Journal
CRITICAL REVIEWS IN FOOD SCIENCE AND NUTRITION
Volume 63, Issue 20, Pages 4274-4287Publisher
TAYLOR & FRANCIS INC
DOI: 10.1080/10408398.2021.2000361
Keywords
Fructose; dose response; meta-analysis; mortality
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We conducted a systematic review and meta-analysis to summarize the associations between food sources of fructose and cardiovascular diseases (CVD), cancer, and all-cause mortality risk. The findings indicated that fruit, breakfast cereals, sweets, and yogurt were associated with lower risk of all-cause and/or CVD mortality, while sugar-sweetened beverages (SSBs) had a harmful relationship with all-cause and CVD mortality. Fruit intake also had an inverse link with cancer mortality.
We aimed to summarize the associations between food sources of fructose and cardiovascular diseases (CVD), cancer, and all-cause mortality risk using a systematic review and meta-analysis. We searched PubMed, Scopus, and Web of Science up to November 2020. We included cohort studies that investigated the relationship between mortality risk (all-cause, CVD, specific CVD, and total and site-specific cancers) and intake of >= 1 food source of fructose (fruit, fruit juice, breakfast cereals, sugar-sweetened beverages (SSBs), sweets, and yogurt) in general adult population. Summary hazard ratios and 95% CIs were estimated using a random-effects model for linear and nonlinear relationships. Findings indicated that each 100 g/d increase in fruit intake was associated with 8-13% lower risk of CVDs, stroke, gastrointestinal, and lung cancer mortality. For all-cause mortality, there was a beneficial relationship up to 200 g/d fruit, and then plateaued. For ischemic heart disease and cancer mortality, there was a beneficial relationship up to 300 g/d followed by a slight increase. Ingestion of breakfast cereals and sweets was also associated with lower risk of all-cause mortality. For yogurt, a non-linear marginal decrease in all-cause mortality was found. Ingestion of each 200 g/d yogurt was associated with a 14% lower risk of CVD mortality. Every 60 g/d increase in sweet intake was linked to a 5% lower risk of all-cause mortality. Contrariwise, every 250 g/d increase in SSBs intake was associated with 7-10% higher risk of all-cause and CVD mortality. In conclusion, beneficial associations were found between fruit, breakfast cereals, sweets, and yogurt with all-cause and/or CVD mortality risk. Fruit intake had also an inverse link with cancer mortality. Conversely, SSBs had a harmful relationship with all-cause and CVD mortality. Registry number: CRD42019144956
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