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Takahashi K, Uenishi N, Sanui M, Uchino S, Yonezawa N, Takei T, Nishioka N, Kobayashi H, Otaka S, Yamamoto K, Yasuda H, Kosaka S, Tokunaga H, Fujiwara N, Kondo T, Ishida T, Komatsu T, Endo K, Moriyama T, Oyasu T, Hayakawa M, Hoshino A, Matsuyama T, Miyamoto Y, Yanagisawa A, Wakabayashi T, Ueda T, Komuro T, Sugimoto T, Lefor AK. Clinical profile of patients with diabetic ketoacidosis and hyperglycemic hyperosmolar syndrome in Japan: a multicenter retrospective cohort study. Acta Diabetol 2024; 61:117-126. [PMID: 37728831 DOI: 10.1007/s00592-023-02181-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 09/03/2023] [Indexed: 09/21/2023]
Abstract
INTRODUCTION Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar syndrome (HHS) are life-threatening complications of diabetes mellitus. Their clinical profiles have not been fully investigated. METHODS A multicenter retrospective cohort study was conducted in 21 acute care hospitals in Japan. Patients included were adults aged 18 or older who had been hospitalized from January 1, 2012, to December 31, 2016 due to DKA or HHS. The data were extracted from patient medical records. A four-group comparison (mild DKA, moderate DKA, severe DKA, and HHS) was performed to evaluate outcomes. RESULTS A total of 771 patients including 545 patients with DKA and 226 patients with HHS were identified during the study period. The major precipitating factors of disease episodes were poor medication compliance, infectious diseases, and excessive drinking of sugar-sweetened beverages. The median hospital stay was 16 days [IQR 10-26 days]. The intensive care unit (ICU) admission rate was 44.4% (mean) and the rate at each hospital ranged from 0 to 100%. The in-hospital mortality rate was 2.8% in patients with DKA and 7.1% in the HHS group. No significant difference in mortality was seen among the three DKA groups. CONCLUSIONS The mortality rate of patients with DKA in Japan is similar to other studies, while that of HHS was lower. The ICU admission rate varied among institutions. There was no significant association between the severity of DKA and mortality in the study population. TRIAL REGISTRATION This study is registered in the UMIN clinical Trial Registration System (UMIN000025393, Registered 23th December 2016).
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Affiliation(s)
- Kyosuke Takahashi
- Department of Anesthesiology and Critical Care Medicine, Jichi Medical University Saitama Medical Center, 1-847 Amanumacho, Omiya-Ku, Saitama City, Saitama Prefecture, 330-0834, Japan.
| | - Norimichi Uenishi
- Department of Emergency and General Internal Medicine, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Masamitsu Sanui
- Department of Anesthesiology and Critical Care Medicine, Jichi Medical University Saitama Medical Center, 1-847 Amanumacho, Omiya-Ku, Saitama City, Saitama Prefecture, 330-0834, Japan
| | - Shigehiko Uchino
- Department of Anesthesiology and Critical Care Medicine, Jichi Medical University Saitama Medical Center, 1-847 Amanumacho, Omiya-Ku, Saitama City, Saitama Prefecture, 330-0834, Japan
| | - Naoki Yonezawa
- Department of Emergency and Critical Care Medicine, Yokohama City Minato Red Cross Hospital, Yokohama, Kanagawa, Japan
| | - Tetsuhiro Takei
- Department of Emergency and Critical Care Medicine, Yokohama City Minato Red Cross Hospital, Yokohama, Kanagawa, Japan
| | - Norihiro Nishioka
- Department of Preventive Services, Kyoto University Graduate School of Medicine, Sakyo, Kyoto, Japan
- Division of Nephrology, Department of Internal Medicine, Okinawa Prefectural Chubu Hospital, Uruma, Okinawa, Japan
| | - Hirotada Kobayashi
- Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada
- Department of Intensive Care Medicine, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Shunichi Otaka
- Department of Emergency Medicine, International University of Health and Welfare Narita Hospital, Narita, Chiba, Japan
- Department of Emergency Medicine, Kumamoto Red Cross Hospital, Higashi, Kumamoto, Japan
| | - Kotaro Yamamoto
- Department of Emergency Medicine, Musashino Red Cross Hospital, Musashino, Tokyo, Japan
| | - Hideto Yasuda
- Department of Emergency Medicine, Musashino Red Cross Hospital, Musashino, Tokyo, Japan
- Department of Emergency Medicine, Jichi Medical University Saitama Medical Center, Omiya, Saitama, Japan
| | - Shintaro Kosaka
- Department of Medicine, Nerima Hikarigaoka Hospital, Nerima, Tokyo, Japan
| | - Hidehiko Tokunaga
- Department of Medicine, Nerima Hikarigaoka Hospital, Nerima, Tokyo, Japan
| | - Naoki Fujiwara
- Department of Medicine, Nerima Hikarigaoka Hospital, Nerima, Tokyo, Japan
- Department of Medicine, Taito Municipal Taito Hospital, Taito, Tokyo, Japan
| | - Takashiro Kondo
- Department of Emergency and Critical Care Medicine, National Hospital Organization Nagoya Medical Center, Nagoya, Aichi, Japan
| | - Tomoki Ishida
- Nanohana Clinic, Ikuno, Osaka, Japan
- Department of Emergency Medicine, Yodogawa Christian Hospital, Higashi Yodogawa, Osaka, Japan
| | - Takayuki Komatsu
- Department of Sports Medicine, Faculty of Medicine, Juntendo University, Bunkyo, Tokyo, Japan
- Department of Emergency and Critical Care Medicine, Juntendo University Nerima Hospital, Nerima, Tokyo, Japan
| | - Koji Endo
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Sakyo, Kyoto, Japan
- Department of General Internal Medicine, Tottori Prefectural Central Hospital, Tottori, Tottori, Japan
| | - Taiki Moriyama
- Department of Emergency Medicine, Hyogo Emergency Medical Center, Kobe, Hyogo, Japan
- Department of Emergency Medicine, Saiseikai Senri Hospital, Suita, Osaka, Japan
| | - Takayoshi Oyasu
- Department of Emergency Medicine, Hokkaido University Hospital, Sapporo, Hokkaido, Japan
| | - Mineji Hayakawa
- Department of Emergency Medicine, Hokkaido University Hospital, Sapporo, Hokkaido, Japan
| | - Atsumi Hoshino
- Department of Intensive Care Medicine, Tokyo Women's Medical University Hospital, Shinjuku, Tokyo, Japan
- Department of Emergency and Critical Care Medicine, Toyooka Public Hospital, Toyooka, Hyogo, Japan
| | - Tasuku Matsuyama
- Department of Emergency Medicine, Kyoto Prefectural University of Medicine, Kamigyo, Kyoto, Japan
| | - Yuki Miyamoto
- Department of Emergency Medicine, Kyoto Prefectural University of Medicine, Kamigyo, Kyoto, Japan
| | - Akihiro Yanagisawa
- Department of Anesthesia, Gyoda General Hospital, Gyoda, Saitama, Japan
- Department of Anesthesiology and Intensive Care, Gunma University Hospital, Maebashi, Gunma, Japan
| | - Tadamasa Wakabayashi
- Department of Medicine, Suwa Central Hospital, Chino, Nagano, Japan
- Department of Cardiology, Suwa Central Hospital, Chino, Nagano, Japan
| | - Takeshi Ueda
- Department of Emergency and General Internal Medicine, Rakuwakai Marutamachi Hospital, Nakagyo, Kyoto, Japan
| | - Tetsuya Komuro
- Department of Medicine, TMG Muneoka Central Hospital, Shiki, Saitama, Japan
- Department of Critical Care, Shonan Kamakura General Hospital, Kamakura, Kanagawa, Japan
| | - Toshiro Sugimoto
- Department of Medicine, Shiga University of Medical Science, Otsu, Shiga, Japan
- Department of Medicine, National Hospital Organization Higashiohmi General Medical Center, Higashiohmi, Shiga, Japan
| | - Alan Kawarai Lefor
- Department of Surgery, Jichi Medical University, Shimotsuke, Tochigi, Japan
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Abstract
Sex and gender differences are seen in cognitive disturbances in a variety of neurological and psychiatry diseases. Men are more likely to have cognitive symptoms in schizophrenia whereas women are more likely to have more severe cognitive symptoms with major depressive disorder and Alzheimer's disease. Thus, it is important to understand sex and gender differences in underlying cognitive abilities with and without disease. Sex differences are noted in performance across various cognitive domains - with males typically outperforming females in spatial tasks and females typically outperforming males in verbal tasks. Furthermore, there are striking sex differences in brain networks that are activated during cognitive tasks and in learning strategies. Although rarely studied, there are also sex differences in the trajectory of cognitive aging. It is important to pay attention to these sex differences as they inform researchers of potential differences in resilience to age-related cognitive decline and underlying mechanisms for both healthy and pathological cognitive aging, depending on sex. We review literature on the progressive neurodegenerative disorder, Alzheimer's disease, as an example of pathological cognitive aging in which human females show greater lifetime risk, neuropathology, and cognitive impairment, compared to human males. Not surprisingly, the relationships between sex and cognition, cognitive aging, and Alzheimer's disease are nuanced and multifaceted. As such, this chapter will end with a discussion of lifestyle factors, like education and diet, as modifiable factors that can alter cognitive aging by sex. Understanding how cognition changes across age and contributing factors, like sex differences, will be essential to improving care for older adults.
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León-García MC, Silva-Gaona OG, Hernández-Ortiz M, Vargas-Ortiz K, Ramírez-Emiliano J, Garay-Sevilla ME, Encarnación-Guevara S, Pérez-Vázquez V. Curcumin Prevents the Glycation of Tricarboxylic Acid Cycle and Cell Respiration Proteins in the Heart of Mice Fed with a High-Fructose Diet. Curr Pharm Des 2022; 28:1769-1778. [PMID: 35362381 DOI: 10.2174/1381612828666220331160501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 02/24/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND A high fructose diet (HFD) induces protein glycation. The latter is related to a higher risk of cardiovascular disease. Curcumin is a natural pleiotropic compound that may possess antiglycant properties. OBJECTIVE To analyze the effect of curcumin on the content of glycated proteins in the hearts of 6-week-old mice fed with a HFD for 15 weeks. METHODS Mice were allocated in four groups (n = 6/group): a control group that received a standard diet (CT); a group that received 30% w/v fructose in water (F); a group that received 0.75% w/w curcumin supplemented in food (C); a group that received 30% w/v fructose in water and 0.75% w/w curcumin supplemented in food (F+C). The content of glycated proteins in the heart was determined by Western Blot (whereas the spots were detected by 2D-PAGE) using anti-AGE and anti-CML antibodies. A densitometric analysis was performed using the ImageLab software. Glycated proteins were identified by MALDI-TOF-MS, and an ontological analysis was performed in terms of biological processes and molecular function based on the STRING and DAVID databases. RESULTS Fourteen glycated protein spots were detected, two of them with anti-AGE and the other 12 with anti-CML. In total, eleven glycated proteins were identified, out of which three had decreased glycation levels due to curcumin exposure. The identified proteins participate in processes such as cellular respiration, oxidative phosphorylation, lipid metabolism, carbohydrate metabolism, the tricarboxylic acid cycle (TAC), and the organization of intermediate filaments. CONCLUSIONS Curcumin decreased the fructose-induced glycation level of the ACO2, NDUFS7, and DLAT proteins.
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Affiliation(s)
- María Cristina León-García
- Dpto. de Ciencias Médicas, División de Ciencias de la Salud, Campus León, Universidad de Guanajuato, León, Guanajuato, México
| | - Oscar Gerardo Silva-Gaona
- Dpto. de Ciencias Médicas, División de Ciencias de la Salud, Campus León, Universidad de Guanajuato, León, Guanajuato, México
| | | | - Katya Vargas-Ortiz
- Dpto. de Ciencias Médicas, División de Ciencias de la Salud, Campus León, Universidad de Guanajuato, León, Guanajuato, México
| | - Joel Ramírez-Emiliano
- Dpto. de Ciencias Médicas, División de Ciencias de la Salud, Campus León, Universidad de Guanajuato, León, Guanajuato, México
| | - Ma Eugenia Garay-Sevilla
- Dpto. de Ciencias Médicas, División de Ciencias de la Salud, Campus León, Universidad de Guanajuato, León, Guanajuato, México
| | | | - Victoriano Pérez-Vázquez
- Dpto. de Ciencias Médicas, División de Ciencias de la Salud, Campus León, Universidad de Guanajuato, León, Guanajuato, México
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Herman MA, Birnbaum MJ. Molecular aspects of fructose metabolism and metabolic disease. Cell Metab 2021; 33:2329-2354. [PMID: 34619074 PMCID: PMC8665132 DOI: 10.1016/j.cmet.2021.09.010] [Citation(s) in RCA: 97] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 09/02/2021] [Accepted: 09/13/2021] [Indexed: 02/06/2023]
Abstract
Excessive sugar consumption is increasingly considered as a contributor to the emerging epidemics of obesity and the associated cardiometabolic disease. Sugar is added to the diet in the form of sucrose or high-fructose corn syrup, both of which comprise nearly equal amounts of glucose and fructose. The unique aspects of fructose metabolism and properties of fructose-derived metabolites allow for fructose to serve as a physiological signal of normal dietary sugar consumption. However, when fructose is consumed in excess, these unique properties may contribute to the pathogenesis of cardiometabolic disease. Here, we review the biochemistry, genetics, and physiology of fructose metabolism and consider mechanisms by which excessive fructose consumption may contribute to metabolic disease. Lastly, we consider new therapeutic options for the treatment of metabolic disease based upon this knowledge.
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Affiliation(s)
- Mark A Herman
- Division of Endocrinology, Metabolism, and Nutrition, Duke University, Durham, NC, USA; Duke Molecular Physiology Institute, Duke University, Durham, NC, USA; Department of Pharmacology and Cancer Biology, Duke University, Durham, NC, USA.
