Sugars and risk of mortality in the NIH-AARP Diet and Health Study

Tasevska, Natasha; Park, Yikyung; Jiao, Li; Hollenbeck, Albert R.; Subar, Amy F.; Potischman, Nancy

doi:10.3945/ajcn.113.069369

Cited by 77 publications

(93 citation statements)

References 77 publications

(78 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…After a median of 14.6 years of follow-up, added sugar intake was associated with a 2-fold greater risk of CVD death comparing extreme quintiles of intake. In contrast, an analysis from the NIH-AARP Diet and Health Study; a prospective cohort of older US adults, found that intake of total fructose but not of added sugar was associated with a modest increase in risk of all-cause mortality in men and women (23). However, total sugars from beverages, including added sugar were positively associated with risk of all-cause, CVD and other-cause mortality in women while only fructose from beverages was positively associated with risk of all-cause and CVD mortality in men.…”

Section: Cardiovascular Riskmentioning

confidence: 99%

Fructose and Cardiometabolic Health

Malik

2015

Journal of the American College of Cardiology

333

146

View full text Add to dashboard Cite

Recent attention has focused on fructose as having a unique role in the pathogenesis cardiometabolic diseases. However since we rarely consume fructose in isolation, the major source of fructose in the diet comes from fructose-containing sugars, sucrose and high fructose corn syrup, in sugar sweetened beverages. Intake of these beverages has been consistently linked to increased risk of obesity, type 2 diabetes and cardiovascular disease in various populations. Putative underlying mechanisms include incomplete compensation for liquid calories, adverse glycemic effects and increased hepatic metabolism of fructose leading to de novo lipogenesis, production of uric acid and accumulation of visceral and ectopic fat. In this review we summarize the epidemiological and clinical trial evidence evaluating added sugars especially sugar-sweetened beverages, and risk of obesity, diabetes and cardiovascular disease addressing potential biological mechanisms with an emphasis on fructose physiology. We also discuss strategies to reduce intake of fructose-containing beverages.

show abstract

Section: Cardiovascular Riskmentioning

confidence: 99%

Fructose and Cardiometabolic Health

Malik

2015

Journal of the American College of Cardiology

333

146

View full text Add to dashboard Cite

show abstract

“…The associations between sugars consumption and cancer have long been studied, yet, are difficult to demonstrate in an epidemiologic context (1–3). One of the major limitations in nutritional epidemiologic analyses is unreliability of self-reported dietary data, which can lead to severely distorted disease association estimates and reduced statistical power to detect an association (4).…”

Section: Introductionmentioning

confidence: 99%

Use of a Urinary Sugars Biomarker to Assess Measurement Error in Self-Reported Sugars Intake in the Nutrition and Physical Activity Assessment Study (NPAAS)

Tasevska

Midthune

Tinker

et al. 2014

Cancer Epidemiology, Biomarkers &Amp; Prevention

Self Cite

View full text Add to dashboard Cite

Background Measurement error (ME) in self-reported sugars intake may be obscuring the association between sugars and cancer risk in nutritional epidemiologic studies. Methods We used 24-hour urinary sucrose and fructose as a predictive biomarker for total sugars, to assess ME in self-reported sugars intake. The Nutrition and Physical Activity Assessment Study (NPAAS) is a biomarker study within the Women’s Health Initiative (WHI) Observational Study, that includes 450 post-menopausal women aged 60–91. Food Frequency Questionnaires (FFQ), 4-day food records (4DFR) and three 24-h dietary recalls (24HRs) were collected along with sugars and energy dietary biomarkers. Results Using the biomarker, we found self-reported sugars to be substantially and roughly equally misreported across the FFQ, 4DFR and 24HR. All instruments were associated with considerable intake- and person-specific bias. Three 24HRs would provide the least attenuated risk estimate for sugars (attenuation factor, AF=0.57), followed by FFQ (AF=0.48), and 4DFR (AF=0.32), in studies of energy-adjusted sugars and disease risk. In calibration models, self-reports explained little variation in true intake (5–6% for absolute sugars; 7–18% for sugars density). Adding participants’ characteristics somewhat improved the percentage variation explained (16–18% for absolute sugars; 29–40% for sugars density). Conclusions None of the self-report instruments provided a good estimate of sugars intake, although overall 24HRs seemed to perform the best. Impact Assuming the calibrated sugars biomarker is unbiased, this analysis suggests that, measuring the biomarker in a subsample of the study population for calibration purposes may be necessary for obtaining unbiased risk estimates in cancer association studies.

show abstract

“…In a large prospective study sugars from beverages -specifically, added fructose from fructose-glucose corn syrup, but not sugars from solid foods -were positively associated with overall mortality but not with the risk of major cancers [84]. Sugar-sweetened beverages raise insulin and glucose levels, and its consumption is associated with obesity and diabetes [85], which have been found to be related to pancreatic cancer risk [86,87].…”

Section: High-calorie Foods and Beveragesmentioning

confidence: 99%

European Code against Cancer 4th Edition: Diet and cancer

Norat

Scoccianti

Boutron‐Ruault

et al. 2015

Cancer Epidemiology

135

View full text Add to dashboard Cite

Lifestyle factors, including diet, have long been recognised as potentially important determinants of cancer risk. In addition to the significant role diet plays in affecting body fatness, a risk factor for several cancers, experimental studies have indicated that diet may influence the cancer process in several ways. Prospective studies have shown that dietary patterns characterised by higher intakes of fruits, vegetables, and whole-grain foods, and lower intakes of red and processed meats and salt, are related to reduced risks of death and cancer, and that a healthy diet can improve overall survival after diagnosis of breast and colorectal cancers. There is evidence that high intakes of fruit and vegetables may reduce the risk of cancers of the aerodigestive tract, and the evidence that dietary fibre protects against colorectal cancer is convincing. Red and processed meats increase the risk of colorectal cancer. Diets rich in high-calorie foods, such as fatty and sugary foods, may lead to increased calorie intake, thereby promoting obesity and leading to an increased risk of cancer. There is some evidence that sugary drinks are related to an increased risk of pancreatic cancer. Taking this evidence into account, the 4th edition of the European Code against Cancer recommends that people have a healthy diet to reduce their risk of cancer: they should eat plenty of whole grains, pulses, vegetables and fruits; limit high-calorie foods (foods high in sugar or fat); avoid sugary drinks and processed meat; and limit red meat and foods high in salt.

show abstract

Sugars and risk of mortality in the NIH-AARP Diet and Health Study

Cited by 77 publications

References 77 publications

Fructose and Cardiometabolic Health

Fructose and Cardiometabolic Health

Use of a Urinary Sugars Biomarker to Assess Measurement Error in Self-Reported Sugars Intake in the Nutrition and Physical Activity Assessment Study (NPAAS)

European Code against Cancer 4th Edition: Diet and cancer

Contact Info

Product

Resources

About