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J Nutr. 2016 Aug;146(8):1528-36. doi: 10.3945/jn.116.230367. Epub 2016 Jun 29.

Frequent Consumption of Sugar- and Artificially Sweetened Beverages and Natural and Bottled Fruit Juices Is Associated with an Increased Risk of Metabolic Syndrome in a Mediterranean Population at High Cardiovascular Disease Risk.

Author information

1
Human Nutrition Unit, Hospital Universitari de Sant Joan de Reus, Faculty of Medicine and Health Sciences, IISPV (Institut d'Investigació Sanitària Pere Virgili), Biochemistry Biotechnology Department, Universitat Rovira i Virgili, Reus, Spain; CIBEROBN (Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición) and.
2
CIBEROBN (Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición) and Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain; IDISNA (Instituto de Investigación Sanitaria de Navarra), Pamplona, Spain.
3
CIBEROBN (Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición) and Department of Preventive Medicine, University of Valencia, Valencia, Spain;
4
CIBEROBN (Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición) and Prevention with Mediterranean Diet Research Network (PREDIMED), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Internal Medicine and.
5
CIBEROBN (Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición) and Lipid Clinic, Endocrinology, and Nutrition Service, Institut d'Investigacions Biomèdiques August Pi Sunyer, Hospital Clínic, University of Barcelona, Barcelona, Spain;
6
CIBEROBN (Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición) and Cardiovascular Risk and Nutrition Research Group, Medical Research Institute of Del Mar Hospital, Barcelona, Spain;
7
CIBEROBN (Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición) and Prevention with Mediterranean Diet Research Network (PREDIMED), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas, Spain;
8
CIBEROBN (Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición) and Prevention with Mediterranean Diet Research Network (PREDIMED), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Cardiology, University Hospital Araba, Vitoria, Spain;
9
CIBEROBN (Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición) and Palma Institute of Health Research, Hospital Son Espases, Palma de Mallorca, Spain;
10
CIBEROBN (Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición) and Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, Centro de Salud San Pablo, Seville, Spain;
11
Department of Public Health and Psychiatry, University of Malaga, Malaga, Spain;
12
Department of Internal Medicine and Lipids and Vascular Risk Unit, Internal Medicine Service, University Hospital of Bellvitge, Barcelona, Spain; and.
13
Human Nutrition Unit, Hospital Universitari de Sant Joan de Reus, Faculty of Medicine and Health Sciences, IISPV (Institut d'Investigació Sanitària Pere Virgili), Biochemistry Biotechnology Department, Universitat Rovira i Virgili, Reus, Spain; CIBEROBN (Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición) and Prevention with Mediterranean Diet Research Network (PREDIMED), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; jordi.salas@urv.cat.

Abstract

BACKGROUND:

The relation between the consumption of sweetened beverages and metabolic syndrome (MetS) is controversial.

OBJECTIVE:

This analysis evaluated the associations between intakes of sugar-sweetened beverages (SSBs), artificially sweetened beverages, and natural and bottled fruit juices and the incidence of MetS in elderly individuals at high risk of cardiovascular disease (CVD) and without MetS at baseline.

METHODS:

We prospectively examined 1868 participants free of MetS at baseline from the PREDIMED (PREvención con DIeta MEDiterránea) study. MetS was defined by using the updated harmonized criteria of the International Diabetes Federation, the American Heart Association, and National Heart, Lung, and Blood Institute. Energy and nutrient intakes were evaluated at baseline and then yearly by using a validated 137-item food-frequency questionnaire. Multivariable-adjusted HRs for MetS and its components were estimated from mean intakes during follow-up. We compared the 2 highest consumption categories (1-5 and >5 servings/wk) with the lowest category (<1 serving/wk).

RESULTS:

A total of 930 incident cases of MetS were documented during a median follow-up of 3.24 y. When we compared consumption of >5 servings/wk with consumption of <1 serving/wk, multivariable HRs (95% CIs) for MetS incidence were 1.43 (1.00, 2.15), 1.74 (1.26, 2.41), 1.30 (1.00, 1.69), and 1.14 (1.04, 1.65) for SSBs, artificially sweetened beverages, natural fruit juices, and bottled fruit juices, respectively.

CONCLUSIONS:

The occasional consumption of SSBs and artificially sweetened beverages (1-5 servings/wk) was not associated with the incidence of MetS in middle-aged and elderly individuals at high risk of CVD. The consumption of >5 servings/wk of all of the types of beverages analyzed was associated with an increased risk of MetS and some of its components. However, for SSBs and bottled fruit juices these associations must be interpreted with caution because of the low frequency of consumption in this population. This trial was registered at clinicaltrials.gov as ISRCTN35739639.

KEYWORDS:

PREDIMED study; artificially sweetened beverages; fruit juices; metabolic syndrome; metabolic syndrome components; sugar-sweetened beverages

PMID:
27358413
DOI:
10.3945/jn.116.230367
[Indexed for MEDLINE]

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