Consumption of Sugar-Sweetened Beverages in Relation to the Metabolic Syndrome among Iranian Adults

Abstract

<b><i>Background:</i></b> Few data are available linking intake of sugar-sweetened beverages (SSBs) with the metabolic syndrome. Furthermore, findings from these studies are inconsistent and most are from Western societies; no information is available in this regard from Middle Eastern populations. <b><i>Objective</i></b>: This study was conducted to assess the relationship between SSB consumption and metabolic syndrome in an Iranian adult population. <b><i>Methods:</i></b> In this cross-sectional study, data from 1,752 people (782 men and 970 women) that were selected with the multistage cluster random sampling method from three counties of Isfahan, Najafabad and Arak were used. A validated food frequency questionnaire was used to assess participants’ usual dietary intakes. Consumption of SSBs was calculated by summing up the consumption of ‘soft drinks’ and ‘artificially sweetened fruit juices’. To categorize participants, we used three levels of SSB consumption: <1 time/week, 1–3 times/week, and >3 times/week. Biochemical assessments were done after an overnight fasting. Metabolic syndrome was defined according to the guidelines of Adult Treatment Panel III. <b><i>Results:</i></b> Subjects with high consumption of SSBs (>3 times/week) were younger than those with low consumption (<1 time/week). Mean BMI was not significantly different across SSB categories. High consumption of SSBs was associated with greater intakes of energy and almost all food groups. We found a significant difference in serum triglyceride levels between men consuming SSBs 1–3 times/week and those consuming <1 time/week. However, after controlling for potential confounders, this association disappeared. In crude models, no significant associations were found between SSB intake and prevalence of the metabolic syndrome in either gender. After adjustment for potential confounders including BMI, we found that men in the top category of SSB intake were 17% more likely to have the metabolic syndrome (odds ratio (OR) 1.17; 95% confidence interval (95% CI) 0.56–2.46), while women in the highest category were 20% less likely to have the syndrome (OR 0.80; 95% CI 0.46–1.42) as compared with those in the bottom category. However, these associations were not significant in either men or women. <b><i>Conclusion:</i></b> Our results do not support the previous findings on the association between SSB consumption and metabolic syndrome. Prospective studies are needed to further explore for this association.

Soft drink intake and the risk of metabolic syndrome: A systematic review and meta-analysis

“…[11][12][13][14][18][19][20][21][22][23][24][25] The process of study selection is shown in Figure 1 [11][12][13][14][18][19][20][21][22][23][24][25] The process of study selection is shown in Figure 1 …”

“…18,19,23 Two studies evaluated the risk of metabolic syndrome with sweetened beverage consumption in younger cohorts (children, adolescents or young adults) and were excluded in a sensitivity analysis. Consequently, gender-specific adjusted hazard ratios extracted from these studies allowed analysis of metabolic syndrome associated with soft drink consumption to be stratified by gender.…”

“…Outcome ascertainment was reliable in 11 of the 12 studies; methods used include patient-reported history, physical assessment, anthropometric measurements and blood tests. From the remaining studies, the following inferences can be made about SSB consumers in comparison to non-consumers: they were more likely to be smokers 19,20,22,23 and consume more calories per day. 24 Of the four prospective cohort studies included in final analysis, the percentage of participants lost to followup was unclear in two; one study lost 14% of participants to follow-up and one study reported a loss to follow-up <10%.…”

“…,19,22,23 The prospective cohort study by Dhingra et al found individuals who consumed the most soft drinks to have significantly higher BMI, waist circumference and triglyceride levels at baseline compared with those who consumed the least 11. …”

Beverage Intake Assessment Questionnaire: Relative Validity and Repeatability in a Spanish Population with Metabolic Syndrome from the PREDIMED-PLUS Study

“…Several authors have assessed the relationship between the consumption of beverages and specific outcomes: for example, the intake of sugar-sweetened beverages (SSBs) and metabolic syndrome (MetS) or type 2 diabetes (T2DM) [3], hypertension [4,5,6] and other cardiometabolic variables [7]; or the intake of drinking water and its relationship to cardiovascular diseases (CVD) [8]. However, the results in some cases are controversial [9,10,11] and it is probably partially attributable to the difficulties in assessing the real fluid pattern [12]. Water is an essential nutrient for life [13] and the research on its contribution to human health is very important, so it is essential that the technique used to assess the consumption of different types of beverage is sufficiently sensitive.…”