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Moon JY, Hua S, Qi Q, Sotres-Alvarez D, Mattei J, Casagrande SS, Mossavar-Rahmani Y, Siega-Riz AM, Gallo LC, Wassertheil-Smoller S, Kaplan RC, Corsino L. Association of Sugar-Sweetened Beverage Consumption with Prediabetes and Glucose Metabolism Markers in Hispanic/Latino Adults in the United States: Results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). J Nutr 2021; 152:235-245. [PMID: 34558625 PMCID: PMC8754574 DOI: 10.1093/jn/nxab334] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/14/2021] [Accepted: 09/16/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Both the incidence of diabetes mellitus and consumption of sugar-sweetened beverages are high in the Hispanic/Latino population in the United States. The associations between consumption of sugar-sweetened beverages, artificially sweetened beverages, and 100% fruit juice with prediabetes and glucose metabolism markers in the diverse Hispanic/Latino population in the United States are unknown. OBJECTIVES The objective of this study was to examine the cross-sectional associations between consumption of sugar-sweetened beverages, artificially sweetened beverages, and 100% fruit juice with prediabetes and glucose metabolism markers such as fasting glucose and insulin, 2-h oral-glucose-tolerance test, HOMA-IR, HOMA index for β-cell function (HOMA-B), and glycated hemoglobin (HbA1c) among US Hispanic/Latino adults. METHODS Using baseline data from the Hispanic Community Health Study/Study of Latinos (2008-2011), beverage consumption was ascertained using two 24-h dietary recalls and a food propensity questionnaire. Diabetes/prediabetes status was defined by self-report, antihyperglycemic medication use, and American Diabetes Association laboratory criteria. Among 9965 individuals without diabetes (5194 normoglycemia, 4771 prediabetes) aged 18-74 y, the associations of beverage consumption with prediabetes and glucose metabolism markers were analyzed using logistic and linear regressions, respectively, accounting for complex survey design. RESULTS Compared with individuals who consumed <1 serving/d (<240 mL/d) of sugar-sweetened beverages, individuals who consumed >2 servings/d (>480 mL/d) had 1.3 times greater odds of having prediabetes (95% CI: 1.06, 1.61) and higher glucose metabolism markers including fasting glucose, fasting insulin, HOMA-IR, and HbA1c. Consumption of artificially sweetened beverages showed an inverse association with β-cell function (HOMA-B). Intake of 100% fruit juice was not significantly associated with prediabetes nor with glucose metabolism markers. CONCLUSIONS Among US Hispanic/Latino adults, higher sugar-sweetened beverage consumption was associated with increased odds of prediabetes and higher glucose metabolism markers. Public health initiatives to decrease sugar-sweetened beverage consumption could potentially reduce the burden of diabetes among Hispanics/Latinos in the United States.
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Affiliation(s)
- Jee-Young Moon
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Simin Hua
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Qibin Qi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Daniela Sotres-Alvarez
- Department of Biostatistics, University of North Carolina–Chapel Hill, Chapel Hill, NC, USA
| | | | | | - Yasmin Mossavar-Rahmani
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Anna María Siega-Riz
- Departments of Nutrition and Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | | | - Robert C Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA,Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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Bernhold QS, Giles H. Older Adults' Age-Related Communication and Routine Dietary Habits. HEALTH COMMUNICATION 2020; 35:1556-1564. [PMID: 31448634 DOI: 10.1080/10410236.2019.1652391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Using the communicative ecology model of successful aging (CEMSA), this study examined whether or not older adults' ways of communicating about a variety of age-related issues (e.g., making age-related excuses for their shortcomings, teasing other people about their age) predict older adults' dietary habits. Participants were classified as engaged, bantering, and disengaged agers based on their own patterns of age-related communication. The probability of being an engaged ager positively predicted fruit consumption and negatively predicted soft drink consumption. The probability of being a bantering ager negatively predicted vegetable consumption. Results suggest the potential to expand the CEMSA's boundary conditions to include routine dietary habits. Future researchers can build on these findings by utilizing additional methods to assess dietary habits and testing whether or not dietary habits mediate the associations between age-related communication and a variety of health problems.
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Affiliation(s)
| | - Howard Giles
- Department of Communication, University of California , Santa Barbara
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Cao M, Zhang Z, Li S, Chen Y, Rong S, Li B, Chen Z. Left-Behind Status Worsens Prognosis of ST-Elevation Myocardial Infarction in Elderly Patients from Southwest China. Med Sci Monit 2020; 26:e927300. [PMID: 33108357 PMCID: PMC7602365 DOI: 10.12659/msm.927300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background This study aimed to assess the association between left-behind status and the prognosis of ST-elevation myocardial infarction (STEMI). Material/Methods A total of 1 015 patients with STEMI patients from 4 tertiary medical centers in southwest China were enrolled and categorized into left-behind and not-left-behind groups. The primary endpoints were major adverse cardiovascular and cerebrovascular events (MACCEs), which were assessed with Kaplan-Meier curves. Multivariate Cox regression analyses were used to explore the predictive value of left-behind status for MACCEs. Results Patients in the left-behind group were older than those in the not-left-behind group (70 vs. 65 years, P<0.001). The patients in the left-behind group had a lower incidence of history of coronary heart disease and diabetes mellitus than those in the not-left-behind group. Meanwhile, the left-behind group had higher levels of alanine aminotransferase (42 vs. 31, P<0.001), low-density lipoprotein cholesterol concentration (2.64 vs. 2.62, P=0.001) and cardiac troponin I (5.11 vs. 2.84, P=0.001) than the not-left-behind group. During the 18-month follow-up, the left-behind group experienced a higher rate of adverse events than the not-left-behind group (123/26.2% vs. 81/14.8%, P<0.001). After multivariate adjustment, the left-behind group also had a 1.778-fold (95% CI: 1.241–2.547, P=0.002) higher risk of experiencing MACCEs than the not-left-behind group. Conclusions Left-behind status is an independent predictor of STEMI prognosis.
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Affiliation(s)
- Maolin Cao
- Department of Cardiology, Yongchuan Hospital of Chongqing Medical University, Chongqing, China (mainland)
| | - Zhe Zhang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China (mainland)
| | - Shichuan Li
- Department of Cardiology, Rongchang District People's Hospital, Chongqing, China (mainland)
| | - Yan Chen
- Department of Cardiology, Yongchuan Hospital of Chongqing Medical University, Chongqing, China (mainland)
| | - Shunkang Rong
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland)
| | - Bo Li
- Department of Cardiology, Central Hospital of Jiangjin District, Chongqing, China (mainland)
| | - Zijun Chen
- Department of Cardiology, Yongchuan Hospital of Chongqing Medical University, Chongqing, China (mainland)
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Lang A, Kuss O, Filla T, Schlesinger S. Association between per capita sugar consumption and diabetes prevalence mediated by the body mass index: results of a global mediation analysis. Eur J Nutr 2020; 60:2121-2129. [PMID: 33037438 PMCID: PMC8137616 DOI: 10.1007/s00394-020-02401-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 09/25/2020] [Indexed: 12/13/2022]
Abstract
Purpose The aim of this study was to examine the mediation of body mass index (BMI) on the association between per capita sugar consumption and diabetes prevalence using country-related data. Research design and methods In this ecological study, based on 192 countries, data on per capita sugar consumption were obtained from the Food and Agriculture Organization of the United Nations (FAO), on BMI from the World Health Organization and on diabetes prevalence from the International Diabetes Federation. Data on demography and economic factors were obtained from the Central Intelligence Agency, the United Nations and the FAO. Multiple linear regression analysis was performed to investigate the association between per capita sugar consumption and diabetes prevalence, and mediation analysis to detect the mediated percentage of BMI on this association. Results Each increase of 100 kcal/day per capita sugar consumption was associated with a 1.62% higher diabetes prevalence [adjusted β-estimator (95% CI): 1.62 (0.71, 2.53)]. Mediation analysis using BMI as the mediator demonstrated an adjusted direct association of 0.55 (95% CI: − 0.22, 1.32) and an adjusted indirect association of 1.07 (95% CI: 0.54, 1.68). Accordingly, the BMI explained 66% (95% CI: 34%, 100%) of the association between per capita sugar consumption on diabetes prevalence. Conclusions These findings indicate that the association between dietary sugar intake and the occurrence of diabetes is mediated by BMI to a large proportion. However, it seems that other mechanisms may explain the association between sugar consumption and development of type 2 diabetes. Electronic supplementary material The online version of this article (10.1007/s00394-020-02401-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alexander Lang
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Institute for Diabetes Research at Heinrich Heine University Düsseldorf, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
| | - Oliver Kuss
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Institute for Diabetes Research at Heinrich Heine University Düsseldorf, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany.,German Center for Diabetes Research (DZD e.V.), München-Neuherberg, Germany
| | - Tim Filla
- Institute for Biometrics and Bioinformatics, University Hospital Düsseldorf, Research at Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Sabrina Schlesinger
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Institute for Diabetes Research at Heinrich Heine University Düsseldorf, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany. .,German Center for Diabetes Research (DZD e.V.), München-Neuherberg, Germany.
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Rivera-Paredez B, Torres-Ibarra L, González-Morales R, Barrientos-Gutiérrez T, Hernández-López R, Ramírez P, León-Maldonado L, Velázquez-Cruz R, Denova-Gutiérrez E, Salmerón J. Cumulative soft drink consumption is associated with insulin resistance in Mexican adults. Am J Clin Nutr 2020; 112:661-668. [PMID: 32597932 PMCID: PMC7458769 DOI: 10.1093/ajcn/nqaa169] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 06/03/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Insulin resistance (IR) is an important risk factor for type 2 diabetes (T2D) and other cardiometabolic diseases. Recent studies suggest that soft drink consumption could increase IR. However, inconsistent findings have been observed. OBJECTIVE The aim was to estimate the association between the cumulative consumption of soft drinks and IR by means of the HOMA-IR in Mexican adults. METHODS We analyzed the association between cumulative consumption of soft drinks and HOMA-IR change after 7 y of follow-up in participants (n = 1073) of the Health Workers Cohort Study. Soft drink consumption was estimated by food-frequency questionnaires. Insulin was measured by chemiluminescence, and fasting glucose was measured with the enzymatic colorimetric method. HOMA-IR was computed as fasting insulin (mIU/L) × fasting glucose (mmol/L)/22.5. To assess the relation between cumulative soft drink consumption and HOMA-IR change, we performed robust linear regression models. Additionally, we used fixed-effects models to estimate the association between changes in soft drink consumption and change in HOMA-IR. RESULTS At baseline, the average age was 44 y. Mean cumulative soft drink consumption was 0.42 servings/d. Median HOMA-IR increased from 1.5 at baseline to 2.0 at follow-up. Soft drink consumption was positively associated with HOMA-IR change. In the multiple linear regression analysis, for each increase in the consumption of 2 (355 mL) soft drinks/d, the average change between baseline and follow-up HOMA-IR showed an increase of 1.11 units (95% CI: 0.74, 1.48). CONCLUSIONS Our data support the hypothesis that, in Mexican adults, a higher soft drink consumption is associated with an increase in HOMA-IR, despite known risk factors. These findings support the need for reinforcing policies to reduce soft drink consumption in our population.
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Affiliation(s)
- Berenice Rivera-Paredez
- Center for Research in Policies, Population and Health, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Leticia Torres-Ibarra
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Romina González-Morales
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | | | - Rubí Hernández-López
- Subgerencia Técnica del Plan de Salud, Gerencia de Administración del Plan de Salud, Dirección General de Administración, Banco de México, Mexico City, Mexico
| | - Paula Ramírez
- Epidemiological Research and Health Services Unit, Mexican Institute of Social Security, Cuernavaca, Mexico
| | - Leith León-Maldonado
- CONACYT–Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Rafael Velázquez-Cruz
- Genomics of Bone Metabolism Laboratory, National Institute of Genomic Medicine (INMEGEN), Mexico City, Mexico
| | | | - Jorge Salmerón
- Center for Research in Policies, Population and Health, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
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Moreira ARO, Batista RFL, Ladeira LLC, Thomaz EBAF, Alves CMC, Saraiva MC, Silva AAM, Brondani MA, Ribeiro CCC. Higher sugar intake is associated with periodontal disease in adolescents. Clin Oral Investig 2020; 25:983-991. [PMID: 32519237 DOI: 10.1007/s00784-020-03387-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 05/28/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Analyze the association between higher added sugar exposure and periodontal disease in adolescents (18-19 years old). MATERIALS AND METHODS This was a cross-sectional study nested to RPS Cohorts Consortium, São Luís, Brazil (n = 2515). The exposure was percentage of daily calories from added sugar (≥ 10%), estimated from a quantitative food frequency. The outcome was periodontal disease estimated by the number of teeth affected by bleeding on probing, periodontal probing depth ≥ 4 mm, and clinical attachment level ≥ 4 mm at the same site. A theoretical model was depicted in a directed acyclic graph to identify the minimal sufficient adjustment set: household income, adolescent's educational level, sex, alcohol use, and smoking. Periodontal disease was categorized into < 2 teeth affected, 2 to 3 teeth affected, and ≥ 4 teeth affected to estimate prevalence ratios (PR) by multinomial logistic regression. To test for consistency, means ratio (MR) were estimated using zero-inflated Poisson. RESULTS High sugar intake was associated with ≥ 4 teeth affected by periodontal disease (PR = 1.42; 95% confidence interval (CI) = 1.03-1.94; p = 0.030); consistency Poisson analysis reinforced these results (MR = 1.15; 95% CI = 1.03-1.29; p = 0.011). CONCLUSION High level of added sugar intake was associated with greater extent of periodontal disease in adolescents. CLINICAL RELEVANCE High sugar intake was associated with periodontal disease in adolescents, supporting the integrated hypothesis of dental caries and periodontal disease and giving impetus to future clinical investigation on the effect of restriction of added sugar consumption in periodontal parameters, which potentially may change traditional treatment protocols of periodontal disease.
