Diet Soda and Sugar-Sweetened Soda Consumption in Relation to Incident Diabetes in the Northern Manhattan Study.
Diet Soda and Sugar-Sweetened Soda Consumption in Relation to Incident Diabetes in the Northern Manhattan Study.
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DOI：
10.1093/cdn/nzy008
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发表时间：
2018-05
影响因子：
4.8
通讯作者：
Sacco RL
中科院分区：
文献类型：
--
作者：
Gardener H;Moon YP;Rundek T;Elkind MSV;Sacco RL
无糖（饮食）和加糖（定期）苏打水消费与糖尿病风险增加有关，但关于无糖苏打水的文献不一致，机制不清楚。我们在一个纵向多种族人群队列中研究了无糖汽水和常规汽水消费与糖尿病发病风险之间的关系。研究人群包括北方曼哈顿研究中基线时无糖尿病和卒中的2019例受试者（平均值± SD年龄：69 ± 10岁; 64%为女性; 23%为白色、22%为黑人、53%为西班牙裔）。在基线时通过食物频率问卷评估苏打水消耗量，并进行连续和分类检查（<1/mo：含糖= 908，饮食= 1615; 1/mo-6/wk：含糖= 830，饮食= 298;每日：含糖= 281，饮食= 106）。Weibull回归模型用于估计苏打水消费与糖尿病发病率之间的关联，调整人口统计学和血管风险因素，包括体重指数（BMI）和卡路里消耗。在11 ± 5年的平均± SD随访期间，368名参与者患上了糖尿病。含糖苏打水与糖尿病发病率呈正相关（每天每苏打水HR = 1.15，95% CI：1.02，1.31）。观察到的无糖汽水与糖尿病风险升高之间的关联在很大程度上是由饮食评估时的BMI解释的，尽管在超重或肥胖的人群中，这种关联仍然很强，并且与BMI无关（每日与<1/mo相比：HR = 1.63，95%CI：1.04，2.55）。这项研究支持了含糖饮料消费在糖尿病流行中的重要性。然而，研究结果支持了先前的研究，即改用人工加糖的减肥饮料可能不会降低糖尿病的风险，因为不能排除食用减肥苏打水作为独立的糖尿病风险因素。
Artificially (diet) and sugar-sweetened (regular) soda consumption have been associated with an increased risk of diabetes, but the literature on diet soda is inconsistent and the mechanisms unclear. We examined the relation between diet soda and regular soda consumption with the risk of incident diabetes in a longitudinal multiethnic population-based cohort. The study population included 2019 participants (mean ± SD age: 69 ± 10 y; 64% women; 23% white, 22% black, 53% Hispanic) in the Northern Manhattan Study who were free of diabetes and stroke at baseline. Soda consumption was assessed by a food-frequency questionnaire at baseline and examined continuously and categorically (<1/mo: sugar-sweetened = 908, diet = 1615; 1/mo–6/wk: sugar-sweetened = 830, diet = 298; daily: sugar-sweetened = 281, diet = 106). Weibull regression models were used to estimate the associations between soda consumption and incident diabetes, adjusting for demographics and vascular risk factors including body mass index (BMI) and calorie consumption. During a mean ± SD follow-up of 11 ± 5 y, 368 participants developed diabetes. Sugar-sweetened soda was positively associated with incident diabetes (per soda per day HR = 1.15, 95% CI: 1.02, 1.31). The observed association between diet soda and elevated risk of diabetes was largely explained by BMI at the time of diet assessment, though the association remained strong and independent of BMI among those who were overweight or obese (daily compared to <1/mo: HR = 1.63, 95% CI: 1.04, 2.55). This study supports the importance of sugar-sweetened beverage consumption in the diabetes epidemic. However, the results support previous studies suggesting that switching to artificially sweetened diet beverages may not lower the risk of diabetes, as diet soda consumption cannot be ruled out as an independent diabetes risk factor.