This study found that men participating in the Health Professionals Follow-up Study had a significantly higher risk of a myocardial infarction if they consumed more sugar-sweetened beverages. The same risk was not apparent for artificially sweetened beverages."
By Todd Neale, Senior Staff Writer, MedPage Today
Published: March 12, 2012
Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston.
Men who frequently drink sodas and other sugar-sweetened beverages may be putting themselves at risk of a heart attack, an observational study showed.
In a study of male healthcare professionals, those who consumed the most sugary drinks -- a median of 6.5 per week -- were 20% more likely to have a myocardial infarction (MI) during follow-up than those who never drank them (RR 1.20, 95% CI 1.09 to 1.33), according to Frank Hu, MD, PhD, of the Harvard School of Public Health in Boston, and colleagues.
A similar relationship was not seen for consumption of artificially sweetened diet beverages, they reported online in Circulation: Journal of the American Heart Association.
"These results, as well as those from other observational studies and trials, support recommendations to reduce the consumption of sugar-sweetened beverages in order to prevent cardiovascular disease," the authors wrote.
Sugar-sweetened beverages have been associated with weight gain and type 2 diabetes, but few studies have examined the relationship between the sugary drinks and coronary heart disease.
Hu and colleagues looked at data from the Health Professionals Follow-Up study, a prospective cohort study of mostly white men who were ages 40 to 75 at baseline in 1986.
The current analysis included 42,883 participants after excluding those with type 2 diabetes, cardiovascular disease, or cancer at baseline.
The men reported their consumption of sugar-sweetened and artificially sweetened beverages at baseline and every four years using a food frequency questionnaire. At baseline, the average intake was 2.5 sugar-sweetened beverages and 3.4 artificially sweetened beverages each week.
Over 22 years of follow-up, there were 3,683 incident coronary heart disease cases, defined as fatal or nonfatal MIs.
The greater risk of having a heart attack in the quartile with the greatest consumption of sugar-sweetened beverages was significant after controlling for numerous potential confounders, including age, smoking, physical activity, alcohol, multivitamins, family history, diet quality, energy intake, body mass index, pre-enrollment weight change, and dieting.
Further adjustment for self-reported high cholesterol, triglycerides, and blood pressure, as well as diagnosed type 2 diabetes, only slightly weakened the association.
"This suggests that sugar-sweetened beverages may impact on coronary heart disease risk above and beyond traditional risk factors," the authors wrote.
When treated as a continuous variable, each additional serving per day of sugar-sweetened beverages was associated with a 19% greater relative risk of coronary heart disease (P<0.01). That is consistent with a previous analysis of women participating in the Nurses' Health Study, which showed that each serving increase was associated with a 15% greater risk. Hu and colleagues also examined the relationship between consuming sugary drinks and various biomarkers, finding an association between greater consumption and adverse effects on triglycerides, C-reactive protein, interleukin-6, tumor necrosis factors 1 and 2, HDL cholesterol, lipoprotein(a), and leptin (P≤0.02 for all). Referring to the inflammatory markers, they noted that "inflammation is a key factor in the pathogenesis of cardiovascular disease and cardiometabolic disease, and could represent an additional pathway by which sugar-sweetened beverages influence risk." The study, according to the authors, was limited by some error in measuring dietary intakes, the uncertain generalizability of the findings beyond the study population, the possibility of unmeasured and residual confounding, and the large number of comparisons that were made. The study was supported by a postdoctoral fellowship from the Canadian Institutes of Health Research. The Health Professionals Follow-up Study is supported by four grants from the National Institutes of Health. The authors reported that they had no conflicts of interest. From the American Heart Association:
Dietary Sugars Intake and Cardiovascular Health
Primary source: Circulation: Journal of the American Heart Association
De Koning L, et al “Sweetened beverage consumption, incident coronary heart disease, and biomarkers of risk in men” Circulation 2012; DOI: 10.1161/CIRCULATIONAHA.111.067017.
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