USA: Study Reveals Elevated Risk of Metabolic Syndrome with High Intake of Added Sugars

A recent study published in the European Journal of Preventive Cardiology has revealed an elevated risk of metabolic syndrome (MetS) with a high intake of food and beverages with added sugars, such as caloric sweeteners and syrups.

"Our study findings are consistent with an increased risk of developing MetS with greater consumption of added sugar (AS), AS-rich carbohydrate (CHO) foods, and sugar-sweetened beverages (SSBs) which support consuming fewer AS-rich CHO foods and SSBs," the researchers wrote.

Several studies have reported positive associations between total carbohydrate intake and incident MetS, but few differentiate the type or quality of carbohydrates relative to MetS. Lyn M Steffen, University of Minnesota School of Public Health, Division of Epidemiology and Community Health, Minneapolis, MN, and colleagues examined the source of CHO intake, including added sugar, AS-rich CHO foods and sugar-sweetened beverages associated with incident metabolic syndrome in adults enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study.

For this purpose, the researchers assessed dietary intake by diet history three times over 20 years among 3154 Black American and White American women and men aged 18-30 years at baseline. Sources of added sugar-rich carbohydrate foods and beverages include sugar-rich refined grain products, sugar products, candy, and SSBs. Incident metabolic syndrome was created according to standard criteria.

The associations of incident MetS across quintiles of cumulative intakes of AS-rich CHO foods and beverages, AS, and SSBs were evaluated using time-dependent Cox proportional-hazards regression analysis, adjusted for potential confounding factors over 30 years of follow-up.

Study Findings

• The associations of added sugar-rich carbohydrate foods and beverages, AS, and sugar-sweetened beverages intakes with incident MetS were consistent.
• Compared to the lowest intake, the greatest intake of AS-rich CHOs, AS, and SSBs was associated with 59%, 44%, and 34% higher risk of developing MetS, respectively.
• Diet quality was lower across increasing quintiles of AS-rich CHO foods and beverages, AS, and SSBs.

“Excessive consumption of these added sugar-rich carbohydrate beverages and foods may lead to a higher risk of metabolic syndrome and its components due to overall poor diet quality, as opposed to healthy diet patterns, including a [Dietary Approaches to Stop Hypertension (DASH), Mediterranean, Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND)] or other plant-based diet patterns, that protects cardiometabolic health," the researchers wrote.

“This type of low-quality diet pattern characterizes a ‘Western diet’ pattern and is known to promote gut dysbiosis, a condition that disrupts intestinal homeostasis resulting in obesity, metabolic disorders, inflammation, dyslipidemia, and insulin resistance.

"This could explain why in our study, we found higher intake of added sugar-rich carbohydrates consisting of carbohydrates low in fibre was significantly associated with metabolic syndrome even after adjusting for BMI," they concluded.

Reference

Goins, R. K., Steffen, L. M., Yi, S., Zhou, X., Van Horn, L., Shikany, J. M., Terry, J. G., & Jacobs, D. R. Consumption of foods and beverages rich in added sugar associated with incident metabolic syndrome: Coronary Artery Risk Development in Young Adults (CARDIA) study. European Journal of Preventive Cardiology. https://doi.org/10.1093/eurjpc/zwad409