College of Health Sciences, VinUniveristy, Vinhomes Ocean Park, Gia Lam District, Hanoi, Viet Nam.
Nutrition Department, Dong A University, 33 Xo Viet Nghe Tinh Hoa Cuong Nam Ward, Hai Chau District, Danang, Viet Nam.
Clin Nutr ESPEN. 2023 Oct;57:655-664. doi: 10.1016/j.clnesp.2023.08.001. Epub 2023 Aug 12.
BACKGROUND & AIMS: Sugar-sweetened beverages (SSBs) are potential modifiable risk factors for reducing the risk of metabolic syndrome (MetS); however, there is a lack of an umbrella review that robustly synthesizes the evidence. This review aims to synthesize the evidence linking habitual SSBs intake with MetS in adults, emphasizing the need for policy and regulatory actions.
Four databases were comprehensively searched for relevant meta-analyses of prospective studies up to July 2023. Two authors independently conducted the screening for eligibility, data extraction, and quality assessment. The outcome of interest was MetS in adults, encompassing its component conditions. The present review was registered with PROSPERO (CRD42023402549).
Of the 16 eligible meta-analyses identified, 30 summary estimates were obtained for the impact of SSBs consumption on obesity, type 2 diabetes, hypertension, and MetS. Seven were rated as 'High' methodological quality, with the rest classified as 'Moderate' and 'Low' quality, consisting of three and six references, respectively. A comparison of the highest and lowest levels of SSBs consumption revealed an increased risk of 18% (95% CI: 13%-24%), 12% (95% CI: 11%-14%), 29% (95% CI: 25%-32%), and 29% (95% CI: 7%-52%) for obesity, hypertension, type 2 diabetes, and MetS, respectively. Consistently, the findings from dose-response analyses are in agreement with and corroborate the existing evidence that SSBs are a significant risk factor for the development of MetS and its related conditions. Noticeably, the quality of evidence was predominantly deemed as highly suggestive and convincing. Moreover, consensus on specific criteria to identify studies related to SSBs in literature searching was lacking, and most primary studies were conducted in developed countries and Europe.
Our findings suggest that more rigorous and targeted policy interventions are warranted to curtail SSBs consumption, in order to alleviate the global burden of MetS.
含糖饮料（SSB）是降低代谢综合征（MetS）风险的潜在可改变的危险因素；然而，目前缺乏一项强有力的综合证据的伞式综述。本综述旨在综合含糖饮料摄入与成年人代谢综合征相关的证据，强调需要采取政策和监管措施。
全面检索了截至 2023 年 7 月的前瞻性研究相关的 Meta 分析的四个数据库。两位作者独立进行了入选标准筛查、数据提取和质量评估。感兴趣的结果是成年人的代谢综合征，包括其组成条件。本综述已在 PROSPERO（CRD42023402549）上注册。
在确定的 16 项符合条件的 Meta 分析中，获得了 30 项关于 SSB 消费对肥胖、2 型糖尿病、高血压和代谢综合征影响的综合估计值。其中 7 项被评为“高”方法学质量，其余被评为“中”和“低”质量，分别由 3 项和 6 项参考文献组成。最高和最低 SSB 消费水平的比较显示，肥胖、高血压、2 型糖尿病和代谢综合征的风险分别增加了 18%（95%CI：13%-24%）、12%（95%CI：11%-14%）、29%（95%CI：25%-32%）和 29%（95%CI：7%-52%）。同样，剂量反应分析的结果与现有的证据一致，并证实 SSB 是代谢综合征及其相关疾病发展的一个重要危险因素。值得注意的是，证据质量主要被认为是高度提示性和令人信服的。此外，在文献检索中确定与 SSB 相关的研究的具体标准缺乏共识，并且大多数初级研究都是在发达国家和欧洲进行的。
我们的研究结果表明，需要采取更严格和有针对性的政策干预措施来限制 SSB 的消费，以减轻全球代谢综合征的负担。
