期刊
AMERICAN JOURNAL OF CLINICAL NUTRITION
卷 102, 期 4, 页码 914-921出版社
OXFORD UNIV PRESS
DOI: 10.3945/ajcn.115.107243
关键词
hypertension; meta-analysis; prospective cohort; sugars; sugar-sweetened beverage
资金
- Canadian Institutes of Health Research through the Canada-wide Human Nutrition Trialists' Network [129920]
- Diet, Digestive tract, and Disease (3D) Centre through the Canada Foundation for Innovation
- Canadian Institutes for Health Research (CIHR)
- Ontario Graduate Scholar award
- CIHR Canada Graduate Scholarship Master's Award
- Government of Canada through the Canada Research Chair Endowment
- PSI Foundation Graham Farquharson Knowledge Translation Fellowship
- Canadian Diabetes Association Clinician Scientist Award
Background: The role of sugar-sweetened beverages (SSBs) that contain free or bound fructose in the pathogenesis of hypertension remains unclear. Objective: We conducted a systematic review and meta-analysis of prospective cohort studies to quantify the association between fructose-containing SSBs and risk of hypertension. Design: MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, and the Cochrane registry were searched from conception through 11 November 2014. Two independent reviewers extracted data and assessed the quality of studies (with the use of the Newcastle-Ottawa Scale). Risk estimates of extreme quantiles of SSB intake (lowest compared with highest) for hypertension incidence were generated with the use of generic inverse-variance methods with random-effects models and expressed as risk ratios with 95% CIs. Heterogeneity was assessed with the Cochran Q statistic and quantified with the I-2 statistic. Results: Six prospective cohort studies (n = 240,508) with 79,251 cases of hypertension observed over >= 3,197,528 person-years of follow-up were included. SSB consumption significantly increased the risk of developing hypertension by 12% (risk ratio: 1.12; 95% CI: 1.06, 1.17) with evidence of significant heterogeneity (I-2 = 62%, P = 0.02) when highest [>= 1 serving (6.7, 8, or 12 oz)/d] and lowest (none) quantiles of intake were compared. With the use of a dose-response analysis, a significant 8.2% increase in risk of every additional SSB per day from none to >= SSB/d (beta = 0.0027, P < 0.001) was identified. Limitations include unexplained heterogeneity and residual confounding. The results may also have been subject to collinearity effects from aspects of a Western dietary pattern. Conclusions: SSBs were associated with a modest risk of developing hypertension in 6 cohorts. There is a need for high-quality randomized trials to assess the role of SSBs in the development of hypertension and its complications.
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