固体和液体来源的游离糖与心血管疾病的关系：一项回顾性队列分析。
Associations of free sugars from solid and liquid sources with cardiovascular disease: a retrospective cohort analysis.
机构信息
Department of Medicine, McGill University, Montreal, QC, Canada.
Centre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre (RI-MUHC), 5252 Boul de Maisonneuve Ouest, Office 3E.09, Montreal, QC, H4A 3S5, Canada.
出版信息
BMC Public Health. 2023 Apr 24;23(1):756. doi: 10.1186/s12889-023-15600-3.
BACKGROUND
The World Health Organization recommends a 10% total energy (TE%) limit for free sugars (i.e., added sugars and naturally occurring sugars in fruit juice, honey, and syrups) based on evidence linking higher intakes with overweight and dental caries. Evidence for cardiovascular disease (CVD) is limited. Impacts may differ by sex, age group, and solid vs. liquid sources; liquids may stimulate more adverse CVD profiles (due to their rapid absorption in the body along along with triggering less satiety). We examined associations of consuming total free sugars ≥ 10 TE% with CVD within four sex and age-defined groups. Given roughly equal free sugar intakes from solid and liquid sources, we also evaluated source-specific associations of free sugars ≥ 5 TE% thresholds.
METHODS
In this retrospective cohort study, we estimated free sugars from 24-h dietary recall (Canadian Community Health Survey, 2004-2005) in relationship to nonfatal and fatal CVD (Discharge Abstract and Canadian Mortality Databases, 2004-2017; International Disease Classification-10 codes for ischemic heart disease and stroke) through multivariable Cox proportional hazards models adjusted for overweight/obesity, health behaviours, dietary factors, and food insecurity. We conducted analyses in separate models for men 55 to 75 years, women 55 to 75 years, men 35 to 55 years, and women 35 to 55 years. We dichotomized total free sugars at 10 TE% and source-specific free sugars at 5 TE%.
RESULTS
Men 55 to 75 years of age had 34% higher CVD hazards with intakes of free sugars from solid sources ≥ 5 TE% vs. below (adjusted HR 1.34, 95% CI 1.05- 1.70). The other three age and sex-specific groups did not demonstrate conclusive associations with CVD.
CONCLUSIONS
Our findings suggest that from a CVD prevention standpoint in men 55 to 75 years of age, there may be benefits from consuming less than 5 TE% as free sugars from solid sources.
背景
世界卫生组织（WHO）建议将游离糖（即添加糖和果汁、蜂蜜和糖浆中天然存在的糖）的总能量（TE%）限制在 10%，这一建议基于高摄入量与超重和龋齿有关的证据。关于心血管疾病（CVD）的证据有限。影响可能因性别、年龄组以及固体和液体来源而异；液体可能会对 CVD 产生更不利的影响（因为它们在体内被迅速吸收，同时触发的饱腹感较少）。我们研究了四个按性别和年龄定义的组中摄入游离糖总量≥10 TE%与 CVD 之间的关联。鉴于固体和液体来源的游离糖摄入量大致相等，我们还评估了游离糖≥5 TE%阈值的特定来源关联。
方法
在这项回顾性队列研究中，我们根据 24 小时膳食回顾（加拿大社区健康调查，2004-2005 年）来估计游离糖，以评估非致命性和致命性 CVD（出院摘要和加拿大死亡率数据库，2004-2017 年；国际疾病分类-10 代码用于缺血性心脏病和中风），通过多变量 Cox 比例风险模型进行调整，以适应超重/肥胖、健康行为、饮食因素和粮食不安全状况。我们分别在 55 至 75 岁男性、55 至 75 岁女性、35 至 55 岁男性和 35 至 55 岁女性的单独模型中进行了分析。我们将总游离糖分为 10 TE%，将特定来源的游离糖分为 5 TE%。
结果
55 至 75 岁的男性摄入固体来源的游离糖≥5 TE%与低于 5 TE%相比，CVD 风险增加 34%（调整后的 HR 1.34，95%CI 1.05-1.70）。其他三个年龄和性别特定组与 CVD 之间没有明确的关联。
结论
我们的研究结果表明，从预防 CVD 的角度来看，55 至 75 岁的男性从固体来源摄入游离糖少于 5 TE%可能会带来益处。
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