Soft drink consumption and risk of developing cardiometabolic risk factors and the metabolic syndrome in middle-aged adults in the community

Background - Consumption of soft drinks has been linked to obesity in children and adolescents, but it is unclear whether it increases metabolic risk in middle-aged individuals. Methods and Results - We related the incidence of metabolic syndrome and its components to soft drink consumption in participants in the Framingham Heart Study (6039 person-observations, 3470 in women; mean age 52.9 years) who were free of baseline metabolic syndrome. Metabolic syndrome was defined as the presence of >= 3 of the following: waist circumference >= 35 inches (women) or >= 40 inches ( men); fasting blood glucose >= 100 mg/dL; serum triglycerides >= 150 mg/dL; blood pressure >= 135/85 mm Hg; and high-density lipoprotein cholesterol < 40 mg/dL ( men) or < 50 mg/dL ( women). Multivariable models included adjustments for age, sex, physical activity, smoking, dietary intake of saturated fat, trans fat, fiber, magnesium, total calories, and glycemic index. Cross-sectionally, individuals consuming >= 1 soft drink per day had a higher prevalence of metabolic syndrome ( odds ratio [ OR], 1.48; 95% CI, 1.30 to 1.69) than those consuming < 1 drink per day. On follow-up ( mean of 4 years), new-onset metabolic syndrome developed in 765 ( 18.7%) of 4095 participants consuming < 1 drink per day and in 474 (22.6%) of 2059 persons consuming >= 1 soft drink per day. Consumption of >= 1 soft drink per day was associated with increased odds of developing metabolic syndrome (OR, 1.44; 95% CI, 1.20 to 1.74), obesity ( OR, 1.31; 95% CI, 1.02 to 1.68), increased waist circumference (OR, 1.30; 95% CI, 1.09 to 1.56), impaired fasting glucose (OR, 1.25; 95% CI, 1.05 to 1.48), higher blood pressure ( OR, 1.18; 95% CI, 0.96 to 1.44), hypertriglyceridemia (OR, 1.25; 95% CI, 1.04 to 1.51), and low high-density lipoprotein cholesterol (OR, 1.32; 95% CI 1.06 to 1.64). Conclusions - In middle-aged adults, soft drink consumption is associated with a higher prevalence and incidence of multiple metabolic risk factors.