A prospective study of artificially sweetened beverage intake and cardiometabolic health among women at high risk - PubMed (original) (raw)

. 2019 Jul 1;110(1):221-232.

doi: 10.1093/ajcn/nqz094.

Shristi Rawal 2, Anne Ahrendt Bjerregaard 3, Thor I Halldorsson 3 4, Mengying Li 1, Sylvia H Ley 5, Jing Wu 6, Yeyi Zhu 7 8, Liwei Chen 9, Aiyi Liu 10, Louise Groth Grunnet 11 12, Mohammad L Rahman 1, Freja Bach Kampmann 11 12 13, James L Mills 1, Sjurdur F Olsen 3, Cuilin Zhang 1

Affiliations

A prospective study of artificially sweetened beverage intake and cardiometabolic health among women at high risk

Stefanie N Hinkle et al. Am J Clin Nutr. 2019.

Abstract

Background: Artificially sweetened beverages (ASBs) are commonly consumed and recommended for individuals at high risk for cardiometabolic diseases; however, the health effects of ASBs remain contradictory. Given that cross-sectional analyses are subject to reverse causation, prospective studies with long-term follow-up are needed to evaluate associations between ASBs and cardiometabolic health, especially among high-risk individuals.

Objective: The aim of this study was to examine associations of ASB intake and cardiometabolic health among high-risk women with prior gestational diabetes mellitus (GDM).

Methods: We included 607 women with GDM from the Danish National Birth Cohort (DNBC; 1996-2002) who completed a clinical exam 9-16 y after the DNBC pregnancy for the Diabetes & Women's Health (DWH) Study (2012-2014). We assessed ASB intake using FFQs completed during the DNBC pregnancy and at the DWH Study clinical exam. We examined cardiometabolic outcomes at the DWH clinical exam. We estimated percentage differences in continuous cardiometabolic markers and RRs for clinical endpoints in association with ASB intake both during pregnancy and at follow-up adjusted for prepregnancy BMI, diet, and lifestyle factors. Sensitivity analyses to account for reverse causation were performed.

Results: In pregnancy and at follow-up, 30.4% and 36.4% of women regularly (≥2 servings/wk) consumed ASB, respectively. Consumption of ASBs, both during pregnancy and at follow-up, was associated with higher glycated hemoglobin (HbA1c), insulin, HOMA-IR, triglycerides, liver fat, and adiposity and with lower HDL at follow-up. After adjustment for covariates, particularly prepregnancy BMI, the majority of associations between ASB intake in pregnancy and outcomes at follow-up became null with the exception of HbA1c. ASB intake at follow-up (≥1 serving/d compared with <1 serving/mo) was associated with higher HbA1c (6.5%; 95% CI: 1.9, 11.3; P-trend = 0.007); however, associations were not upheld in sensitivity analyses for reverse causation.

Conclusions: Among Danish women with a history of GDM, ASB intake was not significantly associated with cardiometabolic profiles.

Keywords: artificially sweetened beverages; cardiometabolic health; diabetes; diet; gestational diabetes; nonnutritive sweeteners; obesity; soda.

Published by Oxford University Press on behalf of the American Society for Nutrition 2019.

PubMed Disclaimer

Similar articles

Cited by

References

    1. Popkin BM, Hawkes C.. Sweetening of the global diet, particularly beverages: patterns, trends, and policy responses. Lancet Diabetes Endocrinol. 2016;4(2):174–86. - PMC - PubMed
    1. Johnson RK, Lichtenstein AH, Anderson CA, Carson JA, Després J-P, Hu FB, Kris-Etherton PM, Otten JJ, Towfighi A, Wylie-Rosett J. Low-calorie sweetened beverages and cardiometabolic health: a science advisory from the American Heart Association. Circulation. 2018;138(9):e126–e40. - PubMed
    1. Burke MV, Small DM.. Physiological mechanisms by which non-nutritive sweeteners may impact body weight and metabolism. Physiol Behav. 2015;152:381–8. - PMC - PubMed
    1. Rogers P, Hogenkamp P, De Graaf C, Higgs S, Lluch A, Ness A, Penfold C, Perry R, Putz P, Yeomans M. Does low-energy sweetener consumption affect energy intake and body weight? A systematic review, including meta-analyses, of the evidence from human and animal studies. Int J Obes. 2016;40(3):381. - PMC - PubMed
    1. Azad MB, Abou-Setta AM, Chauhan BF, Rabbani R, Lys J, Copstein L, Mann A, Jeyaraman MM, Reid AE, Fiander M. Nonnutritive sweeteners and cardiometabolic health: a systematic review and meta-analysis of randomized controlled trials and prospective cohort studies. Can Med Assoc J. 2017;189(28):E929–E39. - PMC - PubMed

Publication types

MeSH terms

Substances

Grants and funding

LinkOut - more resources