Sugary beverages are associated with cardiovascular risk factors in diabetic patients
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Sugar-sweetened beverages (SSBs) containing high amount of added sugars have increased over the last decades. Due to increased risk of cardiovascular events in type 2 diabetes mellitus (T2DM) patients, we designed a study to assess the association between SSBs and metabolic syndrome, a collection of cardiovascular risk factors, in these patients.
A cross-sectional study was performed on T2DM adults (N = 157). Participants had no serious disease or insulin treatment. SSBs records were obtained from a validated food frequency questionnaire. Metabolic syndrome status was extracted from biochemical and anthropometric measurements. Subjects risk factors were compared based on their usual SSBs consumption.
About half of participants consumed at least one serving of SSBs (Mean intake: 145.6 mL/d) on a weekly basis. Men and women had a similar SSBs pattern. Demographic and anthropometric characteristics were identical in both groups. Higher SSBs intake (≥ 0.5 vs <0.5 serving/ week) was positively associated with hypertension (OR: 3.48, 95% CI: 1.31, 9.26) and obesity (OR: 4.61, 95% CI: 1.31, 16.25). After adjustment for confounders, a higher risk of the metabolic syndrome was observed in those with higher SSBs intake (OR: 4.23, 95% CI: 1.42, 12.62).
Drinking SSBs, even in low amounts, could potentially elevate the risk of cardiovascular risk factors in diabetic patients. Reduction of sugary drinks would be an urgent recommendation.
KeywordsDiabetes Metabolic syndrome Sugar-sweetened beverages Cardiovascular risk
We would like to thank the Head and the staff of the Diabetes Research Center and all the participants. The authors’ contribution to the research was as the following: R. Anari suggested the first idea, did the data collection and wrote the first draft; R. Amani and M. Veissi supervised the research; R. Anari did the statistical analysis; R. Amani did the final revision of the manuscript. All authors have approved the final content of the article.
This work was supported by Vice-Chancellor for Research at Ahvaz Jundishapur University of Medical Sciences (Grant number B-94011).
Compliance with ethical standards
Conflicts of interest
The authors declare that they have no conflict of interest.
- 4.International Diabetes Federation. The IDF consensus worldwide definition of the metabolic syndrome. IDF Communication 2006. Available online at https://www.idf.org/e-library/consensus-statements/60-idfconsensus-worldwide-definitionof-the-metabolic-syndrome.html
- 15.Dhingra R, Sullivan L, Jacques PF, Wang TJ, Fox CS, Meigs JB, et al. Soft drink consumption and risk of developing cardiometabolic risk factors and the metabolic syndrome in middle-aged adults in the community. Circulation. 2007;116:480–8.Google Scholar
- 16.Xu F, Park S, Siegel KR. Factors associated with frequency of sugar-sweetened beverage consumption among US adults with diabetes or prediabetes. Am J Health Promot. 2018 Sep;32(7):1489–97 Epub 2017/12/20. eng.Google Scholar
- 17.Basu S, Vellakkal S, Agrawal S, Stuckler D, Popkin B, Ebrahim S. Averting obesity and type 2 diabetes in India through sugar-sweetened beverage taxation: an economic-epidemiologic modeling study. PLoS Med. 2014 Jan;11(1):e1001582 Pubmed Central PMCID: PMC3883641. Epub 2014/01/11. eng.Google Scholar
- 20.Schulze MBHK, Manson JE, Willett WC, Meigs JB, Weikert C, Heidemann C, et al. Dietary pattern, inflammation, and incidence of type 2 diabetes in women. Am J Clin Nutr. 2005;82:675–84.Google Scholar
- 22.Singh GM, Micha R, Khatibzadeh S, Shi P, Lim S, Andrews KG, et al. Global, regional, and national consumption of sugar-sweetened beverages, fruit juices, and milk: a systematic assessment of beverage intake in 187 countries. PloS one. 2015;10(8):e0124845.Google Scholar
- 23.Ejtahed HS, Bahadoran Z, Mirmiran P, Azizi F. Sugar-sweetened beverage consumption is associated with metabolic syndrome in Iranian adults: Tehran lipid and glucose study. Endocrinol Metab. 2015;30(3):334-42.Google Scholar
- 24.Eyre H, Kahn R, Robertson RM, Clark NG, Doyle C, Hong Y, et al. Preventing cancer, cardiovascular disease, and diabetes: a common agenda for the American Cancer Society, the American Diabetes Association, and the American Heart Association. Circulation. 2004;109(25):3244-55.Google Scholar
- 25.Zabetian A, Hadaegh F, Azizi F. Prevalence of metabolic syndrome in Iranian adult population, concordance between the IDF with the ATPIII and the WHO definitions. Diabetes Res Clin Pract. 2007;77(2):251-7.Google Scholar
- 28.International Physical Activity Research Committee. IPAQ Research Committee Guidelines for data processing and analysis of the international physical activity questionnaire (IPAQ). 2005.Google Scholar
- 29.Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma without use of the preparative ultracentrifuge. Clin Chem. 1972;18:499–502.Google Scholar
- 30.Kannel WB, Mcgee DL. Diabetes and cardiovascular risk factors: the Framingham study. Circulation. 1979;59(1):8-13.Google Scholar
- 31.Mirmiran P, Ejtahed H, Bahadoran Z, Bastan S, Azizi F. Sugar-sweetened beverage consumption and risk of general and abdominal obesity in Iranian adults: Tehran lipid and glucose study. Iran J Public Health. 2015;44:1535–43.Google Scholar
- 33.Zhou X, Ji L, Ran X, Su B, Ji Q, Pan C, et al. Prevalence of obesity and its influence on achievement of cardiometabolic therapeutic goals in chinese type 2 diabetes patients: an analysis of the nationwide, cross-sectional 3B study. PLoS One. 2016;11(1):e0144179.Google Scholar
- 39.Te Morenga LA, Howatson AJ, Jones RM, Mann J. Dietary sugars and cardiometabolic risk: systematic review and meta-analyses of randomized controlled trials of the effects on blood pressure and lipids. Am J of Clin Nutr. 2014;100(1):65-79.Google Scholar
- 40.DiNicolantonio JJ, Lucan SC. The wrong white crystals: not salt but sugar as aetiological in hypertension and cardiometabolic disease. Open Heart. 2014;1(1):e000167.Google Scholar
- 41.Brown CM, Dulloo AG, Yepuri G, Montani JP. Fructose ingestion acutely elevates blood pressure in healthy young humans. Am J Physiol Regul Integr Comp Physiol. 2008;294(3): R730-7.Google Scholar
- 45.Hostmark AT, Haug A. Does cheese intake blunt the association between soft drink intake and risk of the metabolic syndrome? Results from the cross-sectional Oslo Health Study. BMJ Open. 2012;(2):e001476.Google Scholar
- 47.Nakagawa T, Hu H, Zharikov S, Tuttle KR, Short RA, Glushakova O, et al. A causal role for uric acid in fructose-induced metabolic syndrome. Am J Physiol Renal Physiol. 2006;290:F625–31.Google Scholar