Attenuation of the association between sugar-sweetened beverages and diabetes risk by adiposity adjustment: a secondary analysis of national health survey data

Jing, Y. P.; Han, Thang S.; Alkhalaf, Majid M.; Lean, Michael E. J.

doi:10.1007/s00394-018-1716-z

Cited by 6 publications

(6 citation statements)

References 32 publications

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“…Observationally, consumption of 100% fruit juice, which may contain as much sucrose as SSB, is unrelated to weight gain in children aged 7-18 years despite slight weight gain in younger children, although this observation has not been confirmed in an RCT [13]. Instead, the observed association of SSB with adiposity in Western populations could be due to modern patterns of sugary/fatty snacking characterized by high SSB consumption, rather to sugar itself [35].…”

Section: Discussionmentioning

confidence: 93%

Association of Sugar-Sweetened Beverage Frequency with Adiposity: Evidence from the “Children of 1997” Birth Cohort

et al. 2020

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Background: Observationally, sugar-sweetened beverage (SSB) consumption is associated with adiposity in Western children but could be confounded. We examined the association of SSB frequency with adiposity in the non-Western setting of Hong Kong. Methods: We examined the associations of SSB consumption frequency at 11 and 13 years assessed by using a food frequency questionnaire with subsequent body mass index (BMI) z-score and overweight/obesity up to 18 years using generalized estimating equations, and with waist circumference, waist-to-hip ratio, and body fat percentage at 16-19 years using linear regression in a population-representative Chinese birth cohort "Children of 1997" (n = 3628). Results: At 11 and 13 years, 6.8% and 8.2% of children respectively consumed SSB daily. Neither SSB frequency at 11 nor at 13 years was associated with subsequent BMI z-score or overweight/obesity up to 18 years, or with waist circumference, waist-to-hip ratio, or body fat percentage at 16-19 years adjusted for age, sex, socioeconomic position, health status, physical activity and other food consumption, although bias to the null from under-reporting cannot be eliminated. Conclusion: Although we cannot definitively exclude a small association of SSB frequency with adiposity, lack of association of SSB frequency with adiposity in a non-Western setting with low SSB consumption suggests that the role of SSB in adiposity appears to be minor.Nutrients 2020, 12, 1015 2 of 13 unreliable [8]. A few randomized controlled trials (RCT) have been conducted in children [9,10], which suggested reducing SSB intake reduces weight. However, meta-analyses of RCTs have revealed mixed findings. One meta-analysis showed no overall effect of SSB intake on weight in children, possibly due to low compliance in some included trials [6]. This meta-analysis also found weight decrease for reduced sugars intake and weight increase for increased sugars intake in trials of adults with ad libitum diets [6]. However, some others showed small effects of SSB intake on weight or BMI, which may be more marked for increasing consumption of SSB on weight gain and among the overweight [5,11,12]. As a beverage containing naturally occurring sugars, 100% fruit juice was not associated with weight gain in children aged 7 to 18 years in a meta-analysis of observational studies [13], but no RCT to date has tested the effect of 100% fruit juice on adiposity in children.Given the inconclusive evidence concerning the effect of SSB on adiposity, assessing the association in settings with different confounding patterns can be helpful [14]. Unlike in Western developed settings, obesity is less clearly socially patterned in Hong Kong Chinese children [15,16]. Chinese children also consume fewer SSBs than those in Western developed countries [17]. SSB consumption in Chinese children may have different socioeconomic patterns than in Western settings, where children of lower SEP tend to consume more SSB [18]. Here, we examined the association of SSB frequency at 11 and 13 years ...

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Section: Discussionmentioning

confidence: 93%

Association of Sugar-Sweetened Beverage Frequency with Adiposity: Evidence from the “Children of 1997” Birth Cohort

et al. 2020

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“…The OR was slightly changed by adjusting for BMI, WC, or total body fat; however, the OR was significantly reduced by adjusting for estimated body fat. These indicators had similar impacts on the relationship between SSB and T2DM, with HbA1c unknown > 6.5% and > 48 mmol/mol in patients with T2DM ( 23 ). Lifestyle modification in individuals with diabetes refers to dietary restrictions, such as SSBs intake, with the benefit of SSBs restriction accomplished through BMI control ( 12 ).…”

Section: Discussionmentioning

confidence: 95%

“…There is a positive correlation between SSBs consumption and diabesity (including BMI and WC level). Additionally, BMI is an important influencing factor, reflecting the complex interaction between SSB and caloric intake in obesity and T2DM progression ( 23 ). This trend also provides a theoretical basis for our results which shows that SSBs correlate with obesity and T2DM.…”

Section: Discussionmentioning

confidence: 99%

The relationship between sugar-sweetened beverages, sleep disorders, and diabesity

Zhang

Liu²,

Xu³

et al. 2023

Front. Endocrinol.

