Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA.
Nutrients. 2024 May 21;16(11):1549. doi: 10.3390/nu16111549.
Understanding the relationship between the intake of sugars and diet quality can inform public health recommendations. This systematic review synthesized recent literature on associations between sugar intake and diet quality in generally healthy populations aged 2 years or older. We searched databases from 2010 to 2022 for studies of any design examining associations between quantified sugar intake in the daily diet and dietary indexes (DIs) or micronutrient intakes. Different sugar types and diet quality measures were analyzed separately. We converted DI results to Pearson's correlations and grouped indexes with or without a free or added sugar component to facilitate cross-study comparisons. Meta-analysis was deemed inappropriate. From 13,869 screened records, we included 27 cross-sectional studies. NUQUEST risk of bias ratings were neutral ( = 18 studies) or poor ( = 9), and strength of evidence by the GRADE approach was very low due to study design. Most studies reported negative associations for added and free sugars with diet quality indexes ( ranging from -0.13 to -0.42) and nutrients of public health concern (fiber, vitamin D, calcium, potassium), while associations with total sugars were mixed. Due to cross-sectional study designs, the clinical relevance of these findings is unclear. Prospective studies are needed to minimize confounding and inform causal relationships.
了解糖摄入量与饮食质量之间的关系可以为公共卫生建议提供信息。本系统评价综合了近期关于一般健康人群（2 岁及以上）中糖摄入量与饮食质量之间关联的文献。我们从 2010 年到 2022 年在数据库中检索了任何设计的研究，这些研究都检查了日常饮食中定量糖摄入量与饮食指数（DI）或微量营养素摄入量之间的关联。分别分析了不同类型的糖和不同的饮食质量测量方法。我们将 DI 结果转换为皮尔逊相关系数，并将含有或不含有游离糖或添加糖成分的指数进行分组，以方便跨研究比较。由于研究设计的原因，我们认为荟萃分析不适用。从 13869 篇筛选记录中，我们纳入了 27 项横断面研究。NUQUEST 偏倚风险评分为中性（=18 项研究）或较差（=9 项研究），并且由于研究设计，GRADE 方法的证据强度非常低。大多数研究报告了添加糖和游离糖与饮食质量指数（范围为-0.13 至-0.42）和公共卫生关注的营养素（纤维、维生素 D、钙、钾）之间的负相关，而与总糖的关联则较为复杂。由于横断面研究设计，这些发现的临床相关性尚不清楚。需要前瞻性研究来最小化混杂因素并阐明因果关系。