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Affiliation(s)
- Ana R O Moreira
- Postgraduate Program of Dentistry, Federal University of Maranhão, Av. dos Portugueses 1966, Cidade Universitária Bacanga, São Luís, MA, 65080-805, Brazil
| | - Rosangela F L Batista
- Postgraduate Program of Public Health, Federal University of Maranhão, São Luís, MA, Brazil
| | - Lorena L C Ladeira
- Postgraduate Program of Dentistry, Federal University of Maranhão, Av. dos Portugueses 1966, Cidade Universitária Bacanga, São Luís, MA, 65080-805, Brazil
| | - Erika B A F Thomaz
- Postgraduate Program of Public Health, Federal University of Maranhão, São Luís, MA, Brazil
| | - Claudia M C Alves
- Postgraduate Program of Dentistry, Federal University of Maranhão, Av. dos Portugueses 1966, Cidade Universitária Bacanga, São Luís, MA, 65080-805, Brazil
- Postgraduate Program of Public Health, Federal University of Maranhão, São Luís, MA, Brazil
| | - Maria C Saraiva
- Department of Pediatric Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, SP, Brazil
| | - Antonio A M Silva
- Postgraduate Program of Public Health, Federal University of Maranhão, São Luís, MA, Brazil
| | - Mario A Brondani
- Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
| | - Cecilia C C Ribeiro
- Postgraduate Program of Dentistry, Federal University of Maranhão, Av. dos Portugueses 1966, Cidade Universitária Bacanga, São Luís, MA, 65080-805, Brazil.
- Postgraduate Program of Public Health, Federal University of Maranhão, São Luís, MA, Brazil.
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11
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Vitelli A, Apuzzi V, Calderaro F, Fattoruso O, Bassi V. A Triad of Ketoacidosis, Hypertriglyceridemia, and Acute Pancreatitis Associated With Sugar-Sweetened Soft Drinks Abuse in a Caucasian Patient With Undiagnosed Type 2 Diabetes Mellitus. Cureus 2020; 12:e8299. [PMID: 32607288 PMCID: PMC7320639 DOI: 10.7759/cureus.8299] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
A 24-year-old obese Caucasian male, without relevant anamnesis, who was admitted to the ER presented with abdominal pain, nausea and vomiting, hyperglycemia, and diabetic ketoacidosis (DKA). The diagnosis of acute pancreatitis (AP) was supported by increased serum levels of triglycerides and lipase associated with abdominal CT scans. The patient was treated for five days with IV regular insulin, hydration, electrolytes replacement, and statin/fibrate therapy with clinical improvement. Some 10% hemoglobin A1c value, normal C-peptide level and negative glutamic acid decarboxylase (GAD-65), and islet cell autoantibodies suggested the diagnosis of a new-onset type 2 diabetes mellitus (DM) presenting with an uncommon triad of DKA and hypertriglyceridemia (HTG)-induced AP. Anamnestic history suggested that DKA was dependent on sugar-sweetened soft drinks abuse (soft drink ketosis), a clinical association more frequent in Asian than in Western patients.
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Affiliation(s)
- Alessandra Vitelli
- U.O.C. Medicina Generale E Lungodegenza, San Giovanni Bosco, Asl Napoli 1 Centro, Naples, ITA
| | - Valentina Apuzzi
- U.O.C. Medicina Generale E Lungodegenza, San Giovanni Bosco, Asl Napoli 1 Centro, Naples, ITA
| | - Francesco Calderaro
- U.O.C. Medicina Genereale E Lungodegenza, San Giovanni Bosco, Asl Napoli 1 Centro, Naples, ITA
| | - Olimpia Fattoruso
- Pathology, San Giovanni Bosco Hospital, ASL Napoli 1 Centro, Naples, ITA
| | - Vincenzo Bassi
- U. O. C. Di Medicina Generale E Lungodegenza, San Giovanni Bosco Hospital, Asl Napoli 1 Centro, Naples, ITA
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12
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Papandreou D, Magriplis E, Abboud M, Taha Z, Karavolia E, Karavolias C, Zampelas A. Consumption of Raw Orange, 100% Fresh Orange Juice, and Nectar- Sweetened Orange Juice-Effects on Blood Glucose and Insulin Levels on Healthy Subjects. Nutrients 2019; 11:nu11092171. [PMID: 31509979 PMCID: PMC6770506 DOI: 10.3390/nu11092171] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 09/04/2019] [Accepted: 09/05/2019] [Indexed: 12/30/2022] Open
Abstract
Objective: The aim of this study is to investigate the effect of consumption of raw orange (RO), 100% fresh orange juice (FOJ), and nectar-sweetened orange juice (NSOJ) on postprandial glucose and insulin levels in non-diabetic young Emirati women. Research Methods: This is a prospective, three-way, crossover study design. Blood records of thirteen normal weight and seven healthy obese university students were analyzed from Zayed University on three random days with the following three meal samples: 2 ROs, 100% FOJ, and NSOJ. Venous blood was collected at 0, 30, 60, 90, and 120 minutes after the respective meal consumption. Statistical analyses included repeated measures analysis of variance and calculations of the area under the glucose and insulin curves (AUC) for each one of the meal samples. Results: Total fasting glucose and insulin levels did not differ by treatment in the normal versus obese group. All three meals had no significant effects on the plasma glucose levels. However, there was a significant change in plasma insulin concentrations at 120 min compared with that at 0 min for RO: −14 (−27.05, −0.90, P < 0.001); 100% FOJ −13.7 (−28.80, 1.44, P < 0.001); and NSOJ: −9.2 (−28.75, 10.30, P < 0.001). Conclusions: This study shows that whole fresh fruit, 100% fruit juice, and sweetened fruit juice did not have a significant effect on the blood glucose levels in non-diabetic Emirati university students. However, a significant decrease in insulin response and HOMA-IR on all three sample meals was observed.
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Affiliation(s)
| | - Emmanouella Magriplis
- Department of Food Science and Human Nutrition, Agriculture University of Athens, 11855 Athens, Greece.
| | - Myriam Abboud
- Department of Health Sciences, CNHS, Zayed University, Abu Dhabi 144534, UAE.
| | - Zainab Taha
- Department of Health Sciences, CNHS, Zayed University, Abu Dhabi 144534, UAE.
| | - Eleftheria Karavolia
- Faculty of Medicine, University of Groningen, 9712KB Groningen, The Netherlands.
| | | | - Antonis Zampelas
- Department of Food Science and Human Nutrition, Agriculture University of Athens, 11855 Athens, Greece.
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13
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den Biggelaar LJCJ, Sep SJS, Mari A, Ferrannini E, van Dongen MCJM, Wijckmans NEG, Schram MT, van der Kallen CJ, Schaper N, Henry RMA, van Greevenbroek MM, Stehouwer CDA, Eussen SJPM. Association of artificially sweetened and sugar-sweetened soft drinks with β-cell function, insulin sensitivity, and type 2 diabetes: the Maastricht Study. Eur J Nutr 2019; 59:1717-1727. [PMID: 31486878 PMCID: PMC7230048 DOI: 10.1007/s00394-019-02026-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 06/10/2019] [Indexed: 12/31/2022]
Abstract
Purpose Artificially sweetened and sugar-sweetened beverage consumptions have both been reported to be associated with type 2 diabetes mellitus (T2D) risk. The aim of the current study was to investigate the potential underlying associations with dynamic pancreatic β-cell function (BCF) and insulin sensitivity. Methods We evaluated cross-sectional associations in 2240 individuals (mean ± SD age 59.6 ± 8.18, 49.4% male, 21.9% T2D) participating in a diabetes-enriched population-based cohort. Artificially sweetened and sugar-sweetened soft drinks and juice consumption were assessed by a food-frequency questionnaire. Glucose metabolism status, insulin sensitivity, and BCF were measured by a seven-point oral glucose tolerance test. Regression analyses were performed to assess associations of artificially and sugar-sweetened beverage consumption with measures of glucose homeostasis. Associations were adjusted for potential confounders, and additionally with and without total energy intake and BMI, as these variables could be mediators. Results Moderate consumption of artificially sweetened soft drink was associated with lower β-cell glucose sensitivity [standardized beta (95% CI), − 0.06 (− 0.11, − 0.02)], total insulin secretion [β − 0.06 (− 0.10, − 0.02)], and with lower β-cell rate sensitivity [odds ratio (95% CI), 1.29 (1.03, 1.62)] compared to abstainers. Daily artificially sweetened soft drink consumption was associated with lower β-cell glucose sensitivity [β − 0.05 (− 0.09, 0.00)], and total insulin secretion [β − 0.05 − 0.09, − 0.01)] compared to abstainers. Conclusions Moderate and daily consumption of artificially sweetened soft drinks was associated with lower BCF, but not with insulin sensitivity. No evidence was found for associations of sugar-sweetened soft drink and juice consumption with BCF or insulin sensitivity in this middle-aged population. Prospective studies are warranted to further investigate the associations of artificially and sugar-sweetened beverage consumption with non-fasting insulin sensitivity and multiple BCF aspects. Electronic supplementary material The online version of this article (10.1007/s00394-019-02026-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Louise J C J den Biggelaar
- Department of Epidemiology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands.
| | - Simone J S Sep
- Department of Rehabilitation Medicine, Maastricht University, Maastricht, The Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Andrea Mari
- C N R Institute of Neuroscience, Padua, Italy
| | | | - Martien C J M van Dongen
- Department of Epidemiology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Nicole E G Wijckmans
- Department of Epidemiology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Miranda T Schram
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- Heart and Vascular Centre, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Carla J van der Kallen
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Nicolaas Schaper
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- Department of Rehabilitation Medicine, Maastricht University, Maastricht, The Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Ronald M A Henry
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- Heart and Vascular Centre, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Marleen M van Greevenbroek
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Coen D A Stehouwer
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Simone J P M Eussen
- Department of Epidemiology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
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14
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Sundborn G, Thornley S, Merriman TR, Lang B, King C, Lanaspa MA, Johnson RJ. Are Liquid Sugars Different from Solid Sugar in Their Ability to Cause Metabolic Syndrome? Obesity (Silver Spring) 2019; 27:879-887. [PMID: 31054268 DOI: 10.1002/oby.22472] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Accepted: 01/29/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Intake of sugary drinks, especially soft drinks, carries increased risk for obesity and diabetes. This article reviews whether sugary drinks carry different risks for metabolic syndrome compared with foods that contain natural or added sugars. METHODS A narrative review was performed to evaluate differences between liquid and solid sugars in their ability to induce metabolic syndrome and to discuss potential mechanisms to account for the differences. RESULTS Epidemiological studies support liquid added sugars, such as soft drinks, as carrying greater risk for development of metabolic syndrome compared with solid sugar. Some studies suggest that fruit juice may also confer relatively higher risk for weight gain and insulin resistance compared with natural fruits. Experimental evidence suggests this may be due to differences in how fructose is metabolized. Fructose induces metabolic disease by reducing the energy levels in liver cells, mediated by the concentration of fructose to which the cells are exposed. The concentration relates to the quantity and speed at which fructose is ingested, absorbed, and metabolized. CONCLUSIONS Although reduced intake of added sugars (sucrose and high-fructose corn syrup) remains a general recommendation, there is evidence that sugary soft drinks may provide greater health risks relative to sugar-containing foods.
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Affiliation(s)
- Gerhard Sundborn
- Department of Pacific Health, The University of Auckland, Auckland, New Zealand
| | - Simon Thornley
- Auckland Regional Public Health Service, Auckland, New Zealand
| | - Tony R Merriman
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
| | - Bodo Lang
- Department of Marketing, Business School, The University of Auckland, Auckland, New Zealand
| | - Christopher King
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Miguel A Lanaspa
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Richard J Johnson
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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15
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Are Fruit Juices Healthier Than Sugar-Sweetened Beverages? A Review. Nutrients 2019; 11:nu11051006. [PMID: 31052523 PMCID: PMC6566863 DOI: 10.3390/nu11051006] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 04/26/2019] [Accepted: 04/29/2019] [Indexed: 02/05/2023] Open
Abstract
Free sugars overconsumption is associated with an increased prevalence of risk factors for metabolic diseases such as the alteration of the blood lipid levels. Natural fruit juices have a free sugar composition quite similar to that of sugar-sweetened beverages. Thus, could fruit juice consumption lead to the same adverse effects on health as sweetened beverages? We attempted to answer this question by reviewing the available evidence on the health effects of both sugar-sweetened beverages and natural fruit juices. We determined that, despite the similarity of fruits juices to sugar-sweetened beverages in terms of free sugars content, it remains unclear whether they lead to the same metabolic consequences if consumed in equal dose. Important discrepancies between studies, such as type of fruit juice, dose, duration, study design, and measured outcomes, make it impossible to provide evidence-based public recommendations as to whether the consumption of fruit juices alters the blood lipid profile. More randomized controlled trials comparing the metabolic effects of fruit juice and sugar-sweetened beverage consumption are needed to shape accurate public health guidelines on the variety and quantity of free sugars in our diet that would help to prevent the development of obesity and related health problems.
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16
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Dietary Sources of Fructose and Its Association with Fatty Liver in Mexican Young Adults. Nutrients 2019; 11:nu11030522. [PMID: 30823422 PMCID: PMC6470703 DOI: 10.3390/nu11030522] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 02/22/2019] [Accepted: 02/25/2019] [Indexed: 02/06/2023] Open
Abstract
Fructose intake has been associated with non-alcoholic fatty liver disease (NAFLD). The objective of this study was to assess the consumption of dietary fructose according to: 1) classification of hepatic steatosis by two indexes and 2) diagnosis of NAFLD by MRI. We conducted a cross-sectional analysis among 100 young adults from Mexico City. The Hepatic Steatosis Index (HSI) and the Fatty Liver Index (FLI) were estimated using Body Mass Index (BMI), waist circumference, and fasting concentrations of glucose, triglycerides, and hepatic enzymes (ALT, AST, GGT). A semi-quantitative food frequency questionnaire was administered to obtain dietary sources of fructose. We estimated the concordance between the hepatic indices and NAFLD and the correlation between the index scores and the percentage of liver fat. Eighteen percent presented NAFLD; 44% and 46% were classified with hepatic steatosis according to HSI and FLI, respectively. We compared dietary intake of fructose by each outcome: HSI, FLI, and NAFLD. Sugar-sweetened beverages (SSB) and juices were consumed significantly more by those with steatosis by FLI and NAFLD suggesting that SSB intake is linked to metabolic alterations that predict the risk of having NAFLD at a young age.
