Department of Internal Medicine and Endocrinology, Aarhus University Hospital, Aarhus, Denmark.
Curr Opin Clin Nutr Metab Care. 2013 Jul;16(4):478-84. doi: 10.1097/MCO.0b013e328361c53e.
Sucrose-sweetened beverages (SSB) have for decades been implicated in cardiometabolic diseases. The purpose of this review is to summarize recent epidemiological but particularly recent human intervention studies on the metabolic effects associated/induced by SSB.
Recent epidemiological studies support the positive association between SSB intake and enhanced risk for metabolic syndrome, type 2 diabetes, coronary heart diseases, and stroke. From the human intervention studies rather similar results are obtained with enhanced accumulation of fat in the liver, muscle, and in the visceral fat depot induced by SSB. Moreover, SSB induces enhanced levels of circulating triglycerides and enhanced de-novo lipogenesis in the liver. The specific effect of SSB on body weigh/obesity is still not completely elucidated but SSB enhances body weight/fat mass even though not to a significant degree in all studies. Concerning the mechanisms for SSB to induce these metabolic aberrations most of the studies are in agreement with the fact that it is mainly fructose (free or as part of the sucrose molecule) that is the main driver of these metabolic aberrations presumably primarily by inducing lipid synthesis in and release from the liver.
There are now convincing evidences for enhanced cardiometabolic risk after higher intake of SSB where both epidemiological studies and human intervention studies are pointing in the same direction. A so-called 'well tolerated' intake of SSB is not determined. Accordingly, intake of SSB should generally be reduced as much as possible to improve the health of the population.
几十年来,蔗糖甜味饮料(SSB)一直与代谢性心血管疾病有关。本综述的目的是总结 SSB 与代谢相关的最新流行病学研究,但特别是最近的人体干预研究。
最近的流行病学研究支持 SSB 摄入与代谢综合征、2 型糖尿病、冠心病和中风风险增加之间的正相关关系。从人体干预研究中,也得到了类似的结果,即 SSB 会导致肝脏、肌肉和内脏脂肪堆积的脂肪堆积增加。此外,SSB 会导致循环甘油三酯水平升高,并增强肝脏中的从头脂肪生成。SSB 对体重/肥胖的具体影响仍不完全清楚,但 SSB 会增加体重/脂肪量,尽管并非所有研究都显著增加。关于 SSB 引起这些代谢异常的机制,大多数研究都一致认为,主要是果糖(游离或作为蔗糖分子的一部分)是引起这些代谢异常的主要驱动因素,可能主要通过诱导肝脏内的脂质合成和释放。
现在有令人信服的证据表明,大量摄入 SSB 会增加心血管代谢风险,这一点在流行病学研究和人体干预研究中都是一致的。目前还没有确定所谓的“可耐受”SSB 摄入量。因此,应尽可能减少 SSB 的摄入,以改善人群健康。