Drinking beverages sweetened artificially, however, was not associated with any detrimental effects in relation to the risk of coronary heart disease (CHD), according to findings published in the American Journal of Clinical Nutrition.
“We found that consumption of sugar-sweetened beverages is associated with a higher risk of CHD in women, even after other risk factors for CHD or an unhealthful diet or lifestyle are accounted for. This finding provides further rationale for limiting the consumption of sugar-sweetened beverages,” wrote lead author Teresa Fung from Simmons College in Boston and Harvard Medical School.
The study evaluated data from 88,520 women aged between 34 and 59 participating in the Nurses' Health Study. The women were free of coronary heart disease (CHD), stroke, or diabetes at the start of the study in 1980. Seven food-frequency questionnaires (FFQs) between 1980 and 2002 were used to evaluate dietary habits.
During 24 years of follow-up, Dr Fung and her co-workers documented 3,105 incident cases of both non-fatal myocardial infarction and fatal CHD.
After adjusting the data for potential confounding factors, the researchers found that consuming two or more servings of sugar-sweetened beverages per day was associated with a 35 per cent increase in the risk of CHD.
Further adjustment for other factors, such as body mass index, energy intake, and incident diabetes did not affect the results.
On the other hand, the researchers noted that artificially sweetened beverages were not associated with CHD risk.
Commenting on the possible mechanism, the researchers said: “Fructose has been the major sweetener in SSB since the mid-1980s, and it increases triacylglycerol synthesis in the liver, which results in elevated triacylglycerol concentrations, which have been associated with a greater risk of CHD.
“Fructose is also the only sugar that can increase blood uric acid concentrations. High uric acid concentrations may reduce endothelial nitric oxide, which could partly mediate a relation between soft drink consumption and risk of CHD.”
The researchers defined sweetened beverages as “caffeinated and non-caffeinated colas other carbonated beverages with sugar, and non-carbonated sweetened beverages”. Artificially sweetened beverages were defined as “all types of low-calorie sweet carbonated beverages, such as diet colas and other diet carbonated beverages”.
Source: American Journal of Clinical Nutrition
April 2009, Volume 89, Pages 1037-1042, doi:10.3945/ajcn.2008.27140
“Sweetened beverage consumption and risk of coronary heart disease in women”
Authors: T.T. Fung, V. Malik, K.M. Rexrode, J.E. Manson, W.C. Willett, F.B. Hu