Endocrinol Metab.  2015 Sep;30(3):334-342. 10.3803/EnM.2015.30.3.334.

Sugar-Sweetened Beverage Consumption Is Associated with Metabolic Syndrome in Iranian Adults: Tehran Lipid and Glucose Study

Affiliations
  • 1Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. parvin.mirmiran@gmail.com
  • 2Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
  • 3Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Abstract

BACKGROUND
Metabolic syndrome (MetS), a cluster of multiple metabolic abnormalities, is one of the major public health challenges worldwide. The current study was conducted to evaluate the association between sugar-sweetened beverage (SSB) consumption and MetS and its components in Iranian adults.
METHODS
This cross-sectional study was conducted among 5,852 men and women, aged 19 to 70 years, who participated in the fourth phase (2009 to 2011) of the Tehran Lipid and Glucose Study. Demographics, anthropometrics, biochemical measurements, and blood pressure (BP) were assessed and MetS was defined by National Cholesterol Education Program Adult Treatment Panel III definition. Frequency and quantity of SSB intakes including carbonated drinks and synthetic fruit juices were collected using a validated semiquantitative food frequency questionnaire.
RESULTS
Mean age of participants (43%, men) was 40.6+/-12.9 years. Significant positive associations between SSBs and waist circumference, triglyceride level, systolic and diastolic BP in the third and fourth quartile of SSBs were observed, after adjustment for all potential confounding variables. The odds of MetS in the third and fourth quartiles compared to the first quartile category of SSBs was 1.21 (95% confidence interval [CI], 1.01 to 1.45) and 1.30 (95% CI, 1.06 to 1.58), respectively (P for trend=0.03). The odds of MetS, abdominal obesity, low high density lipoprotein cholesterol and elevated BP had increasing trends across increasing of SSB consumption (P for trend <0.05).
CONCLUSION
Higher intake of SSBs was associated with the higher odds of MetS in adults. It is suggested that reducing consumption of SSBs could be a practical approach to prevent metabolic abnormalities.

Keyword

Sugar-sweetened beverages; Metabolic syndrome; Obesity, abdominal; Tehran Lipid and Glucose Study

MeSH Terms

Adult*
Beverages*
Blood Pressure
Carbonated Beverages
Cholesterol
Cholesterol, HDL
Confounding Factors (Epidemiology)
Cross-Sectional Studies
Demography
Education
Female
Fruit
Glucose*
Humans
Male
Obesity, Abdominal
Public Health
Triglycerides
Waist Circumference
Cholesterol
Cholesterol, HDL
Glucose