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17
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Dale MTG, Magnus P, Leirgul E, Holmstrøm H, Gjessing HK, Brodwall K, Haugen M, Stoltenberg C, Øyen N. Intake of sucrose-sweetened soft beverages during pregnancy and risk of congenital heart defects (CHD) in offspring: a Norwegian pregnancy cohort study. Eur J Epidemiol 2019; 34:383-396. [DOI: 10.1007/s10654-019-00480-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 01/05/2019] [Indexed: 01/13/2023]
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18
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Stanhope KL, Goran MI, Bosy-Westphal A, King JC, Schmidt LA, Schwarz JM, Stice E, Sylvetsky AC, Turnbaugh PJ, Bray GA, Gardner CD, Havel PJ, Malik V, Mason AE, Ravussin E, Rosenbaum M, Welsh JA, Allister-Price C, Sigala DM, Greenwood MRC, Astrup A, Krauss RM. Pathways and mechanisms linking dietary components to cardiometabolic disease: thinking beyond calories. Obes Rev 2018; 19:1205-1235. [PMID: 29761610 PMCID: PMC6530989 DOI: 10.1111/obr.12699] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Revised: 03/09/2018] [Accepted: 03/31/2018] [Indexed: 12/11/2022]
Abstract
Calories from any food have the potential to increase risk for obesity and cardiometabolic disease because all calories can directly contribute to positive energy balance and fat gain. However, various dietary components or patterns may promote obesity and cardiometabolic disease by additional mechanisms that are not mediated solely by caloric content. Researchers explored this topic at the 2017 CrossFit Foundation Academic Conference 'Diet and Cardiometabolic Health - Beyond Calories', and this paper summarizes the presentations and follow-up discussions. Regarding the health effects of dietary fat, sugar and non-nutritive sweeteners, it is concluded that food-specific saturated fatty acids and sugar-sweetened beverages promote cardiometabolic diseases by mechanisms that are additional to their contribution of calories to positive energy balance and that aspartame does not promote weight gain. The challenges involved in conducting and interpreting clinical nutritional research, which preclude more extensive conclusions, are detailed. Emerging research is presented exploring the possibility that responses to certain dietary components/patterns are influenced by the metabolic status, developmental period or genotype of the individual; by the responsiveness of brain regions associated with reward to food cues; or by the microbiome. More research regarding these potential 'beyond calories' mechanisms may lead to new strategies for attenuating the obesity crisis.
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Affiliation(s)
- K L Stanhope
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - M I Goran
- Department of Preventive Medicine, Diabetes and Obesity Research Institute, University of Southern California, Los Angeles, CA, USA
| | - A Bosy-Westphal
- Institute of Human Nutrition and Food Science, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - J C King
- Children's Hospital Oakland Research Institute, Oakland, CA, USA
| | - L A Schmidt
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA, USA
- California Clinical and Translational Science Institute, University of California, San Francisco, San Francisco, CA, USA
- Department of Anthropology, History, and Social Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - J-M Schwarz
- Touro University, Vallejo, CA, USA
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - E Stice
- Oregon Research Institute, Eugene, OR, USA
| | - A C Sylvetsky
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - P J Turnbaugh
- Department of Microbiology and Immunology, G.W. Hooper Research Foundation, University of California, San Francisco, San Francisco, CA, USA
| | - G A Bray
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - C D Gardner
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - P J Havel
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, CA, USA
- Department of Nutrition, University of California, Davis, Davis, CA, USA
| | - V Malik
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - A E Mason
- Department of Psychiatry, Osher Center for Integrative Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - E Ravussin
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - M Rosenbaum
- Division of Molecular Genetics, Department of Pediatrics, Columbia University, New York, NY, USA
| | - J A Welsh
- Department of Pediatrics, Emory University School of Medicine, Wellness Department, Children's Healthcare of Atlanta, Nutrition and Health Sciences Doctoral Program, Laney Graduate School, Emory University, Atlanta, GA, USA
| | - C Allister-Price
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - D M Sigala
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - M R C Greenwood
- Department of Nutrition, University of California, Davis, Davis, CA, USA
| | - A Astrup
- Department of Nutrition, Exercise, and Sports, Faculty of Sciences, University of Copenhagen, Copenhagen, Denmark
| | - R M Krauss
- Children's Hospital Oakland Research Institute, Oakland, CA, USA
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19
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McKeown NM, Dashti HS, Ma J, Haslam DE, Kiefte-de Jong JC, Smith CE, Tanaka T, Graff M, Lemaitre RN, Rybin D, Sonestedt E, Frazier-Wood AC, Mook-Kanamori DO, Li Y, Wang CA, Leermakers ETM, Mikkilä V, Young KL, Mukamal KJ, Cupples LA, Schulz CA, Chen TA, Li-Gao R, Huang T, Oddy WH, Raitakari O, Rice K, Meigs JB, Ericson U, Steffen LM, Rosendaal FR, Hofman A, Kähönen M, Psaty BM, Brunkwall L, Uitterlinden AG, Viikari J, Siscovick DS, Seppälä I, North KE, Mozaffarian D, Dupuis J, Orho-Melander M, Rich SS, de Mutsert R, Qi L, Pennell CE, Franco OH, Lehtimäki T, Herman MA. Sugar-sweetened beverage intake associations with fasting glucose and insulin concentrations are not modified by selected genetic variants in a ChREBP-FGF21 pathway: a meta-analysis. Diabetologia 2018; 61:317-330. [PMID: 29098321 PMCID: PMC5826559 DOI: 10.1007/s00125-017-4475-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 08/29/2017] [Indexed: 12/13/2022]
Abstract
AIMS/HYPOTHESIS Sugar-sweetened beverages (SSBs) are a major dietary contributor to fructose intake. A molecular pathway involving the carbohydrate responsive element-binding protein (ChREBP) and the metabolic hormone fibroblast growth factor 21 (FGF21) may influence sugar metabolism and, thereby, contribute to fructose-induced metabolic disease. We hypothesise that common variants in 11 genes involved in fructose metabolism and the ChREBP-FGF21 pathway may interact with SSB intake to exacerbate positive associations between higher SSB intake and glycaemic traits. METHODS Data from 11 cohorts (six discovery and five replication) in the CHARGE (Cohorts for Heart and Aging Research in Genomic Epidemiology) Consortium provided association and interaction results from 34,748 adults of European descent. SSB intake (soft drinks, fruit punches, lemonades or other fruit drinks) was derived from food-frequency questionnaires and food diaries. In fixed-effects meta-analyses, we quantified: (1) the associations between SSBs and glycaemic traits (fasting glucose and fasting insulin); and (2) the interactions between SSBs and 18 independent SNPs related to the ChREBP-FGF21 pathway. RESULTS In our combined meta-analyses of discovery and replication cohorts, after adjustment for age, sex, energy intake, BMI and other dietary covariates, each additional serving of SSB intake was associated with higher fasting glucose (β ± SE 0.014 ± 0.004 [mmol/l], p = 1.5 × 10-3) and higher fasting insulin (0.030 ± 0.005 [log e pmol/l], p = 2.0 × 10-10). No significant interactions on glycaemic traits were observed between SSB intake and selected SNPs. While a suggestive interaction was observed in the discovery cohorts with a SNP (rs1542423) in the β-Klotho (KLB) locus on fasting insulin (0.030 ± 0.011 log e pmol/l, uncorrected p = 0.006), results in the replication cohorts and combined meta-analyses were non-significant. CONCLUSIONS/INTERPRETATION In this large meta-analysis, we observed that SSB intake was associated with higher fasting glucose and insulin. Although a suggestive interaction with a genetic variant in the ChREBP-FGF21 pathway was observed in the discovery cohorts, this observation was not confirmed in the replication analysis. TRIAL REGISTRATION Trials related to this study were registered at clinicaltrials.gov as NCT00005131 (Atherosclerosis Risk in Communities), NCT00005133 (Cardiovascular Health Study), NCT00005121 (Framingham Offspring Study), NCT00005487 (Multi-Ethnic Study of Atherosclerosis) and NCT00005152 (Nurses' Health Study).
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Affiliation(s)
- Nicola M McKeown
- Nutritional Epidemiology Program, Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA, 02111, USA.
| | - Hassan S Dashti
- Nutrition & Genomics Laboratory, Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA.
- Center for Genomic Medicine, Massachusetts General Hospital, 185 Cambridge Street, Boston, MA, 02114, USA.
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA.
| | - Jiantao Ma
- National Heart, Lung, and Blood Institute's Framingham Heart Study and Population Sciences Branch, Framingham, MA, USA
| | - Danielle E Haslam
- Nutritional Epidemiology Program, Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA, 02111, USA
| | - Jessica C Kiefte-de Jong
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
- Global Public Health, Leiden University College, The Hague, the Netherlands
| | - Caren E Smith
- Nutrition & Genomics Laboratory, Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Toshiko Tanaka
- Translational Gerontology Branch, National Institute on Aging, Baltimore, MD, USA
| | - Mariaelisa Graff
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA
| | | | - Denis Rybin
- Boston University Data Coordinating Center, Boston University, Boston, MA, USA
| | - Emily Sonestedt
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Alexis C Frazier-Wood
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Dennis O Mook-Kanamori
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands
| | - Yanping Li
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Carol A Wang
- School of Women's and Infants' Health, The University of Western Australia, Crawley, WA, Australia
| | | | - Vera Mikkilä
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland
| | - Kristin L Young
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA
| | - Kenneth J Mukamal
- Division of General Medicine and Primary Care, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - L Adrienne Cupples
- National Heart, Lung, and Blood Institute's Framingham Heart Study and Population Sciences Branch, Framingham, MA, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | | | - Tzu-An Chen
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Ruifang Li-Gao
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Tao Huang
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Wendy H Oddy
- Telethon Kids Institute, Subiaco, WA, Australia
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Olli Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Kenneth Rice
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - James B Meigs
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Ulrika Ericson
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Lyn M Steffen
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Frits R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Albert Hofman
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital, and Finnish Cardiovascular Research Center - Tampere, Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Bruce M Psaty
- Department of Medicine, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Department of Health Services, University of Washington, Seattle, WA, USA
- Group Health Research Institute, Group Health Cooperative, Seattle, WA, USA
| | - Louise Brunkwall
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Andre G Uitterlinden
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Jorma Viikari
- Department of Medicine, University of Turku, Turku, Finland
- Division of Medicine, Turku University Hospital, Turku, Finland
| | | | - Ilkka Seppälä
- Department of Clinical Chemistry, Fimlab Laboratories, and Finnish Cardiovascular Research Center - Tampere, Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Kari E North
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Josée Dupuis
- National Heart, Lung, and Blood Institute's Framingham Heart Study and Population Sciences Branch, Framingham, MA, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | | | - Stephen S Rich
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA, USA
| | - Renée de Mutsert
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Lu Qi
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Craig E Pennell
- School of Women's and Infants' Health, The University of Western Australia, Crawley, WA, Australia
| | - Oscar H Franco
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Terho Lehtimäki
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Mark A Herman
- Division Of Endocrinology, Metabolism, and Nutrition, Department of Medicine, Duke University School of Medicine, Durham, NC, USA
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Falkingham J, Qin M, Vlachantoni A, Evandrou M. Children's migration and lifestyle-related chronic disease among older parents 'left behind' in india. SSM Popul Health 2018; 3:352-357. [PMID: 29349228 PMCID: PMC5769047 DOI: 10.1016/j.ssmph.2017.03.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 03/18/2017] [Accepted: 03/28/2017] [Indexed: 11/22/2022] Open
Abstract
Lifestyle-related chronic diseases such as cardiovascular diseases and diabetes are now the leading causes of death and disability in India. Interestingly, those Indian states with the highest prevalence of lifestyle-related chronic disease among older adults are also found to have the highest rates of international or internal out-migration. This paper investigates the association between having migrant (adult) children and older parents’ lifestyle-related chronic disease in India. Bi-variate and multivariate analysis are conducted using data from a representative sample of 9507 adults aged 60 and older in seven Indian states from the UNFPA project ‘Building Knowledge Base on Ageing in India’. The results show that for any of the diagnosed conditions of hypertension, diabetes and heart disease, the prevalence among older people with a migrant son is higher than among those without. More specifically, the odds ratio of reporting a lifestyle-related chronic disease is higher among older adults with at least one adult son living in another district, State or outside India than those with their children living closer. This study contributes empirical evidence to the academic and policy debate about the consequences of globalization and urbanization for older people's health status generally, and particularly their risk for reporting chronic diseases that relate to changes in their lifestyle. The prevalence of chronic disease is high among ‘left behind’ older parents in India. Children's out-migration and (or) migration within different states and (or) different districts are risk factors. Selected chronic diseases include diagnosed hypertension, diabetes and heart disease. More research is required on the health consequences of globalization and urbanization.
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Affiliation(s)
- Jane Falkingham
- Centre for Research on Ageing and ESRC Centre for Population Change, University of Southampton, Southampton, SO17 1BJ, UK
| | - Min Qin
- Centre for Research on Ageing and ESRC Centre for Population Change, University of Southampton, Southampton, SO17 1BJ, UK
| | - Athina Vlachantoni
- Centre for Research on Ageing and ESRC Centre for Population Change, University of Southampton, Southampton, SO17 1BJ, UK
| | - Maria Evandrou
- Centre for Research on Ageing and ESRC Centre for Population Change, University of Southampton, Southampton, SO17 1BJ, UK
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21
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Preuss HG, Clouatre D, Swaroop A, Bagchi M, Bagchi D, Kaats GR. Blood Pressure Regulation: Reviewing Evidence for Interplay Between Common Dietary Sugars and Table Salt. J Am Coll Nutr 2017; 36:677-684. [PMID: 28960144 DOI: 10.1080/07315724.2017.1345338] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
A popular concept is that the significant global progression in prevalence and intensification of elevated blood pressure (BP) levels is due in part to dietary indiscretions. Excess intake of several food sources causing overweight/obesity plays an important role in BP perturbations. However, certain nutrients are involved in ways other than via body fat accumulation, particularly table salt (sodium chloride) and popular refined carbohydrates like dietary sugars (sucrose, fructose, high fructose corn syrup). In nondiabetics and diabetics, several functions of salt and sugar influence BP and metabolism. For example, salt intake is linked to volume expansion, insulin resistance, and hypertension, while sugar intake is associated with enhanced salt sensitivity via urinary sodium retention, insulin resistance, and hypertension. The key postulate evaluated here is that when two popular nutrients-salt and dietary sugars-are consumed together in adequate amounts, their respective individual BP effects are significantly amplified. In previous laboratory studies, a sugar challenge did not increase BP in the face of marked sodium depletion, and combining sugar and salt challenges caused a synergistic BP elevation. Among examples of amplification on the clinical side, the greatest increases in BP following sugar challenges were seen in diabetic subjects having the highest sodium excretion. Interplay between table salt and common dietary sugars in BP regulation is a reasonable postulate and should be carefully considered when developing optimal prevention and treatment regimens to ameliorate the worldwide crisis arising from harmful elevated BP levels.
