Pase Matthew P, Himali Jayandra J, Beiser Alexa S, Aparicio Hugo J, Satizabal Claudia L, Vasan Ramachandran S, Seshadri Sudha, Jacques Paul F
From the Department of Neurology (M.P.P., J.J.H., A.S.B., H.J.A., C.L.S., S.S.) and Sections of Preventive Medicine and Epidemiology, Department of Medicine (R.S.V), Boston University School of Medicine, MA; Framingham Heart Study, MA (M.P.P., J.J.H., A.S.B., H.J.A., C.L.S., R.S.V., S.S., P.F.J.); Centre for Human Psychopharmacology, Swinburne University of Technology, Australia (M.P.P.); Department of Biostatistics (J.J.H., A.S.B.) and Department of Epidemiology (R.S.V.), Boston University School of Public Health, MA; and Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA (P.F.J.).
Stroke. 2017 May;48(5):1139-1146. doi: 10.1161/STROKEAHA.116.016027.
Sugar- and artificially-sweetened beverage intake have been linked to cardiometabolic risk factors, which increase the risk of cerebrovascular disease and dementia. We examined whether sugar- or artificially sweetened beverage consumption was associated with the prospective risks of incident stroke or dementia in the community-based Framingham Heart Study Offspring cohort.
We studied 2888 participants aged >45 years for incident stroke (mean age 62 [SD, 9] years; 45% men) and 1484 participants aged >60 years for incident dementia (mean age 69 [SD, 6] years; 46% men). Beverage intake was quantified using a food-frequency questionnaire at cohort examinations 5 (1991-1995), 6 (1995-1998), and 7 (1998-2001). We quantified recent consumption at examination 7 and cumulative consumption by averaging across examinations. Surveillance for incident events commenced at examination 7 and continued for 10 years. We observed 97 cases of incident stroke (82 ischemic) and 81 cases of incident dementia (63 consistent with Alzheimer's disease).
After adjustments for age, sex, education (for analysis of dementia), caloric intake, diet quality, physical activity, and smoking, higher recent and higher cumulative intake of artificially sweetened soft drinks were associated with an increased risk of ischemic stroke, all-cause dementia, and Alzheimer's disease dementia. When comparing daily cumulative intake to 0 per week (reference), the hazard ratios were 2.96 (95% confidence interval, 1.26-6.97) for ischemic stroke and 2.89 (95% confidence interval, 1.18-7.07) for Alzheimer's disease. Sugar-sweetened beverages were not associated with stroke or dementia.
Artificially sweetened soft drink consumption was associated with a higher risk of stroke and dementia.
含糖及人工甜味饮料的摄入与心血管代谢危险因素相关，而这些因素会增加脑血管疾病和痴呆的风险。在基于社区的弗雷明汉心脏研究后代队列中，我们研究了饮用含糖或人工甜味饮料是否与发生中风或痴呆的前瞻性风险相关。
我们对2888名年龄大于45岁的参与者进行了中风发病情况研究（平均年龄62岁[标准差9岁]；男性占45%），对1484名年龄大于60岁的参与者进行了痴呆发病情况研究（平均年龄69岁[标准差6岁]；男性占46%）。在队列检查第5次（1991 - 1995年）、第6次（1995 - 1998年）和第7次（1998 - 2001年）时，使用食物频率问卷对饮料摄入量进行量化。我们在检查第7次时量化近期摄入量，并通过对各次检查结果求平均值来量化累积摄入量。对发病事件的监测从检查第7次开始，持续10年。我们观察到97例中风发病病例（82例为缺血性中风）和81例痴呆发病病例（63例符合阿尔茨海默病）。
在对年龄、性别、教育程度（用于痴呆分析）、热量摄入、饮食质量、身体活动和吸烟进行调整后，人工甜味软饮料近期和累积摄入量较高与缺血性中风、全因痴呆和阿尔茨海默病痴呆风险增加相关。将每日累积摄入量与每周0份（参照值）进行比较时，缺血性中风的风险比为2.96（95%置信区间，1.26 - 6.97），阿尔茨海默病的风险比为2.89（95%置信区间，1.18 - 7.07）。含糖饮料与中风或痴呆无关。
饮用人工甜味软饮料与中风和痴呆风险较高相关。
