean National Health and Nutrition Examination Survey (KNHANES) to see if the consumption of sugar sweetened beverages was causally linked to obesity and MetS. Food questionnaires were used in the original study to assess which foods and drinks the participants consumed during a 1-year period. Within the study group the number of participants with obesity was 34.9% and MetS was 26.7% respectively. They found that the participants who regularly consumed >4 sugar sweetened beverages per week consumed more calories on average than those who did not drink these beverages. In men, it was linked to higher blood pressure and blood glucose levels whilst in women it linked to a higher body mass index (BMI), increased waist circumference, and elevated cholesterol. Overall drinking 1 sugar sweetened beverage per day increased the risks of obesity in women by 59% and MetS by 61% whilst in men it increased the prevalence of obesity by 41% and MetS by 7%. Therefore drinking sugar sweetened beverages increases the risk of both obesity and MetS.
Abstract
It is well known that the consumption of sugar-sweetened beverages (SSBs) increases the risk of developing obesity and metabolic syndrome (MetS). However, there are not many studies investigating the link between SSBs and increased incidences of diseases in the Asian population, and in particular, in Korea. We explored the association of SSB consumption with the risk of developing obesity and MetS among Korean adults (12,112 participants from the 2012⁻2016 Korean National Health and Nutrition Examination Survey). We calculated the total SSB consumption frequency by counting each beverage item, including soda beverages, fruit juices, and sweetened rice drinks. Obesity was defined as a body mass index ≥25 kg/m², and MetS was defined using the National Cholesterol Education Program, Adult Treatment Panel III. A survey logistic regression analyses was conducted to examine the association of SSB consumption with obesity and MetS, adjusting for related confounders such as age, energy intake, household income, education, alcohol drinking, smoking status, and physical activity. The SSB consumption was positively associated with an increased risk of the prevalence for obesity (Odd ratio (OR): 1.60; 95% confidence interval (CI): 1.23⁻2.09; p for trend = 0.0009) and MetS (OR: 1.61; 95% CI: 1.20⁻2.16; p for trend = 0.0003) among women. In men, SSB consumption only contributed to a higher prevalence of obesity (OR: 1.38; 95% CI: 1.11⁻1.72; p for trend = 0.0041). In conclusion, increased consumption of SSBs was closely linked with a higher prevalence of obesity and MetS in the Korean population.