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Affiliation(s)
- Harry G Preuss
- a Department of Biochemistry , Georgetown University Medical Center , Washington , DC , USA
| | | | - Anand Swaroop
- c Cepham Research Center , Piscataway , New Jersey , USA
| | | | - Debasis Bagchi
- c Cepham Research Center , Piscataway , New Jersey , USA.,e Department of Pharmacological and Pharmaceutical Services , University of Houston , Houston , Texas , USA
| | - Gilbert R Kaats
- f Integrative Health Technologies , San Antonio , Texas , USA
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22
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Meng G, Zhang B, Yu F, Li C, Zhang Q, Liu L, Wu H, Xia Y, Bao X, Shi H, Su Q, Gu Y, Fang L, Yang H, Yu B, Sun S, Wang X, Zhou M, Jia Q, Jiao H, Wang B, Guo Q, Carvalhoa LA, Sun Z, Song K, Yu M, Niu K. Soft drinks consumption is associated with nonalcoholic fatty liver disease independent of metabolic syndrome in Chinese population. Eur J Nutr 2017; 57:2113-2121. [PMID: 28702720 DOI: 10.1007/s00394-017-1485-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 06/08/2017] [Indexed: 02/06/2023]
Abstract
PURPOSE Excessive consumption of soft drinks is associated with nonalcoholic fatty liver disease (NAFLD). However, the association between soft drinks consumption and NAFLD is unclear in non-Caucasian adults with relatively low soft drinks consumption. The aim of this study was to assess the association between soft drinks consumption and NAFLD in Chinese adults. METHODS A cross-sectional study was conducted with 26,790 adults living in Tianjin, China. NAFLD (with elevated alanine aminotransferase [ALT]) was diagnosed by the liver ultrasonography and serum ALT concentrations. Soft drinks consumption was assessed using a validated self-administered food frequency questionnaire, and it was summarized as three categories for analysis: almost never (reference), <1 cup/week, and ≥1 cups/week. Metabolic syndrome (MetS) was defined according to the criteria of the American Heart Association scientific statements of 2009. The association between soft drinks consumption and NAFLD was assessed by multiple logistic regression analysis. RESULTS The prevalence of NAFLD and NAFLD with elevated ALT was 27.1 and 6.5%, respectively. After adjustment for potential confounding variables (including MetS), the odds ratios (95% confidence intervals) for NAFLD or NAFLD with elevated ALT across soft drinks consumption were 1.00 (reference) for almost never, 1.14 (1.02-1.27) or 1.16 (0.98-1.37) for <1 cup/week, and 1.26 (1.14-1.40) or 1.32 (1.13-1.53) for ≥1 cups/week (both P for trend <0.001), respectively. CONCLUSIONS This is the first study to demonstrate that soft drinks consumption is associated with NAFLD independent of MetS in Chinese adults with relatively low soft drinks consumption. These results suggest that reducing soft drinks consumption might be beneficial to the prevention of NAFLD.
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Affiliation(s)
- Ge Meng
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Bo Zhang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Fei Yu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Chunlei Li
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Qing Zhang
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Li Liu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Hongmei Wu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Yang Xia
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Xue Bao
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Hongbin Shi
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Qian Su
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Yeqing Gu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Liyun Fang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Huijun Yang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Bin Yu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Shaomei Sun
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Xing Wang
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Ming Zhou
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Qiyu Jia
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Huanli Jiao
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China.,Department of Gastroenterology, Tianjin Medical University General Hospital, Tianjin, China
| | - Bangmao Wang
- Department of Gastroenterology, Tianjin Medical University General Hospital, Tianjin, China
| | - Qi Guo
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, China
| | - Livia A Carvalhoa
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Zhong Sun
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, China
| | - Kun Song
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Ming Yu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, China.
| | - Kaijun Niu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, China. .,Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China.
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23
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Ma J, Jacques PF, Meigs JB, Fox CS, Rogers GT, Smith CE, Hruby A, Saltzman E, McKeown NM. Sugar-Sweetened Beverage but Not Diet Soda Consumption Is Positively Associated with Progression of Insulin Resistance and Prediabetes. J Nutr 2016; 146:2544-2550. [PMID: 27934644 DOI: 10.3945/jn.116.234047] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 05/06/2016] [Accepted: 10/11/2016] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Previous studies have shown an inconsistent relation between habitual beverage consumption and insulin resistance and prediabetes. OBJECTIVE The objective of the present study was to test the hypothesis that the consumption of sugar-sweetened beverages (SSBs), rather than diet soda, is associated with long-term progression of insulin resistance and the development of prediabetes. METHODS We analyzed the prospective association between cumulative mean consumption of SSBs or diet soda and incident prediabetes (n = 1685) identified across a median of 14 y of follow-up in participants [mean ± SD age: 51.9 ± 9.2 y; 59.6% women; mean ± SD body mass index (BMI; kg/m2): 26.3 ± 4.4] of the Framingham Offspring cohort. The prospective association between beverage consumption and change in homeostasis model assessment of insulin resistance (HOMA-IR; n = 2076) over ∼7 y was also analyzed. The cumulative mean consumption of SSBs and diet soda was estimated by using food-frequency questionnaires. Multivariable Cox proportional hazards models and linear regression models were implemented to estimate the HRs of incident prediabetes and change in HOMA-IR, respectively. RESULTS After adjustment for multiple potential confounders, including baseline BMI, we observed that SSB intake was positively associated with incident prediabetes (P-trend < 0.001); the highest SSB consumers (>3 servings/wk; median: 6 servings/wk) had a 46% higher risk of developing prediabetes than did the SSB nonconsumers (HR: 1.46; 95% CI: 1.16, 1.83). Higher SSB intake was also associated with a greater increase in HOMA-IR (P-trend = 0.006). No prospective associations were observed between diet soda intake and risk of prediabetes (P-trend = 0.24) or changes in HOMA-IR (P-trend = 0.25). These associations were similar after additional adjustment for change in BMI. CONCLUSION Regular SSB intake, but not diet soda intake, is associated with a greater increase in insulin resistance and a higher risk of developing prediabetes in a group of middle-aged adults.
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Affiliation(s)
| | | | - James B Meigs
- Division of General Internal Medicine, Department of Medicine, Harvard Medical School and Massachusetts General Hospital, Boston, MA; and
| | - Caroline S Fox
- Framingham Heart Study, Population Science Branch, National Heart, Lung, and Blood Institute, Framingham, MA
| | | | | | | | - Edward Saltzman
- Energy Metabolism Laboratory, USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
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Zhao L, Guo X, Wang O, Zhang H, Wang Y, Zhou F, Liu J, Ji B. Fructose and glucose combined with free fatty acids induce metabolic disorders in HepG2 cell: A new model to study the impacts of high-fructose/sucrose and high-fat diets in vitro. Mol Nutr Food Res 2016; 60:909-21. [DOI: 10.1002/mnfr.201500635] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 11/26/2015] [Accepted: 12/29/2015] [Indexed: 01/22/2023]
Affiliation(s)
- Liang Zhao
- Beijing Key Laboratory of Functional Food from Plant Resources; College of Food Science and Nutritional Engineering; China Agricultural University; Beijing P. R. China
| | - Xiaoxuan Guo
- Beijing Key Laboratory of Functional Food from Plant Resources; College of Food Science and Nutritional Engineering; China Agricultural University; Beijing P. R. China
| | - Ou Wang
- Beijing Key Laboratory of Functional Food from Plant Resources; College of Food Science and Nutritional Engineering; China Agricultural University; Beijing P. R. China
| | | | - Yong Wang
- Beijing Key Laboratory of Functional Food from Plant Resources; College of Food Science and Nutritional Engineering; China Agricultural University; Beijing P. R. China
| | - Feng Zhou
- Beijing Key Laboratory of Functional Food from Plant Resources; College of Food Science and Nutritional Engineering; China Agricultural University; Beijing P. R. China
| | - Jia Liu
- China National Research Institute of Food and Fermentation Industries; Beijing P. R. China
| | - Baoping Ji
- Beijing Key Laboratory of Functional Food from Plant Resources; College of Food Science and Nutritional Engineering; China Agricultural University; Beijing P. R. China
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25
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Silveira JQ, Dourado GKZS, Cesar TB. Red-fleshed sweet orange juice improves the risk factors for metabolic syndrome. Int J Food Sci Nutr 2015; 66:830-6. [DOI: 10.3109/09637486.2015.1093610] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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26
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Stanhope KL. Sugar consumption, metabolic disease and obesity: The state of the controversy. Crit Rev Clin Lab Sci 2015; 53:52-67. [PMID: 26376619 DOI: 10.3109/10408363.2015.1084990] [Citation(s) in RCA: 397] [Impact Index Per Article: 44.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The impact of sugar consumption on health continues to be a controversial topic. The objective of this review is to discuss the evidence and lack of evidence that allows the controversy to continue, and why resolution of the controversy is important. There are plausible mechanisms and research evidence that supports the suggestion that consumption of excess sugar promotes the development of cardiovascular disease (CVD) and type 2 diabetes (T2DM) both directly and indirectly. The direct pathway involves the unregulated hepatic uptake and metabolism of fructose, leading to liver lipid accumulation, dyslipidemia, decreased insulin sensitivity and increased uric acid levels. The epidemiological data suggest that these direct effects of fructose are pertinent to the consumption of the fructose-containing sugars, sucrose and high fructose corn syrup (HFCS), which are the predominant added sugars. Consumption of added sugar is associated with development and/or prevalence of fatty liver, dyslipidemia, insulin resistance, hyperuricemia, CVD and T2DM, often independent of body weight gain or total energy intake. There are diet intervention studies in which human subjects exhibited increased circulating lipids and decreased insulin sensitivity when consuming high sugar compared with control diets. Most recently, our group has reported that supplementing the ad libitum diets of young adults with beverages containing 0%, 10%, 17.5% or 25% of daily energy requirement (Ereq) as HFCS increased lipid/lipoprotein risk factors for CVD and uric acid in a dose-response manner. However, un-confounded studies conducted in healthy humans under a controlled, energy-balanced diet protocol that enables determination of the effects of sugar with diets that do not allow for body weight gain are lacking. Furthermore, recent reports conclude that there are no adverse effects of consuming beverages containing up to 30% Ereq sucrose or HFCS, and the conclusions from several meta-analyses suggest that fructose has no specific adverse effects relative to any other carbohydrate. Consumption of excess sugar may also promote the development of CVD and T2DM indirectly by causing increased body weight and fat gain, but this is also a topic of controversy. Mechanistically, it is plausible that fructose consumption causes increased energy intake and reduced energy expenditure due to its failure to stimulate leptin production. Functional magnetic resonance imaging (fMRI) of the brain demonstrates that the brain responds differently to fructose or fructose-containing sugars compared with glucose or aspartame. Some epidemiological studies show that sugar consumption is associated with body weight gain, and there are intervention studies in which consumption of ad libitum high-sugar diets promoted increased body weight gain compared with consumption of ad libitum low- sugar diets. However, there are no studies in which energy intake and weight gain were compared in subjects consuming high or low sugar, blinded, ad libitum diets formulated to ensure both groups consumed a comparable macronutrient distribution and the same amounts of fiber. There is also little data to determine whether the form in which added sugar is consumed, as beverage or as solid food, affects its potential to promote weight gain. It will be very challenging to obtain the funding to conduct the clinical diet studies needed to address these evidence gaps, especially at the levels of added sugar that are commonly consumed. Yet, filling these evidence gaps may be necessary for supporting the policy changes that will help to turn the food environment into one that does not promote the development of obesity and metabolic disease.
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Affiliation(s)
- Kimber L Stanhope
- a Department of Molecular Biosciences , School of Veterinary Medicine and.,b Department of Nutrition , University of California , Davis , CA , USA
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27
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Sugar sweetened beverages and fatty liver disease: Rising concern and call to action. J Hepatol 2015; 63:306-8. [PMID: 26036988 DOI: 10.1016/j.jhep.2015.05.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 05/22/2015] [Indexed: 01/05/2023]
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29
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Fung TT, Kashambwa R, Sato K, Chiuve SE, Fuchs CS, Wu K, Giovannucci E, Ogino S, Hu FB, Meyerhardt JA. Post diagnosis diet quality and colorectal cancer survival in women. PLoS One 2014; 9:e115377. [PMID: 25506700 PMCID: PMC4266679 DOI: 10.1371/journal.pone.0115377] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Accepted: 11/21/2014] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Dietary factors are known to influence colorectal cancer (CRC) risk, however, their association with CRC survival is unclear. Therefore, we prospectively examined the association between diet quality scores, dietary patterns and colorectal cancer (CRC) survival. METHODS 1201 women diagnosed with stage I-III CRC between 1986 and 2008, were followed through 2010. Diet was assessed via a food frequency questionnaire administered at least 6 months after diagnosis. We computed the Alternate Healthy Eating Index-2010 (AHEI-2010), alternate Mediterranean Diet score (aMED) and Dietary Approaches to Stop Hypertension score (DASH) and derived two dietary patterns, Western (unhealthy) and prudent (healthy), by principal component analysis for each woman. RESULTS During follow-up, we documented 435 deaths, including 162 from CRC. After adjusting for potential confounders, only a higher AHEI-2010 score was significantly associated with lower overall mortality (HR comparing extreme quintiles = 0.71, 95% CI 0.52-0.98, p trend = 0.01) as well as borderline significantly with lower risk of CRC mortality by the trend test (HR Q5 vs Q1 = 0.72, 95% CI = 0.43-1.21, p trend = 0.07). When AHEI-2010 components were examined separately, inverse associations for overall mortality were primarily accounted for by moderate alcohol intake (HR comparing abstainers vs 5-15 g/d = 1.30, 95%CI = 1.05-1.61) and lower intake of sugar sweetened beverages and fruit juices combined (HR for each additional serving = 1.11, 95% CI = 1.01-1.23). No other diet quality score or dietary pattern was associated with overall or CRC-specific mortality. CONCLUSION Higher AHEI-2010 score may be associated with lower overall mortality, moderate alcohol consumption and lower consumption of sugar sweetened beverages and juices combined appeared to account for most of the observed associations.
