Kazemi Asma, Soltani Sepideh, Mokhtari Zeinab, Khan Tauseef, Golzarand Mahdieh, Hosseini Elham, Jayedi Ahmad, Ebrahimpour-Koujan Soraiya, Akhlaghi Masoumeh
Nutrition Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Crit Rev Food Sci Nutr. 2023;63(20):4274-4287. doi: 10.1080/10408398.2021.2000361. Epub 2021 Nov 30.
We aimed to summarize the associations between food sources of fructose and cardiovascular diseases (CVD), cancer, and all-cause mortality risk using a systematic review and meta-analysis. We searched PubMed, Scopus, and Web of Science up to November 2020. We included cohort studies that investigated the relationship between mortality risk (all-cause, CVD, specific CVD, and total and site-specific cancers) and intake of ≥1 food source of fructose (fruit, fruit juice, breakfast cereals, sugar-sweetened beverages (SSBs), sweets, and yogurt) in general adult population. Summary hazard ratios and 95% CIs were estimated using a random-effects model for linear and nonlinear relationships. Findings indicated that each 100 g/d increase in fruit intake was associated with 8-13% lower risk of CVDs, stroke, gastrointestinal, and lung cancer mortality. For all-cause mortality, there was a beneficial relationship up to 200 g/d fruit, and then plateaued. For ischemic heart disease and cancer mortality, there was a beneficial relationship up to 300 g/d followed by a slight increase. Ingestion of breakfast cereals and sweets was also associated with lower risk of all-cause mortality. For yogurt, a non-linear marginal decrease in all-cause mortality was found. Ingestion of each 200 g/d yogurt was associated with a 14% lower risk of CVD mortality. Every 60 g/d increase in sweet intake was linked to a 5% lower risk of all-cause mortality. Contrariwise, every 250 g/d increase in SSBs intake was associated with 7-10% higher risk of all-cause and CVD mortality. In conclusion, beneficial associations were found between fruit, breakfast cereals, sweets, and yogurt with all-cause and/or CVD mortality risk. Fruit intake had also an inverse link with cancer mortality. Conversely, SSBs had a harmful relationship with all-cause and CVD mortality.Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2021.2000361 . CRD42019144956.
我们旨在通过系统评价和荟萃分析总结果糖的食物来源与心血管疾病（CVD）、癌症及全因死亡风险之间的关联。我们检索了截至2020年11月的PubMed、Scopus和科学网。我们纳入了队列研究，这些研究调查了一般成年人群中死亡风险（全因、CVD、特定CVD以及全部和特定部位癌症）与≥1种果糖食物来源（水果、果汁、早餐谷物、含糖饮料（SSB）、甜食和酸奶）摄入量之间的关系。使用随机效应模型对线性和非线性关系估计汇总风险比和95%可信区间。研究结果表明，水果摄入量每增加100 g/d，CVD、中风、胃肠道和肺癌死亡风险降低8 - 13%。对于全因死亡率，水果摄入量在200 g/d以内存在有益关系，之后趋于平稳。对于缺血性心脏病和癌症死亡率，水果摄入量在达到300 g/d之前存在有益关系，之后略有增加。摄入早餐谷物和甜食也与较低的全因死亡风险相关。对于酸奶，发现全因死亡率呈非线性边际下降。每天摄入200 g酸奶与CVD死亡风险降低14%相关。甜食摄入量每增加60 g/d与全因死亡风险降低5%相关。相反，SSB摄入量每增加250 g/d与全因和CVD死亡风险分别升高7 - 10%相关。总之，发现水果、早餐谷物、甜食和酸奶与全因和/或CVD死亡风险之间存在有益关联。水果摄入量与癌症死亡率也呈负相关。相反，SSB与全因和CVD死亡存在有害关系。本文的补充数据可在网上获取，网址为https://doi.org/10.1080/10408398.2021.2000361 。CRD42019144956。
