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May 13, 2020
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Sugar-sweetened beverage intake increases CVD risk in women

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Cheryl A.M. Anderson

The consumption of one or more servings of sugar-sweetened beverages per day was associated with an increased risk for CVD, stroke and revascularization, according to a study published in the Journal of the American Heart Association.

“Healthy foods and beverages are associated with cardiovascular health,” Cheryl A.M. Anderson, PhD, MPH, MS, professor and interim chair of family and public health at University of California, San Diego, told Healio. “This study shows that what you drink matters. Intake of equal to or greater than one serving per day of sugar-sweetened beverages was positively associated with CVD, revascularization and stroke.”

California Teachers Study data

Lorena S. Pacheco, PhD, MPH, RDN, CPH, graduate research assistant and co-investigator at University of California, San Diego, at the time of the study and is now a postdoctoral researcher at Harvard T.H. Chan School of Public Health, and colleagues analyzed data from 106,178 women (mean age, 52 years) from the California Teachers Study who were free from CVD and diabetes at baseline (1995-1996).

Several questions in the self-administered food frequency questionnaires focused on sugar-sweetened beverage intake. Women were then categorized based on their intake: rare or never (n = 43,425; mean age, 56 years), more than rare/never to less than one serving per week (n = 35,422; mean age, 50 years), one or more servings per week to less than one serving per day (n = 22,825; mean age, 49 years) and one or more servings per day (n = 4,506; mean age, 49 years).

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Increased risk for CV event by at least one sugar-sweetened beverage per day.

The incidence of CVD was defined as the first occurrence of revascularization procedure, fatal or nonfatal MI, or fatal or nonfatal stroke. Follow-up was conducted until a CVD event diagnosis, relocation out of California, death or Dec. 31, 2015, whichever came first.

During 1,807,182 person-years of follow-up, there were 8,848 incident cases of CVD, of which 2,889 were revascularization, 2,677 were MI and 5,258 were stroke.

Compared with women who rarely or never consumed sugar-sweetened beverages, those who consumed one or more servings per day had a 19% increased risk for CVD (HR = 1.19; 95% CI, 1.06-1.34; P for trend = .016), 26% increased risk for first revascularization event (HR = 1.26; 95% CI, 1.04-1.54; P for trend = .037) and a 21% increased risk for stroke (HR = 1.21; 95% CI, 1.04-1.41; P for trend = .056) after adjusting for potential confounders.

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Increased risk by beverage type

A higher risk for CVD was also observed in women who consumed one or more servings of fruit drinks per day (HR = 1.42; 95% CI, 1-2.01; P for trend = .021) and caloric soft drinks (HR = 1.23; 95% CI, 1.05-1.44; P for trend = .0002) compared with those who rarely or never consumed these beverages.

“When talking about diet with patients, ask about the barriers and facilitators of eating a healthy dietary pattern,” Anderson said in an interview. “This should address both healthy foods and beverages. It may also be important for cardiologists to know and share local resources that can help address barriers patients may face.” – by Darlene Dobkowski

For more information:

Cheryl A.M. Anderson, PhD, MPH, MS, can be reached at c1anderson@health.ucsd.edu.

Disclosures: The authors report no relevant financial disclosures.