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Affiliation(s)
- Teresa T. Fung
- Department of Nutrition, Simmons College, Boston, Massachusetts, United States of America
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, United States of America
- * E-mail:
| | - Rutendo Kashambwa
- Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts, United States of America
| | - Kaori Sato
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, Massachusetts, United States of America
| | - Stephanie E. Chiuve
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Charles S. Fuchs
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, Massachusetts, United States of America
| | - Kana Wu
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Edward Giovannucci
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Shuji Ogino
- Channing Division of Network Medicine, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, Massachusetts, United States of America
| | - Frank B. Hu
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, United States of America
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Jeffrey A. Meyerhardt
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, Massachusetts, United States of America
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Leung CW, Laraia BA, Needham BL, Rehkopf DH, Adler NE, Lin J, Blackburn EH, Epel ES. Soda and cell aging: associations between sugar-sweetened beverage consumption and leukocyte telomere length in healthy adults from the National Health and Nutrition Examination Surveys. Am J Public Health 2014; 104:2425-31. [PMID: 25322305 DOI: 10.2105/ajph.2014.302151] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We tested whether leukocyte telomere length maintenance, which underlies healthy cellular aging, provides a link between sugar-sweetened beverage (SSB) consumption and the risk of cardiometabolic disease. METHODS We examined cross-sectional associations between the consumption of SSBs, diet soda, and fruit juice and telomere length in a nationally representative sample of healthy adults. The study population included 5309 US adults, aged 20 to 65 years, with no history of diabetes or cardiovascular disease, from the 1999 to 2002 National Health and Nutrition Examination Surveys. Leukocyte telomere length was assayed from DNA specimens. Diet was assessed using 24-hour dietary recalls. Associations were examined using multivariate linear regression for the outcome of log-transformed telomere length. RESULTS After adjustment for sociodemographic and health-related characteristics, sugar-sweetened soda consumption was associated with shorter telomeres (b = -0.010; 95% confidence interval [CI] = -0.020, -0.001; P = .04). Consumption of 100% fruit juice was marginally associated with longer telomeres (b = 0.016; 95% CI = -0.000, 0.033; P = .05). No significant associations were observed between consumption of diet sodas or noncarbonated SSBs and telomere length. CONCLUSIONS Regular consumption of sugar-sweetened sodas might influence metabolic disease development through accelerated cell aging.
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Affiliation(s)
- Cindy W Leung
- Cindy W. Leung is with the Center for Health and Community, School of Medicine, University of California, San Francisco. Barbara A. Laraia is with the School of Public Health, University of California, Berkeley. Belinda Needham is with the Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor. David H. Rehkopf is with the Department of Medicine, Stanford University, Palo Alto, CA. Nancy E. Adler and Elissa S. Epel are with the Center for Health and Community and the Department of Psychiatry, School of Medicine, University of California, San Francisco. Jue Lin and Elizabeth H. Blackburn are with the Department of Biochemistry and Biophysics, University of California, San Francisco
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Lana A, Rodríguez-Artalejo F, Lopez-Garcia E. Consumption of sugar-sweetened beverages is positively related to insulin resistance and higher plasma leptin concentrations in men and nonoverweight women. J Nutr 2014; 144:1099-105. [PMID: 24828025 DOI: 10.3945/jn.114.195230] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The mechanisms for the association of the consumption of sugar-sweetened beverages (SSBs) with obesity and type 2 diabetes are only partly understood. The objective of the study was to examine the association of habitual SSB consumption with biomarkers of energy metabolism, including serum glucose, glycated hemoglobin, insulin, insulin resistance [homeostasis model assessment of insulin resistance (HOMA-IR)], and leptin. Data were taken from the Study on Nutrition and Cardiovascular Risk in Spain (ENRICA), a cross-sectional study conducted during 2008-2010 in 7842 individuals representative of the population of Spain aged 18-59 y. Diet was assessed with a validated computerized diet history. Biomarkers were determined in 12-h fasting blood samples. Analyses were performed with linear regression with adjustment for the main confounders, including body mass index (BMI), waist circumference, and morbidity. In men, a 1-serving (200 mL)/d increase in the consumption of SSBs was associated with higher plasma concentrations of insulin (2.14%, P = 0.01), higher HOMA-IR (1.90%, P = 0.04), and higher concentrations of leptin (2.73%, P = 0.01). Among women, these associations were found only in those with a BMI <25 kg/m² (insulin: 2.88%, P = 0.004; HOMA-IR: 3.03%, P = 0.01; and leptin: 4.57%, P = 0.01) or with a waist circumference <80 cm (insulin: 2.79%, P = 0.01; HOMA-IR: 3.00%, P = 0.01; and leptin: 3.63%, P = 0.05). In conclusion, the consumption of SSBs was associated with higher concentrations of insulin and leptin and a higher HOMA-IR in men and in nonoverweight women. Insulin resistance and higher leptin may be early markers of metabolic dysfunction associated with SSBs.
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Affiliation(s)
- Alberto Lana
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/La Paz Health Research Institute, CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; and Department of Medicine, Area of Preventive Medicine and Public Health, School of Medicine and Health Sciences, Universidad de Oviedo, Oviedo, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/La Paz Health Research Institute, CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; and
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/La Paz Health Research Institute, CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; and
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Green AK, Jacques PF, Rogers G, Fox CS, Meigs JB, McKeown NM. Sugar-sweetened beverages and prevalence of the metabolically abnormal phenotype in the Framingham Heart Study. Obesity (Silver Spring) 2014; 22:E157-63. [PMID: 24550031 PMCID: PMC4139414 DOI: 10.1002/oby.20724] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 02/06/2014] [Accepted: 02/14/2014] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The purpose of this study was to examine the relationship between usual sugar-sweetened beverage (SSB) consumption and prevalence of abnormal metabolic health across body mass index (BMI) categories. METHODS The metabolic health of 6,842 non-diabetic adults was classified using cross-sectional data from the Framingham Heart Study Offspring (1998-2001) and Third Generation (2002-2005) cohorts. Adults were classified as normal weight, overweight or obese and, within these categories, metabolic health was defined based on five criteria-hypertension, elevated fasting glucose, elevated triglycerides, low HDL cholesterol, and insulin resistance. Individuals without metabolic abnormalities were considered metabolically healthy. Logistic regression was used to examine the associations between categories of SSB consumption and risk of metabolic health after stratification by BMI. RESULTS Comparing the highest category of SSB consumers (median of 7 SSB per week) to the lowest category (non-consumers), odds ratios (95% confidence intervals) for metabolically abnormal phenotypes, compared to the metabolically normal, were 1.9 (1.1-3.4) among the obese, 2.0 (1.4-2.9) among the overweight, and 1.9 (1.4-2.6) among the normal weight individuals. CONCLUSIONS In this cross-sectional analysis, it is observed that, irrespective of weight status, consumers of SSB were more likely to display metabolic abnormalities compared to non-consumers in a dose-dependent manner.
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Affiliation(s)
| | - Paul F. Jacques
- U.S. Department of Agriculture, Jean Mayer Human Nutrition
Research Center on Aging, Tufts University, Boston, MA
- Friedman School of Nutrition Science and Policy, Tufts
University, Boston, MA
| | - Gail Rogers
- U.S. Department of Agriculture, Jean Mayer Human Nutrition
Research Center on Aging, Tufts University, Boston, MA
| | - Caroline S. Fox
- National Heart, Lung and Blood Institute’s Framingham
Heart Study, Framingham, MA, and the Division of Endocrinology, Metabolism and Diabetes,
Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School,
Boston, MA
| | - James B. Meigs
- General Medicine Division, Department of Medicine, Massachusetts
General Hospital and Harvard Medical School, Boston, MA
| | - Nicola M. McKeown
- U.S. Department of Agriculture, Jean Mayer Human Nutrition
Research Center on Aging, Tufts University, Boston, MA
- Friedman School of Nutrition Science and Policy, Tufts
University, Boston, MA
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Heden TD, Liu Y, Kearney ML, Kanaley JA. Weight classification does not influence the short-term endocrine or metabolic effects of high-fructose corn syrup-sweetened beverages. Appl Physiol Nutr Metab 2013; 39:544-52. [PMID: 24766236 DOI: 10.1139/apnm-2013-0407] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Obesity and high-fructose corn syrup (HFCS)-sweetened beverages are associated with an increased risk of chronic disease, but it is not clear whether obese (Ob) individuals are more susceptible to the detrimental effects of HFCS-sweetened beverages. The purpose of this study was to examine the endocrine and metabolic effects of consuming HFCS-sweetened beverages, and whether weight classification (normal weight (NW) vs. Ob) influences these effects. Ten NW and 10 Ob men and women who habitually consumed ≤355 mL per day of sugar-sweetened beverages were included in this study. Initially, the participants underwent a 4-h mixed-meal test after a 12-h overnight fast to assess insulin sensitivity, pancreatic and gut endocrine responses, insulin secretion and clearance, and glucose, triacylglycerol, and cholesterol responses. Next, the participants consumed their normal diet ad libitum, with 1065 mL per day (117 g·day(-1)) of HFCS-sweetened beverages added for 2 weeks. After the intervention, the participants repeated the mixed-meal test. HFCS-sweetened beverages did not significantly alter body weight, insulin sensitivity, insulin secretion or clearance, or endocrine, glucose, lipid, or cholesterol responses in either NW or Ob individuals. Regardless of previous diet, Ob individuals, compared with NW individuals, had ∼28% lower physical activity levels, 6%-9% lower insulin sensitivity, 12%-16% lower fasting high-density-lipoprotein cholesterol concentrations, 84%-144% greater postprandial triacylglycerol concentrations, and 46%-79% greater postprandial insulin concentrations. Greater insulin responses were associated with reduced insulin clearance, and there were no differences in insulin secretion. These findings suggest that weight classification does not influence the short-term endocrine and metabolic effects of HFCS-sweetened beverages.
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Affiliation(s)
- Timothy D Heden
- Department of Nutrition and Exercise Physiology, University of Missouri, 217 Gwynn Hall, Columbia, MO 65211, USA
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Wang JW, Mark S, Henderson M, O'Loughlin J, Tremblay A, Wortman J, Paradis G, Gray-Donald K. Adiposity and glucose intolerance exacerbate components of metabolic syndrome in children consuming sugar-sweetened beverages: QUALITY cohort study. Pediatr Obes 2013; 8:284-93. [PMID: 23172617 DOI: 10.1111/j.2047-6310.2012.00108.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Revised: 08/26/2012] [Accepted: 09/12/2012] [Indexed: 12/23/2022]
Abstract
BACKGROUND Sugar-sweetened beverage (SSB) consumption is linked to weight gain and metabolic syndrome (MetS) components in children, but whether these associations are modified by excess weight and glucose tolerance status in children is not known. OBJECTIVE The objective of this study was to examine the cross-sectional associations between SSB intake and MetS components among children above and below the 85th body mass index (BMI) percentile and those with and without impaired glucose tolerance (IGT). METHODS Data were from the QUébec Adiposity and Lifestyle InvesTigation in Youth study (2005-2008). Caucasian children aged 8-10 years (n = 632) were recruited from 1040 primary schools in Québec, Canada. SSB consumption was assessed by three 24-h dietary recalls, body fat mass by dual-energy absorptiometry, physical activity by 7-d accelerometer. Multivariate linear regressions were used, with age, sex, fat mass index and physical activity as covariates, including waist circumference (WC), systolic blood pressure (SBP), concentrations of triglyceride and high-density lipoprotein cholesterol and homeostasis model assessment of insulin resistance (HOMA-IR) as outcome variables. RESULTS Among overweight children, a 100-mL higher SSB consumption was associated with a 0.1-unit higher HOMA-IR (P = 0.009) and a 1.1-mm Hg higher SBP (P = 0.001). In children with IGT, a 100-mL higher SSB consumption was associated with a 1.4-mm Hg higher SBP and a 4.0-cm higher WC (P < 0.001). These associations were not observed among children <85th BMI percentile. CONCLUSIONS Our results suggest that the association between higher SSB consumption and MetS components is more evident in overweight/obese and glucose-intolerant children.