Reference

1. Kassi E, Pervanidou P, Kaltsas G, Chrousos G. Metabolic syndrome: definitions and controversies. BMC Med. 2011; 9:48.
2. Schmidt AM. Insulin resistance and metabolic syndrome: mechanisms and consequences. Arterioscler Thromb Vasc Biol. 2012; 32:1753.
3. Zabetian A, Hadaegh F, Azizi F. Prevalence of metabolic syndrome in Iranian adult population, concordance between the IDF with the ATPIII and the WHO definitions. Diabetes Res Clin Pract. 2007; 77:251–257.
4. Bianchi C, Penno G, Daniele G, Benzi L, Del Prato S, Miccoli R. Optimizing management of metabolic syndrome to reduce risk: focus on life-style. Intern Emerg Med. 2008; 3:87–98.
5. Collino M. High dietary fructose intake: sweet or bitter life? World J Diabetes. 2011; 2:77–81.
6. Malik VS, Popkin BM, Bray GA, Despres JP, Willett WC, Hu FB. Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes: a meta-analysis. Diabetes Care. 2010; 33:2477–2483.
7. Dolan LC, Potter SM, Burdock GA. Evidence-based review on the effect of normal dietary consumption of fructose on blood lipids and body weight of overweight and obese individuals. Crit Rev Food Sci Nutr. 2010; 50:889–918.
8. Dolan LC, Potter SM, Burdock GA. Evidence-based review on the effect of normal dietary consumption of fructose on development of hyperlipidemia and obesity in healthy, normal weight individuals. Crit Rev Food Sci Nutr. 2010; 50:53–84.
9. Ruxton CH, Gardner EJ, McNulty HM. Is sugar consumption detrimental to health? A review of the evidence 1995-2006. Crit Rev Food Sci Nutr. 2010; 50:1–19.
10. Khosravi-Boroujeni H, Sarrafzadegan N, Mohammadifard N, Alikhasi H, Sajjadi F, Asgari S, et al. Consumption of sugar-sweetened beverages in relation to the metabolic syndrome among Iranian adults. Obes Facts. 2012; 5:527–537.
11. Azizi F, Ghanbarian A, Momenan AA, Hadaegh F, Mirmiran P, Hedayati M, et al. Prevention of non-communicable disease in a population in nutrition transition: Tehran Lipid and Glucose Study phase II. Trials. 2009; 10:5.
12. Azizi F, Rahmani M, Emami H, Mirmiran P, Hajipour R, Madjid M, et al. Cardiovascular risk factors in an Iranian urban population: Tehran lipid and glucose study (phase 1). Soz Praventivmed. 2002; 47:408–426.
13. Esfahani FH, Asghari G, Mirmiran P, Azizi F. Reproducibility and relative validity of food group intake in a food frequency questionnaire developed for the Tehran Lipid and Glucose Study. J Epidemiol. 2010; 20:150–158.
14. United States Department of Agriculture (USDA). Food composition table (FCT) [Internet]. Washington DC: USDA;2014. cited 2015 Jan 7. Available from: http://www.nal.usda.gov/fnic/foodcomp.
15. Azar M, Sarkisian E. Food composition table of Iran: National Nutrition and Food Research Institute. Tehran: Shahid Beheshti University Press;1980.
16. United States Department of Agriculture (USDA). USDA database for the added sugars content of selected foods [Internet]. Washington DC: USDA;2014. cited 2015 Jan 7. Available from: http://www.ars.usda.gov/nutrientdata/.
17. Kriska AM, Knowler WC, LaPorte RE, Drash AL, Wing RR, Blair SN, et al. Development of questionnaire to examine relationship of physical activity and diabetes in Pima Indians. Diabetes Care. 1990; 13:401–411.
18. Momenan AA, Delshad M, Sarbazi N, Rezaei Ghaleh N, Ghanbarian A, Azizi F. Reliability and validity of the Modifiable Activity Questionnaire (MAQ) in an Iranian urban adult population. Arch Iran Med. 2012; 15:279–282.
19. IPAQ Research Committee. Guidelines for data processing and analysis of the International Physical Activity Questionnaire (IPAQ) [Internet]. International Physical Activity Questionnaire Research Committee;2005. cited 2015 Jan 8. Available from: http://www.ipaq.ki.se.
20. Azizi F, Hadaegh F, Khalili D, Esteghamati A, Hosseinpanah F, Delavari A, et al. Appropriate definition of metabolic syndrome among Iranian adults: report of the Iranian National Committee of Obesity. Arch Iran Med. 2010; 13:426–428.
21. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2005; 112:2735–2752.
22. Balaghi S, Faramarzi E, Mahdavi R, Ghaemmaghami J. Fluids intake and beverage consumption pattern among university students. Health Promot Perspect. 2011; 1:54–61.
23. Green AK, Jacques PF, Rogers G, Fox CS, Meigs JB, McKeown NM. Sugar-sweetened beverages and prevalence of the metabolically abnormal phenotype in the Framingham Heart Study. Obesity (Silver Spring). 2014; 22:E157–E163.
24. Barrio-Lopez MT, Martinez-Gonzalez MA, Fernandez-Montero A, Beunza JJ, Zazpe I, Bes-Rastrollo M. Prospective study of changes in sugar-sweetened beverage consumption and the incidence of the metabolic syndrome and its components: the SUN cohort. Br J Nutr. 2013; 110:1722–1731.
25. Odegaard AO, Choh AC, Czerwinski SA, Towne B, Demerath EW. Sugar-sweetened and diet beverages in relation to visceral adipose tissue. Obesity (Silver Spring). 2012; 20:689–691.
26. Malik VS, Popkin BM, Bray GA, Despres JP, Hu FB. Sugar-sweetened beverages, obesity, type 2 diabetes mellitus, and cardiovascular disease risk. Circulation. 2010; 121:1356–1364.
27. DiMeglio DP, Mattes RD. Liquid versus solid carbohydrate: effects on food intake and body weight. Int J Obes Relat Metab Disord. 2000; 24:794–800.
28. Palmer JR, Boggs DA, Krishnan S, Hu FB, Singer M, Rosenberg L. Sugar-sweetened beverages and incidence of type 2 diabetes mellitus in African American women. Arch Intern Med. 2008; 168:1487–1492.
29. Kelishadi R, Mansourian M, Heidari-Beni M. Association of fructose consumption and components of metabolic syndrome in human studies: a systematic review and meta-analysis. Nutrition. 2014; 30:503–510.
30. Jurgens H, Haass W, Castaneda TR, Schurmann A, Koebnick C, Dombrowski F, et al. Consuming fructose-sweetened beverages increases body adiposity in mice. Obes Res. 2005; 13:1146–1156.
31. Sievenpiper JL, Carleton AJ, Chatha S, Jiang HY, de Souza RJ, Beyene J, et al. Heterogeneous effects of fructose on blood lipids in individuals with type 2 diabetes: systematic review and meta-analysis of experimental trials in humans. Diabetes Care. 2009; 32:1930–1937.
32. Hostmark AT, Haug A. Does cheese intake blunt the association between soft drink intake and risk of the metabolic syndrome? Results from the cross-sectional Oslo Health Study. BMJ Open. 2012; 2:e001476.
33. Malik AH, Akram Y, Shetty S, Malik SS, Yanchou Njike V. Impact of sugar-sweetened beverages on blood pressure. Am J Cardiol. 2014; 113:1574–1580.
34. Nakagawa T, Hu H, Zharikov S, Tuttle KR, Short RA, Glushakova O, et al. A causal role for uric acid in fructose-induced metabolic syndrome. Am J Physiol Renal Physiol. 2006; 290:F625–F631.
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