Janzi Suzanne, González-Padilla Esther, Ramne Stina, Bergwall Sara, Borné Yan, Sonestedt Emily
Nutritional Epidemiology, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.
Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Front Public Health. 2024 Dec 9;12:1452085. doi: 10.3389/fpubh.2024.1452085. eCollection 2024.
The adverse health effects of sugar-sweetened beverage intake are well-established, but the implications of overall added sugar intake remain unclear. We investigated the associations between intake of added sugar and various sugar-sweetened foods and beverages and risk of 7 cardiovascular diseases in 69,705 participants aged 45-83 years (47.2% female) from the Swedish Mammography cohort and Cohort of Swedish men.
Questionnaire-based diet and lifestyle assessments were administered in 1997 and 2009. National registers were used for ascertainment of ischemic stroke ( = 6,912), hemorrhagic stroke ( = 1,664), myocardial infarction ( = 6,635), heart failure ( = 10,090), aortic stenosis ( = 1,872), atrial fibrillation ( = 13,167), and abdominal aortic aneurysm ( = 1,575) until December 31st, 2019. The associations were studied using Cox regression with time-updated exposure and covariate data.
Added sugar intake was positively associated with ischemic stroke and abdominal aortic aneurysm, although the highest risks of most outcomes were found in the lowest intake category. Positive linear associations were found between toppings intake and abdominal aortic aneurysm, and between sweetened beverage intake and ischemic stroke, heart failure, atrial fibrillation, and abdominal aortic aneurysm. Negative linear associations were found between treats intake (pastries, ice cream, chocolate, and sweets) and all outcomes, and between toppings intake (table sugar, honey, jams, and marmalades) and heart failure and aortic stenosis.
The findings suggest that the associations between added sugar intake and cardiovascular diseases vary by disease and source of added sugar. The findings emphasize the adverse health effects of sweetened beverage consumption and indicate higher cardiovascular diseases risks with lower treats intake, which warrants further investigation.
摄入含糖饮料对健康的不良影响已得到充分证实，但总体添加糖摄入量的影响仍不明确。我们在来自瑞典乳腺X线摄影队列和瑞典男性队列的69705名45 - 83岁参与者（47.2%为女性）中，研究了添加糖及各种含糖食品和饮料的摄入量与7种心血管疾病风险之间的关联。
1997年和2009年进行了基于问卷的饮食和生活方式评估。利用国家登记册确定截至2019年12月31日的缺血性中风（n = 6912）、出血性中风（n = 1664）、心肌梗死（n = 6635）、心力衰竭（n = 10090）、主动脉瓣狭窄（n = 1872）、心房颤动（n = 13167）和腹主动脉瘤（n = 1575）情况。使用Cox回归分析，结合随时间更新的暴露因素和协变量数据来研究这些关联。
添加糖摄入量与缺血性中风和腹主动脉瘤呈正相关，尽管大多数结局的最高风险出现在摄入量最低的类别中。发现浇头摄入量与腹主动脉瘤之间、含糖饮料摄入量与缺血性中风、心力衰竭、心房颤动和腹主动脉瘤之间存在正线性关联。发现零食摄入量（糕点、冰淇淋、巧克力和糖果）与所有结局之间、浇头摄入量（食糖、蜂蜜、果酱和橘子酱）与心力衰竭和主动脉瓣狭窄之间存在负线性关联。
研究结果表明，添加糖摄入量与心血管疾病之间的关联因疾病和添加糖来源而异。这些发现强调了饮用含糖饮料对健康的不良影响，并表明零食摄入量较低时心血管疾病风险较高，这值得进一步研究。