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Affiliation(s)
- J W Wang
- School of Dietetics and Human Nutrition, McGill University, Ste-Anne-de-Bellevue, Québec, Canada
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Simopoulos AP. Dietary omega-3 fatty acid deficiency and high fructose intake in the development of metabolic syndrome, brain metabolic abnormalities, and non-alcoholic fatty liver disease. Nutrients 2013; 5:2901-23. [PMID: 23896654 PMCID: PMC3775234 DOI: 10.3390/nu5082901] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2013] [Revised: 07/24/2013] [Accepted: 07/24/2013] [Indexed: 12/11/2022] Open
Abstract
Western diets are characterized by both dietary omega-3 fatty acid deficiency and increased fructose intake. The latter found in high amounts in added sugars such as sucrose and high fructose corn syrup (HFCS). Both a low intake of omega-3 fatty acids or a high fructose intake contribute to metabolic syndrome, liver steatosis or non-alcoholic fatty liver disease (NAFLD), promote brain insulin resistance, and increase the vulnerability to cognitive dysfunction. Insulin resistance is the core perturbation of metabolic syndrome. Multiple cognitive domains are affected by metabolic syndrome in adults and in obese adolescents, with volume losses in the hippocampus and frontal lobe, affecting executive function. Fish oil supplementation maintains proper insulin signaling in the brain, ameliorates NAFLD and decreases the risk to metabolic syndrome suggesting that adequate levels of omega-3 fatty acids in the diet can cope with the metabolic challenges imposed by high fructose intake in Western diets which is of major public health importance. This review presents the current status of the mechanisms involved in the development of the metabolic syndrome, brain insulin resistance, and NAFLD a most promising area of research in Nutrition for the prevention of these conditions, chronic diseases, and improvement of Public Health.
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Affiliation(s)
- Artemis P Simopoulos
- The Center for Genetics, Nutrition and Health, 2001 S Street, NW, Suite 530, Washington, DC 20009, USA.
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Romero-Polvo A, Denova-Gutiérrez E, Rivera-Paredez B, Castañón S, Gallegos-Carrillo K, Halley-Castillo E, Borges G, Flores M, Salmerón J. Association between dietary patterns and insulin resistance in Mexican children and adolescents. ANNALS OF NUTRITION AND METABOLISM 2013; 61:142-50. [PMID: 23037180 DOI: 10.1159/000341493] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2012] [Accepted: 06/12/2012] [Indexed: 02/03/2023]
Abstract
BACKGROUND/OBJECTIVE Insulin resistance (IR) is a metabolic disorder that is increasing worldwide and has been associated with several negative health outcomes. The aim of this study was to evaluate the relationship between different dietary patterns and IR among Mexican children and adolescents. METHODS We performed a cross-sectional analysis on baseline data from Mexican children and adolescents aged 7–18 years participating in the Health Workers Cohort Study. We included 916 children and adolescents of both sexes. Fasting serum glucose and insulin levels were determined by standardized methods. We defined IR using the homeostasis model assessment (HOMA) as ≥3.5. Factor analysis was used to identify dietary patterns. The associations of interest, those between IR and dietary patterns, were analyzed with multiple logistic regression models. RESULTS IR prevalence was 20.3% among girls and boys aged 7–18 years, for whom the prevalence of overweight and obesity was 29.7%. We identified 3 major dietary patterns in this group: ‘Western’, ‘prudent’ and ‘high protein/fat’. For the purposes of this analysis we compared the upper versus the lower quintile of each dietary pattern. Independently of other covariates, participants in the highest quintile of the Western pattern had 92% greater odds of IR (OR 1.92, 95% CI: 1.08–3.43) compared with those in the lowest quintile. CONCLUSIONS These findings support the hypothesis that high carbohydrate diets like our Western dietary pattern may increase IR in young people. This result emphasizes the importance of preventive nutrition interventions geared toward Mexican children and adolescents.
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Affiliation(s)
- Angeles Romero-Polvo
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Instituto Mexicano del Seguro Social, México City, Mexico
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Karsenty J, Landrier JF, Rousseau-Ralliard D, Robbez-Masson V, Margotat A, Deprez P, Lechêne P, Grynberg A, Lairon D, Planells R, Gastaldi M. Beneficial effects of omega-3 fatty acids on the consequences of a fructose diet are not mediated by PPAR delta or PGC1 alpha. Eur J Nutr 2012; 52:1865-74. [PMID: 23269653 DOI: 10.1007/s00394-012-0488-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Accepted: 12/12/2012] [Indexed: 11/29/2022]
Abstract
PURPOSE To study, in high-fructose-fed rats, the effect of a dietary enrichment in omega-3 polyunsaturated fatty acids (n-3 PUFA) on the expression of genes involved in lipid metabolism and cardiovascular function. METHODS Twenty-eight male "Wistar Han" rats received for 8 weeks, either a standard chow food or an isocaloric 67% fructose diet enriched or not in alpha-linolenic acid (ALA) or in docosahexaenoic (DHA) and eicosapentaenoic acids (EPA) mix (DHA/EPA). After sacrifice, blood was withdrawn for biochemical analyses; heart, periepididymal adipose tissue and liver were collected and analyzed for the expression of 22 genes by real-time PCR. RESULTS Fructose intake resulted in an increase in liver weight and triglyceride content, plasma triglyceride and cholesterol concentrations, although no difference in glucose and insulin. In the liver, lipogenesis was promoted as illustrated by an increase in stearoyl-CoA desaturase and fatty acid synthase (Fasn) together with a decrease in PPAR gamma, delta and PPAR gamma coactivator 1 alpha (PGC1 alpha) expression. In the heart, Fasn and PPAR delta expression were increased. The addition of ALA or DHA/EPA into the diet resulted in a protection against fructose effects except for the decreased expression of PPARs in the liver that was not counterbalanced by n-3 PUFA suggesting that n-3 PUFA and fructose act independently on the expression of PPARs and PGC1 alpha. CONCLUSIONS In liver, but not in heart, the fructose-enriched diet induces an early tissue-specific reduction in PPAR gamma and delta expression, which is insensitive to n-3 PUFA intake and dissociated from lipogenesis.
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Affiliation(s)
- Julie Karsenty
- Aix Marseille Université, NORT, 13005, Marseille, France
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O’Neil CE, Nicklas TA, Rampersaud GC, Fulgoni III VL. 100% orange juice consumption is associated with better diet quality, improved nutrient adequacy, decreased risk for obesity, and improved biomarkers of health in adults: National Health and Nutrition Examination Survey, 2003-2006. Nutr J 2012; 11:107. [PMID: 23234248 PMCID: PMC3545988 DOI: 10.1186/1475-2891-11-107] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2012] [Accepted: 11/30/2012] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Consumption of 100% orange juice (OJ) has been positively associated with nutrient adequacy and diet quality, with no increased risk of overweight/obesity in children; however, no one has examined these factors in adults. The purpose of this study was to examine the association of 100% OJ consumption with nutrient adequacy, diet quality, and risk factors for metabolic syndrome (MetS) in a nationally representative sample of adults. METHODS Data from adults 19+ years of age (n = 8,861) participating in the National Health and Nutrition Examination Survey 2003-2006 were used. The National Cancer Institute method was used to estimate the usual intake (UI) of 100% OJ consumption, selected nutrients, and food groups. Percentages of the population below the Estimated Average Requirement (EAR) or above the Adequate Intake (AI) were determined. Diet quality was measured by the Healthy Eating Index-2005 (HEI-2005). Covariate adjusted logistic regression was used to determine if consumers had a lower odds ratio of being overweight or obese or having risk factors of MetS or MetS. RESULTS Usual per capita intake of 100% OJ was 50.3 ml/d. Among consumers (n = 2,310; 23.8%), UI was 210.0 ml/d. Compared to non-consumers, consumers had a higher (p < 0.05) percentage (% ± SE) of the population meeting the EAR for vitamin A (39.7 ± 2.5 vs 54.0 ± 1.2), vitamin C (0.0 ± 0.0 vs 59.0 ± 1.4), folate (5.8 ± 0.7 vs 15.1 ± 0.9), and magnesium (51.6 ± 1.6 vs 63.7 ± 1.2). Consumers were also more likely to be above the AI for potassium (4.1 ± 0.8 vs 1.8 ± 0.2). HEI-2005 was significantly (p < 0.05) higher in consumers (55.0 ± 0.4 vs 49.7 ± 0.3). Consumers also had higher intakes of total fruit, fruit juice, whole fruit, and whole grain. Consumers had a lower (p < 0.05) mean body mass index (27.6 ± 0.2 vs 28.5 ± 0.1), total cholesterol levels (197.6 ± 1.2 vs 200.8 ± 0.75 mg/dL), and low density lipoprotein-cholesterol levels (112.5 ± 1.4 vs 116.7 ± 0.93 mg/dL). Finally, compared to non-consumers of 100% OJ, consumers were 21% less likely to be obese and male consumers were 36% less likely to have MetS. CONCLUSION The results suggest that moderate consumption of 100% OJ should be encouraged to help individuals meet the USDA daily recommendation for fruit intake and as a component of a healthy diet.
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Affiliation(s)
- Carol E O’Neil
- Louisiana State University Agricultural Center, 261 Knapp Hall, Baton Rouge, Louisiana, 70803, USA
| | - Theresa A Nicklas
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, 77030, USA
| | - Gail C Rampersaud
- Food Science and Human Nutrition Department, University of Florida, Gainesville, Florida, 32611, USA
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Diet soft drink consumption is associated with an increased risk of vascular events in the Northern Manhattan Study. J Gen Intern Med 2012; 27:1120-6. [PMID: 22282311 PMCID: PMC3514985 DOI: 10.1007/s11606-011-1968-2] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2011] [Revised: 10/14/2011] [Accepted: 12/02/2011] [Indexed: 02/06/2023]
Abstract
BACKGROUND Diet and regular soft drinks have been associated with diabetes and the metabolic syndrome, and regular soft drinks with coronary heart disease. OBJECTIVE To determine the association between soft drinks and combined vascular events, including stroke. DESIGN A population-based cohort study of stroke incidence and risk factors. PARTICANTS: Participants (N= 2564, 36% men, mean age 69 ± 10, 20% white, 23% black, 53% Hispanic) were from the Northern Manhattan Study. MAIN MEASURES We assessed diet and regular soft drink consumption using a food frequency questionnaire at baseline, and categorized: none (<1/month, N = 1948 diet, N = 1333 regular), light (1/month-6/week, N = 453 diet, N = 995 regular), daily (≥1/day, N = 163 diet, N = 338 regular). Over a mean follow-up of 10 years, we examined the association between soft drink consumption and 591 incident vascular events (stroke, myocardial infarction, vascular death) using Cox models. KEY RESULTS Controlling for age, sex, race/ethnicity, education, smoking, physical activity, alcohol consumption, BMI, daily calories, consumption of protein, carbohydrates, total fat, saturated fat, and sodium, those who drank diet soft drinks daily (vs. none) had an increased risk of vascular events, and this persisted after controlling further for the metabolic syndrome, peripheral vascular disease, diabetes, cardiac disease, hypertension, and hypercholesterolemia (HR = 1.43, 95% CI = 1.06-1.94). There was no increased risk of vascular events associated with regular soft drinks or light diet soft drink consumption. CONCLUSIONS Daily diet soft drink consumption was associated with several vascular risk factors and with an increased risk for vascular events. Further research is needed before any conclusions can be made regarding the potential health consequences of diet soft drink consumption.
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Nutritional determinants of worldwide diabetes: an econometric study of food markets and diabetes prevalence in 173 countries. Public Health Nutr 2012; 16:179-86. [PMID: 22691632 DOI: 10.1017/s1368980012002881] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Ageing and urbanization leading to sedentary lifestyles have been the major explanations proposed for a dramatic rise in diabetes worldwide and have been the variables used to predict future diabetes rates. However, a transition to Western diets has been suggested as an alternative driver. We sought to determine what socio-economic and dietary factors are the most significant population-level contributors to diabetes prevalence rates internationally. DESIGN Multivariate regression models were used to study how market sizes of major food products (sugars, cereals, vegetable oils, meats, total joules) corresponded to diabetes prevalence, incorporating lagged and cumulative effects. The underlying social determinants of food market sizes and diabetes prevalence rates were also studied, including ageing, income, urbanization, overweight prevalence and imports of foodstuffs. SETTING Data were obtained from 173 countries. SUBJECTS Population-based survey recipients were the basis for diabetes prevalence and food market data. RESULTS We found that increased income tends to increase overall food market size among low- and middle-income countries, but the level of food importation significantly shifts the content of markets such that a greater proportion of available joules is composed of sugar and related sweeteners. Sugar exposure statistically explained why urbanization and income have been correlated with diabetes rates. CONCLUSIONS Current diabetes projection methods may estimate future diabetes rates poorly if they fail to incorporate the impact of nutritional factors. Imported sugars deserve further investigation as a potential population-level driver of global diabetes.
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Mattei J, Malik V, Hu FB, Campos H. Substituting homemade fruit juice for sugar-sweetened beverages is associated with lower odds of metabolic syndrome among Hispanic adults. J Nutr 2012; 142:1081-7. [PMID: 22551801 PMCID: PMC3349979 DOI: 10.3945/jn.111.149344] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Consumption of sugar-sweetened beverages (SSB) has been associated with metabolic syndrome (MetS); however, studies conducted on Hispanic adults are scarce. To determine the association between beverages consumed by Hispanic adults and MetS and its components, data were analyzed in 1872 Costa Rican adults who served as controls of a population-based, case-control study of coronary heart disease. Multivariate-adjusted means were calculated for components of MetS by servings (never, ≤ 1/wk; 2-6/wk, ≥ 1/d) of 2 traditional fruit-based beverages ("fresco" and freshly-squeezed homemade fruit juice, separately) and 2 SSB (instant drinks and regular sodas, separately and combined). The prevalence ratio (PR) of MetS was calculated for each beverage and the OR was calculated by substituting one serving of homemade fruit juice or water for one of SSB. Significant positive trends were observed for increasing servings of instant drinks with plasma TG and waist circumference and for regular soda with waist circumference (all P-trend < 0.001). Increasing servings of homemade fruit juice were positively associated with HDL cholesterol (P-trend = 0.033). Consuming ≥1 serving/d of instant drinks was associated with a higher PR of MetS [1.42 (95% CI: 1.11, 1.83)] compared with no consumption. Substituting one serving of homemade fruit juice for instant drink was associated with 29% (95% CI: 7, 47%) lower odds of MetS and for regular soda with 30% (95% CI: 1, 50%) lower odds. Substituting water for combined SSB was marginally significant (OR = 0.86 (95% CI: 0.74, 1.00). In conclusion, reducing the consumption of SSB and substituting them with homemade fruit juices in moderation may be a culturally appropriate approach to lower MetS among Hispanic adults.
