Added Sugar, Sugar-Sweetened Beverages, and Artificially Sweetened Beverages and Risk of Cardiovascular Disease: Findings from the Women's Health Initiative and a Network Meta-Analysis of Prospective Studies.
Added Sugar, Sugar-Sweetened Beverages, and Artificially Sweetened Beverages and Risk of Cardiovascular Disease: Findings from the Women's Health Initiative and a Network Meta-Analysis of Prospective Studies.
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作者：
Yang B;Glenn AJ;Liu Q;Madsen T;Allison MA;Shikany JM;Manson JE;Chan KHK;Wu WC;Li J;Liu S;Lo K
Much remains unknown about the role of added sugar in relation to cardiovascular disease (CVD) and the relative contributions of sugar-sweetened beverages (SSB) or artificially sweetened beverages (ASB) to CVD risk. Among the 109,034 women who participated in Women’s Health Initiative, we assessed average intakes of added sugar, SSB and ASB, and conducted Cox regression to estimate the hazard ratios (HRs) and their 95% confidence intervals for CVD risk. The consistency of findings was compared to a network meta-analysis of all available cohorts. During an average of 17.4 years of follow-up, 11,597 cases of total CVD (nonfatal myocardial infarction, coronary heart disease (CHD) death, stroke, coronary revascularization, and/or incident heart failure) were confirmed. Added sugar as % energy intake daily (%EAS) at ≥15.0% was positively associated with total CVD (HR = 1.08 [1.01, 1.15]) and CHD (HR = 1.20 [1.09, 1.32]). There was also a higher risk of total CVD associated with ≥1 serving of SSB intake per day (HR = 1.29 [1.17, 1.42]), CHD (1.35 [1.16, 1.57]), and total stroke (1.30 [1.10, 1.53]). Similarly, ASB intake was associated with an increased risk of CVD (1.14 [1.03, 1.26]) and stroke (1.24 [1.04, 1.48]). According to the network meta-analysis, there was a large amount of heterogeneity across studies, showing no consistent pattern implicating added sugar, ASB, or SSB in CVD outcomes. A diet containing %EAS ≥15.0% and consuming ≥1 serving of SSB or ASB may be associated with a higher CVD incidence. The relative contribution of added sugar, SSB, and ASB to CVD risk warrants further investigation.
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DOI：
10.1136/bmj.h3576
发表时间：
2015-07-21
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Imamura F;O'Connor L;Ye Z;Mursu J;Hayashino Y;Bhupathiraju SN;Forouhi NG
通讯作者：
Forouhi NG
影响因子：
8.3
作者：
Demel SL;Kittner S;Ley SH;McDermott M;Rexrode KM
通讯作者：
Rexrode KM
影响因子：
5
作者：
Janzi S;Ramne S;González-Padilla E;Johnson L;Sonestedt E
通讯作者：
Sonestedt E
影响因子：
37.8
作者：
de Koning L;Malik VS;Kellogg MD;Rimm EB;Willett WC;Hu FB
通讯作者：
Hu FB
影响因子：
--
作者：
Guenther, Patricia M.;Reedy, Jill;Krebs-Smith, Susan M.
通讯作者：
Krebs-Smith, Susan M.