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BackgroundDiabetes and obesity in adults are global issues. Obesity and type 2 diabetes mellitus (T2DM) are increasingly categorized under the umbrella term “diabesity.” Health risk factors (HRFs), which include altering sleep habits and reducing sugar-sweetened beverages (SSBs) consumption, have emerged as relatively novel and crucial strategies for preventing and treating diabetes.ObjectiveWe aimed to explore: 1) whether SSBs could affect diabesity in China’s community; 2) whether HRFs could moderate this relationship; and 3) whether a three-way interaction exists between HRFs, SSBs, and diabesity.MethodsOn December 10, 2018, we investigated diabetes complications in four cities in Anhui Province and obtained basic and lifestyle information using a detailed questionnaire. The primary exposure was SSBs and outcomes were body mass index (BMI) and waist circumference (WC), while glycated hemoglobin (HbA1c) and sleep patterns (including duration and disorders) were considered moderators.ResultsOverall, 1920 participants were enrolled, and those who did not complete the questionnaire were excluded. Finally, this study included 1765 participants, with a response rate of 92.0%. The mean age was (57.10 ± 10.0) years. Patients with lower educational levels were more likely to have a lower prevalence of WC (χ2 = 2.73) and BMI (χ2 = 3.47), and some HRFs were positively correlated with WC and BMI. Additionally, SSBs were significantly associated with BMI (β = 1.29) and WC (β = 2.97), and there was also differences based on sex, some HRFs, such as HbA1c, FBG and TG, showed higher levels in male participants, whereas TC level was higher in female participants. In the moderation analysis, sleep patterns were also associated with total cholesterol, triglyceride, and BMI. Furthermore, there were three-way interaction effects among HbA1c, sleep patterns, and SSBs on total cholesterol, triglyceride, BMI, and WC. Moreover, sensitivity analysis demonstrated that our results were robust.ConclusionSSBs positively correlated with patterns dose-dependently. Moreover, SSBs could also be associated with sleep patterns, and blood glucose levels were correlated with diabesity. A three-way interaction effect was discovered between SSBs, sleep patterns, blood glucose levels, and patterns. Therefore, understanding the diabesity caused by SSBs and other HRFs can help prevent its occurrence.

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“…Additionally, BMI itself is an important influencing factor, reflecting the complex interaction between diet styles and caloric intake in obesity and T2DM progression. They also looked at the availability of dietary interventions; 40 this trend also provides a theoretical basis for our results, which show that diet styles correlate with obesity and T2DM. Furthermore, a large number of studies have shown that in patients with T2DM and obesity, more stringent dietary energy restriction management and intake of a very low calorie diet can significantly reduce HbA1c and fasting blood glucose levels and maintain sustained remission of diabetes 41,42 and effectiveness of lipid management for at least 2 years.…”

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confidence: 77%

Complex Association Among Diet Styles, Sleep Patterns, and Obesity in Patients with Diabetes

Zhang¹,

Wang²,

Zhang³

et al. 2023

DMSO

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Background: Health risk factors (HRFs), including the adjustment of disturbed sleep patterns (including disorders and duration) and improvement of dietary intake, have become relatively novel and critical strategies to prevent the development of diabesity and treat diabetic complications. Objective: We aimed to explore 1) whether there was an association between diet styles (including healthy and unhealthy diets) and diabesity; 2) whether sleep patterns could moderate this relationship; and 3) whether there was a complex interaction association between sleep patterns, diet styles, and diabesity. Methods: The study was based on a national survey conducted by the China National Diabetic Chronic Complications Study Group, this study extracted data from some cities in Anhui Province and obtained basic and lifestyle information using a detailed questionnaire for analysis. The primary exposure was diet styles, and the outcomes were body mass index (BMI) and waist circumference (WC), while HbA1c and FBG and sleep patterns were moderators. Data were pooled using logistic regression and moderation analysis. Results:The overall response rate was 92.0%. This study ultimately included 1765 participants. The mean age was 57.10 ± 10.0 years. Sociographically, participants with lower educational levels were more likely to have lower levels of WC (χ 2 = 2.73) and BMI (χ 2 = 3.47), were female (t=6.54), were more likely to have lower educational levels (F=13.78) and were older (F=23.75), were more likely to have higher detection rates of sleep disorders and were more likely to have other HRFs (walking, SSBs, HbA1c and TG). Additionally, diet styles were also significantly associated with BMI and WC. In the moderation analysis, SES (socioeconomic status) also affected the correlation between healthy diet style, sleep disorders and WC (β=0.20), neither in BMI nor unhealthy diet style in BMI and WC; the combination effect between diet styles, sleep patterns and HbA1c was associated with WC and BMI. Conclusion: Complex associations and interactions were found between diet styles, sleep patterns, HbA1c, and diabesity. Therefore, it is necessary to understand the dietary pattern and other HRFS that cause diabesity, so as to strengthen further preventive measures. These results can provide some theoretical basis for the treatment of diabesity in the public health field.

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Attenuation of the association between sugar-sweetened beverages and diabetes risk by adiposity adjustment: a secondary analysis of national health survey data

Cited by 6 publications

References 32 publications

Association of Sugar-Sweetened Beverage Frequency with Adiposity: Evidence from the “Children of 1997” Birth Cohort

Association of Sugar-Sweetened Beverage Frequency with Adiposity: Evidence from the “Children of 1997” Birth Cohort

The relationship between sugar-sweetened beverages, sleep disorders, and diabesity

Complex Association Among Diet Styles, Sleep Patterns, and Obesity in Patients with Diabetes

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