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Affiliation(s)
- Josiemer Mattei
- Department of Nutrition, Harvard School of Public Health, Boston, MA
| | - Vasanti Malik
- Department of Nutrition, Harvard School of Public Health, Boston, MA
| | - Frank B. Hu
- Department of Nutrition, Harvard School of Public Health, Boston, MA,Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Hannia Campos
- Department of Nutrition, Harvard School of Public Health, Boston, MA,To whom correspondence should be addressed. E-mail:
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Odegaard AO, Choh AC, Czerwinski SA, Towne B, Demerath EW. Sugar-sweetened and diet beverages in relation to visceral adipose tissue. Obesity (Silver Spring) 2012; 20:689-91. [PMID: 21901024 PMCID: PMC3288354 DOI: 10.1038/oby.2011.277] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Frequent sugar-sweetened beverage (SSB) intake has been consistently associated with increased adiposity and cardio-metabolic risk, whereas the association with diet beverages is more mixed. We examined how these beverages associate with regional abdominal adiposity measures, specifically visceral adipose tissue (VAT). In a cross-sectional analysis of 791 non-Hispanic white men and women aged 18-70 we examined how beverage consumption habits obtained from a food frequency questionnaire associate with overall and abdominal adiposity measures from MRI. With increasing frequency of SSB intake, we observed increases in waist circumference (WC) and the proportion of visceral to subcutaneous abdominal adipose tissue (VAT%), with no change in total body fat (TBF%) or BMI. Greater frequency of diet beverage intake was associated with greater WC, BMI, and TBF%, but was not associated with variation in visceral adiposity We conclude that increased frequency of SSB consumption is associated with a more adverse abdominal adipose tissue deposition pattern.
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Affiliation(s)
- Andrew O Odegaard
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.
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Abstract
With the diabetes epidemic reaching menacing proportions worldwide, there is an urgent need for the development of cost-efficient prevention strategies to be effective at the population level. Great potential in this direction lies in properly designed, large-scale dietary interventions. The macronutrient composition and the caloric content of our diet are major determinants of glucose homeostasis and there is a continuously growing list of foods, nutrients or individual compounds that have been associated with an increased or reduced incidence of diabetes mellitus. These include fat, carbohydrates, fibre, alcohol, polyphenols and other micronutrients or individual dietary compounds, which have been shown to either promote or prevent a progression towards a (pre-)diabetic state. This review aims to briefly summarize relevant epidemiological data linking foods to diabetes and to provide insights into the mechanisms through which these effects are mediated. These include improvement of insulin sensitivity or promotion of insulin resistance, regulation of inflammatory pathways, regulation of glucose transport and tissue glucose uptake, aggravation or attenuation of postprandial glycaemia/insulinaemia, interactions with hormonal responses and β-cell-dependent mechanisms.
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Affiliation(s)
- Theodoros Thomas
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.
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Stanhope KL. Role of fructose-containing sugars in the epidemics of obesity and metabolic syndrome. Annu Rev Med 2011; 63:329-43. [PMID: 22034869 DOI: 10.1146/annurev-med-042010-113026] [Citation(s) in RCA: 148] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
There is controversy concerning the role of sugar in the epidemics of obesity and metabolic syndrome. There is less controversy concerning the effects of fructose on components of metabolic syndrome; consumption of fructose has been shown to increase visceral adipose deposition and de novo lipogenesis (DNL), produce dyslipidemia, and decrease insulin sensitivity in older, overweight/obese subjects. This review examines the potential mechanisms of these effects of fructose and considers whether these mechanisms are relevant to the effects of consuming sucrose or high-fructose corn syrup. Evidence demonstrating that the commonly consumed sugars increase visceral adipose deposition, DNL, and insulin insensitivity is limited or inconclusive. Evidence that sugar consumption promotes development of an unfavorable lipid profile is strong and suggests that the upper added sugar consumption limit of 25% of energy or less, suggested in the Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans 2010, may merit re-evaluation.
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Affiliation(s)
- Kimber L Stanhope
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, California, USA.
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Pereira MA, Fulgoni VL. Consumption of 100% fruit juice and risk of obesity and metabolic syndrome: findings from the national health and nutrition examination survey 1999-2004. J Am Coll Nutr 2011; 29:625-9. [PMID: 21677126 DOI: 10.1080/07315724.2010.10719901] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES The health effects of added sugars have received much attention, but few studies have examined the association between foods that naturally contain sugar, such as 100% fruit juice, and risk of obesity and related conditions. Therefore, our purpose was to study the association between 100% fruit juice intake and risk of obesity and metabolic syndrome in a representative sample of the U.S. population. METHODS Cross-sectional analysis of a multiethnic sample of U.S. adults from the National Health and Nutrition Examination Survey 1999-2004 was undertaken to examine the association between 100% fruit juice consumption and the odds of obesity (body mass index [BMI] ≥ 30 kg/m2) and metabolic syndrome (Adult Treatment Panel [ATP] III definition). We used logistic regression analysis to estimate the odds of obesity and metabolic syndrome per category of fruit juice consumption exposure, while adjusting for covariates that may be confounders of this association. RESULTS Of 14,196 adults included in the sample, 3961 were consumers of fruit juice. Consumers of 100% fruit juice, relative to nonconsumers, had lower mean BMI, lower waist circumference, and lower homeostasis model assessment (HOMA) insulin resistance (p < 0.001). Level of intake (oz/d) had a linear inverse association with HOMA (p < 0.001), whereas the association with BMI and waist circumference was U-shaped (p < 0.001). Consumers relative to nonconsumers had 22% (95% confidence interval [CI] = 13%-30%) lower odds of obesity and 15% (95% CI = 10%-28%) lower odds of metabolic syndrome. After adjustment for demographics and lifestyle factors, the lower odds of obesity remained statistically significant, but a statistically significant reduction in odds of metabolic syndrome was no longer noted. CONCLUSIONS Compared with nonconsumers, those who consumed 100% fruit juice were leaner, were more insulin sensitive, and had lower odds of obesity and metabolic syndrome. The association with metabolic syndrome was explained primarily by other lifestyle factors, while the association with obesity remained independent. Experimental studies are needed to determine whether any direct physiologic link exists between consumption of 100% fruit juice and lower risks for obesity and metabolic syndrome.
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Affiliation(s)
- Mark A Pereira
- Division of Epidemiology and Community Health, University of Minnesota, 1300 South Second St., Suite 300, Minneapolis, MN 55454, USA.
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Stanhope KL, Bremer AA, Medici V, Nakajima K, Ito Y, Nakano T, Chen G, Fong TH, Lee V, Menorca RI, Keim NL, Havel PJ. Consumption of fructose and high fructose corn syrup increase postprandial triglycerides, LDL-cholesterol, and apolipoprotein-B in young men and women. J Clin Endocrinol Metab 2011; 96:E1596-605. [PMID: 21849529 PMCID: PMC3200248 DOI: 10.1210/jc.2011-1251] [Citation(s) in RCA: 212] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
CONTEXT The American Heart Association Nutrition Committee recommends women and men consume no more than 100 and 150 kcal of added sugar per day, respectively, whereas the Dietary Guidelines for Americans, 2010, suggests a maximal added sugar intake of 25% or less of total energy. OBJECTIVE To address this discrepancy, we compared the effects of consuming glucose, fructose, or high-fructose corn syrup (HFCS) at 25% of energy requirements (E) on risk factors for cardiovascular disease. PARTICIPANTS, DESIGN AND SETTING, AND INTERVENTION: Forty-eight adults (aged 18-40 yr; body mass index 18-35 kg/m(2)) resided at the Clinical Research Center for 3.5 d of baseline testing while consuming energy-balanced diets containing 55% E complex carbohydrate. For 12 outpatient days, they consumed usual ad libitum diets along with three servings per day of glucose, fructose, or HFCS-sweetened beverages (n = 16/group), which provided 25% E requirements. Subjects then consumed energy-balanced diets containing 25% E sugar-sweetened beverages/30% E complex carbohydrate during 3.5 d of inpatient intervention testing. MAIN OUTCOME MEASURES Twenty-four-hour triglyceride area under the curve, fasting plasma low-density lipoprotein (LDL), and apolipoprotein B (apoB) concentrations were measured. RESULTS Twenty-four-hour triglyceride area under the curve was increased compared with baseline during consumption of fructose (+4.7 ± 1.2 mmol/liter × 24 h, P = 0.0032) and HFCS (+1.8 ± 1.4 mmol/liter × 24 h, P = 0.035) but not glucose (-1.9 ± 0.9 mmol/liter × 24 h, P = 0.14). Fasting LDL and apoB concentrations were increased during consumption of fructose (LDL: +0.29 ± 0.082 mmol/liter, P = 0.0023; apoB: +0.093 ± 0.022 g/liter, P = 0.0005) and HFCS (LDL: +0.42 ± 0.11 mmol/liter, P < 0.0001; apoB: +0.12 ± 0.031 g/liter, P < 0.0001) but not glucose (LDL: +0.012 ± 0.071 mmol/liter, P = 0.86; apoB: +0.0097 ± 0.019 g/liter, P = 0.90). CONCLUSIONS Consumption of HFCS-sweetened beverages for 2 wk at 25% E increased risk factors for cardiovascular disease comparably with fructose and more than glucose in young adults.
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Affiliation(s)
- Kimber L Stanhope
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, One Shields Avenue, Davis, California 95616, USA.
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Harris DE, Blum JW, Bampton M, O'Brien LM, Beaudoin CM, Polacsek M, O'Rourke KA. Location of food stores near schools does not predict the weight status of Maine high school students. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2011; 43:274-278. [PMID: 21683275 DOI: 10.1016/j.jneb.2010.08.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2010] [Revised: 08/09/2010] [Accepted: 08/15/2010] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To examine the relationship between stores selling calorie-dense food near schools and student obesity risk, with the hypothesis that high availability predicts increased risk. METHODS Mail surveys determined height, weight, and calorie-dense food consumption for 552 students at 11 Maine high schools. Driving distance from all food stores within 2 km (1.24 miles) of schools (or the closest store) was computed, and the impact of food store density and proximity to schools on student body mass index was determined by logistic regression. RESULTS Ten schools had ≥ 1 store selling soda, and 8 schools had ≥1 fast-food restaurant within 1 km (0.62 miles). There were no significant relationships between the proximity or density of food stores around schools and student obesity risk. Students obtained sugar-sweetened beverages in many locations including at school. CONCLUSIONS AND IMPLICATIONS Unhealthful food choices are ubiquitous. Consequently, stores selling these food items near schools have no significant affect on student obesity.
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Affiliation(s)
- David E Harris
- College of Nursing and Health Professions, University of Southern Maine, Portland, ME 04104, USA.
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Stanhope KL, Griffen SC, Bremer AA, Vink RG, Schaefer EJ, Nakajima K, Schwarz JM, Beysen C, Berglund L, Keim NL, Havel PJ. Metabolic responses to prolonged consumption of glucose- and fructose-sweetened beverages are not associated with postprandial or 24-h glucose and insulin excursions. Am J Clin Nutr 2011; 94:112-9. [PMID: 21613559 PMCID: PMC3127512 DOI: 10.3945/ajcn.110.002246] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Consumption of sugar-sweetened beverages has been shown to be associated with dyslipidemia, insulin resistance, fatty liver, diabetes, and cardiovascular disease. It has been proposed that adverse metabolic effects of chronic consumption of sugar-sweetened beverages are a consequence of increased circulating glucose and insulin excursions, ie, dietary glycemic index (GI). OBJECTIVE We determined whether the greater adverse effects of fructose than of glucose consumption were associated with glucose and insulin exposures. DESIGN The subjects were studied in a metabolic facility and consumed energy-balanced diets containing 55% of energy as complex carbohydrate for 2 wk (GI = 64). The subjects then consumed 25% of energy requirements as fructose- or glucose-sweetened beverages along with their usual ad libitum diets for 8 wk at home and then as part of energy-balanced diets for 2 wk at the metabolic facility (fructose GI = 38, glucose GI = 83). The 24-h glucose and insulin profiles and fasting plasma glycated albumin and fructosamine concentrations were measured 0, 2, 8, and 10 wk after beverage consumption. RESULTS Consumption of fructose-sweetened beverages lowered glucose and insulin postmeal peaks and the 23-h area under the curve compared with the baseline diet and with the consumption of glucose-sweetened beverages (all P < 0.001, effect of sugar). Plasma glycated albumin concentrations were lower 10 wk after fructose than after glucose consumption (P < 0.01, effect of sugar), whereas fructosamine concentrations did not differ between groups. CONCLUSION The results suggest that the specific effects of fructose, but not of glucose and insulin excursions, contribute to the adverse effects of consuming sugar-sweetened beverages on lipids and insulin sensitivity. This study is registered at clinicaltrials.gov as NCT01165853.
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Affiliation(s)
- Kimber L Stanhope
- Department of Molecular Biosciences, School of Veterinary Medicine, School of Medicine, University of California, Davis, CA 95616, USA.
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Van den Berg VL. Current opinion: Is added dietary sugar detrimental to health? S Afr Fam Pract (2004) 2011. [DOI: 10.1080/20786204.2011.10874095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- VL Van den Berg
- Department of Nutrition and Dietetics, School of Allied Health Professions, Faculty of Health Sciences, University of the Free State
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Abstract
The rising prevalence of obesity, not only in adults but also in children and adolescents, is one of the most important public health problems in developed and developing countries. As one possible way to tackle obesity, a great interest has been stimulated in understanding the relationship between different types of dietary carbohydrate and appetite regulation, body weight and body composition. The present article reviews the conclusions from recent reviews and meta-analyses on the effects of different starches and sugars on body weight management and metabolic disturbances, and provides an update of the most recent studies on this topic. From the literature reviewed in this paper, potential beneficial effects of intake of starchy foods, especially those containing slowly-digestible and resistant starches, and potential detrimental effects of high intakes of fructose become apparent. This supports the intake of whole grains, legumes and vegetables, which contain more appropriate sources of carbohydrates associated with reduced risk of cardiovascular and other chronic diseases, rather than foods rich in sugars, especially in the form of sugar-sweetened beverages.
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