Sugar-sweetened or artificially-sweetened beverage consumption, physical activity, and risk of cardiovascular disease in adults: a prospective cohort study
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Background: Whether physical activity could mitigate the adverse impacts of sugar-sweetened beverages (SSBs) or artificially sweetened beverages (ASBs) on incident cardiovascular disease (CVD) remains uncertain. Objectives: This study aimed to examine the independent and joint associations between SSB or ASB consumption and physical activity and risk of CVD, defined as fatal and nonfatal coronary artery disease and stroke, in adults from 2 United States-based prospective cohort studies. Methods: Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% CIs between SSB or ASB intake and physical activity with incident CVD among 65,730 females in the Nurses’ Health Study (1980–2016) and 39,418 males in the Health Professional's Follow-up Study (1986–2016), who were free from chronic diseases at baseline. SSBs and ASBs were assessed every 4-y and physical activity biannually. Results: A total of 13,269 CVD events were ascertained during 3,001,213 person-years of follow-up. Compared with those who never/rarely consumed SSBs or ASBs, the HR for CVD for participants consuming ≥2 servings/d was 1.21 (95% CI: 1.12, 1.32; P-trend < 0.001) for SSBs and 1.03 (95% CI: 0.97, 1.09; P-trend = 0.06) for those consuming ≥2 servings/d of ASBs. The HR for CVD per 1 serving increment of SSB per day was 1.18 (95% CI: 1.10, 1.26) and 1.12 (95% CI: 1.04, 1.20) for participants meeting and not meeting physical activity guidelines (≥7.5 compared with <7.5 MET h/wk), respectively. Compared with participants who met physical activity guidelines and never/rarely consumed SSBs, the HR for CVD was 1.47 (95% CI: 1.37, 1.57) for participants not meeting physical activity guidelines and consuming ≥2 servings/wk of SSBs. No significant associations were observed for ASB when stratified by physical activity. Conclusions: Higher SSB intake was associated with CVD risk regardless of physical activity levels. These results support current recommendations to limit the intake of SSBs even for physically active individuals.
| Originalsprog | Engelsk |
|---|---|
| Bogserie | American Journal of Clinical Nutrition |
| Vol/bind | 119 |
| Udgave nummer | 3 |
| Sider (fra-til) | 669-681 |
| Antal sider | 13 |
| ISSN | 0002-9165 |
| DOI | |
| Status | Udgivet - 2024 |
Bibliografisk note
Funding Information:
All authors have completed the ICMJE uniform disclosure form at www.icmje.org/disclosure-of-interest/ and declare the following: support from the National Institutes of Health ( NIH ) for the submitted work; LSP has been supported by grants T32 DK007703-26 from NIH and Harvard Chan Yerby Fellowship at Harvard T.H. Chan School of Public Health as a research fellow for the current work, and discloses awards from NHLBI and from the Nutrition Obesity Research Center at Harvard; DKT has been supported by grant R01DK125803 from NIH and is currently a member of the 2025 United States Dietary Guidelines Scientific Advisory Committee, reviewing beverages and cardiovascular disease; SNB has been supported by grants R01DK131753 and R01DK120560 from NIH and discloses a pending patent “system and methods for conducting nutritional health risk assessments and adapting risk analyses based on actual health outcomes” (provisional application filed on May 20, 2022; United States Application No. 63/344,293); WCW is part of the EAT Foundation Advisory Board (unpaid position) and receives royalties for the textbook Nutritional Epidemiology, Oxford University Press; DSL discloses royalties for books that recommend a carbohydrate-modified diet; CBE has been supported by grant R01DK125273 from NIH and from Thrasher Research Fund, New Balance Foundation, and Arnold Ventures, and honoraria from Columbia Cornell Obesity course and University of Arkansas for Medical Sciences (speaker); J-PD-C has been supported by grants and received payments (research grant review committee), from the Dairy Farmers of Canada . DEH reports grants from NIH (T32CA009001) and the Boston Nutrition Obesity Research Center and received honoraria and consulting fees from Boston University . MGF reports support from Novo Nordisk Foundation (grant NNF18CC0034900). This study was supported by the aforementioned sources of funding, with no additional sponsors. All other authors report no conflicts of interest. DKT is the Academic Editorial and DSL is an Associate Editor for The American Journal of Clinical Nutrition and played no role in the Journal’s evaluation of the manuscript.
Funding Information:
The research reported in this manuscript was supported by National Institutes of Health grants UM1 CA186107, U01 CA167552, R01 HL034594, R01 HL088521, and R01 HL35464. Moreover, this work was supported by grant T32 DK007703-26 from the National Institute of Diabetes and Digestive and Kidney Diseases and the Harvard Chan Yerby Fellowship at Harvard T.H. Chan School of Public Health (to LSP).
Publisher Copyright:
© 2024 American Society for Nutrition
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