Consumption of foods and beverages rich in added sugar associated with incident metabolic syndrome: the Coronary Artery Risk Development in Young Adults (CARDIA) study

• Published in: European journal of preventive cardiology 2024-06, Vol.31 (8), p.986-996
• Main Authors: Goins, Rae K, Steffen, Lyn M, Yi, So-Yun, Zhou, Xia, Van Horn, Linda, Shikany, James M, Terry, James G, Jacobs, David R
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Black or African American; Coronary Artery Disease - epidemiology; Coronary Artery Disease - etiology; Dietary Carbohydrates - administration & dosage; Dietary Carbohydrates - adverse effects; Female; Full Research Paper; Humans; Incidence; Male; Metabolic Syndrome - epidemiology; Nutritive Value; Prospective Studies; Risk Assessment; Risk Factors; Sugar-Sweetened Beverages - adverse effects; Time Factors; United States - epidemiology; White; Young Adult
• ISSN: 2047-4873; 2047-4881; 2047-4881
• DOI: 10.1093/eurjpc/zwad409

Abstract Aims Numerous studies report positive associations between total carbohydrate (CHO) intake and incident metabolic syndrome (MetS), but few differentiate quality or type of CHO relative to MetS. We examined source of CHO intake, including added sugar (AS), AS-rich CHO foods, and sugar-sweetened beverages (SSBs) associated with incident MetS in adults enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study. Methods and results Among 3154 Black American and White American women and men aged 18–30 years at baseline, dietary intake was assessed by diet history three times over 20 years. Sources of AS-rich CHO foods and beverages include sugar-rich refined grain products, candy, sugar products, and SSBs. Incident MetS was created according to standard criteria. Time-dependent Cox proportional hazards regression analysis evaluated the associations of incident MetS across quintiles of cumulative intakes of AS-rich CHO foods and beverages, AS, and SSBs adjusted for potential confounding factors over 30 years of follow-up. The associations of AS-rich CHO foods and beverages, AS, and SSB intakes with incident MetS were consistent. Compared with the lowest intake, the greatest intakes of AS-rich CHOs, AS, and SSBs were associated with 59% (Ptrend < 0.001), 44% (Ptrend = 0.01), and 34% (Ptrend = 0.03) higher risk of developing MetS, respectively. As expected, diet quality was lower across increasing quintiles of AS-rich CHO foods and beverages, AS, and SSBs (all Ptrend < 0.001). Conclusion Our study findings are consistent with an elevated risk of developing MetS with greater consumption of AS, AS-rich CHO foods, and SSBs, which support consuming fewer AS-rich CHO foods and SSBs. Lay Summary Metabolic syndrome (MetS) is a condition consisting of three out of five heart disease risk factors. Researchers have found that the risk of developing MetS increases as carbohydrate (CHO) intake also increases. However, how this risk is related to the type and quality of CHO has not been well studied. To study this, we used data from 3154 African American and White American women and men aged 18–30 years old at baseline (1985–86). Information was collected about their health and what they ate. This allowed us to find out if MetS occurred over time if it ever did. We determined how much added sugar (AS), sugar-sweetened beverages (SSBs), and AS-rich CHO foods and beverages they ate. Added sugar–rich foods and beverages contain sugars, syrups, and ca