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软饮料和 100%纯果汁摄入与全因死亡率、心血管疾病死亡率和癌症死亡率的关系:一项基于前瞻性队列研究的系统评价和剂量反应荟萃分析。

Association of soft drink and 100% fruit juice consumption with all-cause mortality, cardiovascular diseases mortality, and cancer mortality: A systematic review and dose-response meta-analysis of prospective cohort studies.

机构信息

Gansu Provincial Hospital, Lanzhou, China.

Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China.

出版信息

Crit Rev Food Sci Nutr. 2022;62(32):8908-8919. doi: 10.1080/10408398.2021.1937040. Epub 2021 Jun 13.

Abstract

Sugar-sweetened beverages (SSBs), artificially sweetened beverages (ASBs), and 100% fruit juices are frequently consumed and have been documented that they could lead to serious disease burden. However, inconsistent evidence on the association between SSBs, ASBs, and 100% fruit juices consumption and mortality have been presented. PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, and PsycINFO were systematically searched. We conducted a random-effects meta-analysis and dose-response meta-analysis to assess the association and calculated the pooled hazard ratio with 95% confidence interval. And we evaluated the certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Thirteen studies with 1,539,127 participants proved eligible. An SSB-consumption increase per 250 mL/day was associated with a 4% greater risk of all-cause mortality (5 more per 1000 persons; low certainty) and 8% greater risk of cardiovascular disease mortality (3 more per 1000 persons; low certainty). ASB-consumption increase per 250 mL/day demonstrated a 4% greater risk of all-cause mortality (5 more per 1000 persons; low certainty) and 4% greater risk of cardiovascular disease mortality (2 more per 1000 persons; low certainty). The association of SSBs and ASBs with cancer mortality was not significant, with a very low certainty of evidence. There was evidence of a linear dose-response association between SSB intake and cancer mortality, as well as between ASB intake and all-cause mortality and cancer mortality. We observed a non-linear dose-response association between ASB intake and CVD mortality and SSB intake and all-cause and CVD mortality. Low certainty of evidence demonstrated that per 250 mL/day consumption increase in SSBs and ASBs had a small impact on all-cause and cardiovascular disease mortality but not on cancer mortality. The association of 100% fruit juice consumption with all-cause and cardiovascular disease mortality was uncertain.

摘要

含糖饮料(SSB)、人工甜味饮料(ASB)和 100%纯果汁经常被饮用,已有文献证明它们可能导致严重的疾病负担。然而,关于 SSB、ASB 和 100%纯果汁摄入与死亡率之间的关联,证据并不一致。我们系统地检索了 PubMed、Embase、Web of Science、Cochrane 中央对照试验注册库和 PsycINFO。我们进行了随机效应荟萃分析和剂量反应荟萃分析,以评估相关性,并计算了汇总风险比及其 95%置信区间。我们使用推荐评估、制定和评估(GRADE)方法评估证据的确定性。有 13 项研究,涉及 1539127 名参与者,被证明符合条件。SSB 摄入量每天增加 250 毫升与全因死亡率增加 4%相关(每 1000 人增加 5 人;低确定性)和心血管疾病死亡率增加 8%相关(每 1000 人增加 3 人;低确定性)。ASB 摄入量每天增加 250 毫升与全因死亡率增加 4%相关(每 1000 人增加 5 人;低确定性)和心血管疾病死亡率增加 4%相关(每 1000 人增加 2 人;低确定性)。SSB 和 ASB 与癌症死亡率之间的关联不显著,证据确定性非常低。SSB 摄入量与癌症死亡率之间以及 ASB 摄入量与全因死亡率和癌症死亡率之间存在线性剂量反应关系的证据。我们观察到 ASB 摄入量与 CVD 死亡率和 SSB 摄入量与全因和 CVD 死亡率之间存在非线性剂量反应关系。低确定性的证据表明,SSB 和 ASB 摄入量每天增加 250 毫升对全因和心血管疾病死亡率有较小影响,但对癌症死亡率没有影响。100%纯果汁摄入与全因和心血管疾病死亡率的关联不确定。

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