Consuming More Food, Beverages with Added Sugar Linked to Greater Risk for Metabolic Syndrome

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Greater consumption of foods and beverages with added sugar (AS) was associated with an increased risk for metabolic syndrome (MetS), according to new research published in the European Journal of Preventive Cardiology.

Findings showed that compared to the lowest intake of AS-rich food and beverages, the highest intake was associated with a 59% higher risk of developing MetS over 30 years of follow-up.

“Numerous studies report positive associations between total carbohydrate (CHO) intake and incident [MetS], but few differentiate quality or type of CHO relative to MetS,” wrote first author Rae K. Goins, MPH, BS, Division of Epidemiology and Community Health, University of Minnesota School of Public Health, and colleagues. “We examined source of CHO intake, including [AS], AS-rich CHO foods and sugar-sweetened beverages (SSBs) associated with incident MetS in adults enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study.”

According to the study, AS-rich foods and beverages contain sugars, syrups, and caloric sweeteners added to them during production or preparation; and AS-rich CHO foods included refined grain breads, rolls, bakery products, candy, and jellies.

Goins and coauthors used data from 3154 Black and White adults aged 18-30 years at baseline. They collected data on MetS components 3 times over a 20-year period. Participants reported foods and beverages consumed in the past month, including brand name, amount consumed, and frequency of intake.

For the purpose the study, MetS was defined as the presence of at least 3 of the following risk factors:

• Fasting plasma glucose ≥100 mg/dL or undergoing drug treatment for elevated glucose or diabetes;
• High-density lipoprotein cholesterol (HDL-C) <40 mg/dL for men or <50 mg/dL for women;
• Fasting triglycerides ≥150 mg/dL or undergoing drug treatment for elevated triglycerides;
• Waist circumference >102 cm in men or >88 cm in women; and
• Systolic blood pressure ≥130 mmHg or diastolic blood pressure ≥85 mmHg or undergoing drug treatment for hypertension.

Participants were stratified into quintiles of cumulative intakes of AS-rich CHO food and beverages, AS, and SSBs, with quintile 1 (Q1) being the lowest intake and quintile 5 (Q5) the highest intake.

After researchers adjusted for demographic and lifestyle characteristics, they found that compared to participants in the lowest quintile (Q1), those in the highest quintile (Q5) of AS-rich CHOs, AS, and SSBs were associated with 59% (P_trend<.001), 44% (P_trend=.01), and 34% (P_trend=.03) higher risk of developing MetS, respectively.

Also, as investigators hypothesized, results showed that diet quality was lower across increasing quintiles of AS-rich CHOs, AS, and SSBs (all P_trend<.001).

“These results support the US 2020-2025 Dietary Guidelines as well as WHO Nutrition Guidelines for CHO to limit daily intake of AS and free sugars, respectively,” concluded researchers. “Further research of CHO composition and quality is warranted to better understand the complexities between type of CHO and cardiometabolic risk factors.”

Source: Goins RK, Steffen LM, Yi SY, et al. Consumption of foods and beverages rich in added sugar associated with incident metabolic syndrome: Coronary Artery Risk Development in Young Adults (CARDIA) study. Eur J Prev Cardiol. Published online January 3, 2024. doi:10.1093/eurjpc/zwad409