A prospective study of artificially sweetened beverage intake and cardiometabolic health among women at high risk

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

  • Stefanie N. Hinkle
  • Shristi Rawal
  • Anne Ahrendt Bjerregaard
  • Thor I. Halldorsson
  • Mengying Li
  • Sylvia H. Ley
  • Jing Wu
  • Yeyi Zhu
  • Liwei Chen
  • Aiyi Liu
  • Grunnet, Louise Groth
  • Mohammad L. Rahman
  • Freja Bach Kampmann
  • James L. Mills
  • Sjurdur F. Olsen
  • Cuilin Zhang

Background: Artificially sweetened beverages (ASBs) are commonly consumed and recommended for individuals at high risk for cardiometabolic diseases; however, the health effects of ASBs remain contradictory. Given that cross-sectional analyses are subject to reverse causation, prospective studies with long-term follow-up are needed to evaluate associations between ASBs and cardiometabolic health, especially among high-risk individuals. Objective: The aim of this studywas to examine associations of ASB intake and cardiometabolic health among high-riskwomenwith prior gestational diabetes mellitus (GDM). Methods: We included 607 women with GDM from the Danish National Birth Cohort (DNBC; 1996-2002) who completed a clinical exam 9-16 y after the DNBC pregnancy for the Diabetes & Women's Health (DWH) Study (2012-2014). We assessed ASB intake using FFQs completed during the DNBC pregnancy and at the DWH Study clinical exam. We examined cardiometabolic outcomes at the DWH clinical exam. We estimated percentage differences in continuous cardiometabolic markers and RRs for clinical endpoints in association with ASB intake both during pregnancy and at follow-up adjusted for prepregnancy BMI, diet, and lifestyle factors. Sensitivity analyses to account for reverse causation were performed. Results: In pregnancy and at follow-up, 30.4% and 36.4% of women regularly (≥2 servings/wk) consumed ASB, respectively. Consumption of ASBs, both during pregnancy and at follow-up, was associated with higher glycated hemoglobin (HbA1c), insulin, HOMA-IR, triglycerides, liver fat, and adiposity and with lower HDL at follow-up. After adjustment for covariates, particularly prepregnancy BMI, the majority of associations between ASB intake in pregnancy and outcomes at follow-up became null with the exception of HbA1c. ASB intake at follow-up (≥1 serving/d compared with <1 serving/mo) was associated with higher HbA1c (6.5%; 95% CI: 1.9, 11.3; P-trend = 0.007); however, associations were not upheld in sensitivity analyses for reverse causation. Conclusions: Among Danish women with a history of GDM, ASB intake was not significantly associated with cardiometabolic profiles.

OriginalsprogEngelsk
Artikelnummernzq094
BogserieAmerican Journal of Clinical Nutrition
Vol/bind110
Udgave nummer1
Sider (fra-til)221-232
Antal sider12
ISSN0002-9165
DOI
StatusUdgivet - 2019
Eksternt udgivetJa

Bibliografisk note

Funding Information:
This work was supported by the Intramural Research Program of the Eu-nice Kennedy Shriver National Institute of Child Health and Human Development at the NIH (contracts HHSN275201000020C, HHSN275201500003C, HHSN275201300026I, and HSN275201100002I), the March of Dimes Birth Defects Foundation (grants 6-FY-96-0240, 6-FY97-0553, 6-FY97-0521, and 6-FY00-407), Innovation Fund Denmark [grants 09-067124 and 11-115923, (Centre for Fetal Programming)], the Health Foundation (grant 11/263-96), the Heart Foundation (grant 96-2-4-83-22450), the European Union (grant FP7-289346-EarlyNutrition), and the Danish Diabetes Academy supported by the Novo Nordisk Foundation. YZ is supported by a career development award from the NIH Building Interdisciplinary Research Careers in Women’s Health Program (grant 5K12HD05216). SHL is supported by grant P20GM109036 from the National Institute of General Medical Sciences of the NIH.

Publisher Copyright:
© American Society for Nutrition 2019.

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