Association between soft drink consumption and carotid atherosclerosis in a large-scale adult population: The TCLSIH cohort study

Ge Meng; Tongfeng Liu; Sabina Rayamajhi; Amrish Thapa; Shunming Zhang; Xuena Wang; Hongmei Wu; Yeqing Gu; Qing Zhang; Li Liu; Shaomei Sun; Xing Wang; Ming Zhou; Qiyu Jia; Kun Song; Zhongze Fang; Kaijun Niu

doi:10.1016/j.numecd.2023.07.002

Association between soft drink consumption and carotid atherosclerosis in a large-scale adult population: The TCLSIH cohort study

Nutr Metab Cardiovasc Dis. 2023 Nov;33(11):2209-2219. doi: 10.1016/j.numecd.2023.07.002. Epub 2023 Jul 19.

Authors

Ge Meng¹, Tongfeng Liu¹, Sabina Rayamajhi², Amrish Thapa², Shunming Zhang², Xuena Wang², Hongmei Wu², Yeqing Gu³, Qing Zhang⁴, Li Liu⁴, Shaomei Sun⁴, Xing Wang⁴, Ming Zhou⁴, Qiyu Jia⁴, Kun Song⁴, Zhongze Fang⁵, Kaijun Niu⁶

Affiliations

¹ Department of Toxicology and Health Inspection and Quarantine, School of Public Health, Tianjin Medical University, Tianjin, China; Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.
² Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; School of Public Health, Tianjin University of Traditional Chinese Medicine, Tianjin, China; School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
³ Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China.
⁴ Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China.
⁵ Department of Toxicology and Health Inspection and Quarantine, School of Public Health, Tianjin Medical University, Tianjin, China. Electronic address: [email protected].
⁶ Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; School of Public Health, Tianjin University of Traditional Chinese Medicine, Tianjin, China; School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China; Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China; Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Tianjin Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China; National Demonstration Center for Experimental Preventive Medicine Education, Tianjin Medical University, Tianjin, China. Electronic address: [email protected].

PMID: 37586920
DOI: 10.1016/j.numecd.2023.07.002

Abstract

Background and aims: Carotid atherosclerosis indicates an increased risk for cardiac-cerebral vascular disease. Given the pattern of consumption in China, sugar-sweetened beverage is the main type of soft drink consumed. As soft drinks contain a high amount of fructose, they may be a risk factor of carotid atherosclerosis. A prospective cohort study was conducted to investigate the association between soft drink consumption and the incidence of carotid atherosclerosis in a Chinese adult population.

Methods and results: A total of 3828 participants (men: 2007 and women: 1821) were included. Carotid atherosclerosis was measured by using ultrasonography and was defined by increased carotid intima-media thickness and/or carotid plaques. Soft drink consumption was assessed using a validated food frequency questionnaire. Cox proportional hazards regression analysis was used to assess the association of soft drink consumption categories with the incidence of carotid atherosclerosis. During a mean follow-up of 3.20 years, 1009 individuals of the 3828 eligible participants developed carotid atherosclerosis. After adjusting for potential confounding factors, we compared the higher levels to the lowest level of soft drink consumption in women, and we estimated the multivariable hazard ratios and 95% confidence intervals of incident carotid atherosclerosis to be 1.09 (0.80, 1.50), and 1.56 (1.14, 2.13) (P for trend <0.05). However, there was no significant association between soft drink consumption and the incidence of carotid atherosclerosis in men or total population.

Conclusion: The result indicated that soft drink consumption was associated with a higher incidence of carotid atherosclerosis in women.

Trial registered: UMIN Clinical Trials Registry.

Trial registration number: UMIN000027174. TRIAL REGISTRATION WEBSITE: https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000031137.

Keywords: Carotid atherosclerosis; Carotid intima-media thickness; Carotid plaques; Soft drink; Woman.

Copyright © 2023 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.