Division of Epidemiology and Community Health, University of Minnesota School of Public Health, 300 West Bank Office Building 1300 S. 2nd St., Minneapolis, MN, USA.
Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Eur J Prev Cardiol. 2024 Jun 3;31(8):986-996. doi: 10.1093/eurjpc/zwad409.
Numerous studies report positive associations between total carbohydrate (CHO) intake and incident metabolic syndrome (MetS), but few differentiate quality or type of CHO relative to MetS. We examined source of CHO intake, including added sugar (AS), AS-rich CHO foods, and sugar-sweetened beverages (SSBs) associated with incident MetS in adults enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study.
Among 3154 Black American and White American women and men aged 18-30 years at baseline, dietary intake was assessed by diet history three times over 20 years. Sources of AS-rich CHO foods and beverages include sugar-rich refined grain products, candy, sugar products, and SSBs. Incident MetS was created according to standard criteria. Time-dependent Cox proportional hazards regression analysis evaluated the associations of incident MetS across quintiles of cumulative intakes of AS-rich CHO foods and beverages, AS, and SSBs adjusted for potential confounding factors over 30 years of follow-up. The associations of AS-rich CHO foods and beverages, AS, and SSB intakes with incident MetS were consistent. Compared with the lowest intake, the greatest intakes of AS-rich CHOs, AS, and SSBs were associated with 59% (Ptrend < 0.001), 44% (Ptrend = 0.01), and 34% (Ptrend = 0.03) higher risk of developing MetS, respectively. As expected, diet quality was lower across increasing quintiles of AS-rich CHO foods and beverages, AS, and SSBs (all Ptrend < 0.001).
Our study findings are consistent with an elevated risk of developing MetS with greater consumption of AS, AS-rich CHO foods, and SSBs, which support consuming fewer AS-rich CHO foods and SSBs.
许多研究报告称，总碳水化合物（CHO）的摄入量与代谢综合征（MetS）的发生呈正相关，但很少有研究区分 CHO 的质量或类型与 MetS 的关系。我们研究了 CHO 摄入量的来源，包括添加糖（AS）、富含 AS 的 CHO 食物和含糖饮料（SSB）与参与冠状动脉风险发展（CARDIA）研究的成年人发生 MetS 的关系。
在基线时年龄为 18-30 岁的 3154 名美国黑人和白人女性和男性中，通过 20 年三次的饮食史评估膳食摄入量。富含 AS 的 CHO 食物和饮料的来源包括含糖的精制谷物产品、糖果、糖制品和 SSB。根据标准标准创建了新的 MetS。时间依赖性 Cox 比例风险回归分析评估了在 30 年的随访中，随着富含 AS 的 CHO 食物和饮料、AS 和 SSB 摄入量累积五分位数的增加，与新发生的 MetS 之间的关联。富含 AS 的 CHO 食物和饮料、AS 和 SSB 摄入与新发生的 MetS 之间的关联是一致的。与最低摄入量相比，富含 AS 的 CHO、AS 和 SSB 的最大摄入量与 MetS 的发生风险分别增加了 59%（Ptrend <0.001）、44%（Ptrend=0.01）和 34%（Ptrend=0.03）。正如预期的那样，随着富含 AS 的 CHO 食物和饮料、AS 和 SSB 摄入量的增加，饮食质量逐渐降低（所有 Ptrend<0.001）。
我们的研究结果与摄入更多 AS、富含 AS 的 CHO 和 SSB 会增加发生 MetS 的风险一致，这支持减少摄入富含 AS 的 CHO 和 SSB。
