Chronic Consumption of Artificial Sweetener in Packets or Tablets and Type 2 Diabetes Risk: Evidence from the E3N-European Prospective Investigation into Cancer and Nutrition Study
Chronic Consumption of Artificial Sweetener in Packets or Tablets and Type 2 Diabetes Risk: Evidence from the E3N-European Prospective Investigation into Cancer and Nutrition Study
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DOI：
10.1159/000458769
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发表时间：
2017-01-01
影响因子：
3.9
通讯作者：
Boutron-Ruault, Marie-Christine
中科院分区：
文献类型：
--
作者：
Fagherazzi, Guy;Gusto, Gaelle;Boutron-Ruault, Marie-Christine
背景：人工甜味剂对代谢性疾病的影响存在争议。含糖饮料与2型糖尿病（T2 D）风险增加有关，但偏见和反向因果关系被怀疑影响了观察到的关联。此外，有人建议，有必要调查食用袋装或片剂人工甜味剂的频率和持续时间与T2 D风险之间的关系。研究方法：我们使用了1993年至2011年进行的前瞻性E3 N-欧洲癌症和营养前瞻性调查研究中61，440名女性的数据。我们估计了T2 D风险的风险比（HR）和95% CI，这些风险与使用袋装或片剂中的人工甜味剂的频率和持续时间相关。结果如下：与“从不或很少”使用人工甜味剂的消费者相比，“总是或几乎总是”使用人工甜味剂的人患T2 D的风险增加（多变量模型[MM]中HR = 1.83 [95%CI 1.66-2.02]，进一步调整体重指数（BMI）时HR = 1.33 [95%CI 1.20-1.47]）。与从未或很少使用者相比，使用人工甜味剂包或片剂超过10年的女性也有T2 D风险增加（MM中HR = 2.10 [95% CI 1.83-2.40]，调整BMI后HR = 1.15 [95% CI 1.00-1.33]）。结论：我们的数据表明，更高频率和更长时间的人工甜味剂包或片剂消费与T2 D风险相关，独立于主要的T2 D风险因素，但部分由肥胖介导。在推广这些仍被广泛推荐为健康糖替代品的产品时，应采取预防原则。(C)2017 S. Karger AG，巴塞尔
Background: The influence of artificial sweeteners on metabolic diseases is controversial. Artificially sweetened beverages have been associated with an increased risk of type 2 diabetes (T2D) but biases and reverse causation have been suspected to have influenced the observed association. In addition, it has been suggested that investigation into the relationship between the frequency and duration of the consumption of packet or tablet artificial sweeteners and T2D risk is necessary. Methods: We used data from 61,440 women in the prospective E3N-European Prospective Investigation into Cancer and Nutrition study, conducted between 1993 and 2011. We estimated hazards ratios (HRs) and 95% CIs of T2D risk associated with both the frequency and the duration of use of artificial sweeteners consumed in packets or tablets. Results: Compared to "never or rare" consumers of artificial sweeteners, those using them "always or almost always" had an increased risk of T2D (HR = 1.83 [95% CI 1.66-2.02] in the multivariate model [MM], HR = 1.33 [95% CI 1.20-1.47] when further adjusted for body mass index, BMI). Women consuming artificial sweeteners in packets or tablets for more than 10 years also had an increased risk of T2D compared to never or rare users ( HR = 2.10 [95% CI 1.83-2.40] in the MM and HR = 1.15 [95% CI 1.00-1.33] when adjusted for BMI, respectively). Conclusions: Our data suggest that both a higher frequency and a longer consumption of artificial sweeteners in packets or tablets was associated with T2D risk, independently of major T2D risk factors, but partially mediated by adiposity. A precautionary principle should be applied to the promotion of these products that are still largely recommended as healthy sugar substitutes. (C) 2017 S. Karger AG, Basel