Artificially Sweetened Beverage Consumption Is Positively Associated with Newly Diagnosed Diabetes in Normal-Weight but Not in Overweight or Obese Brazilian Adults

被引:16
作者
Yarmolinsky, James [1 ,2 ]
Duncan, Bruce B. [1 ,2 ,3 ]
Chambless, Lloyd E. [4 ]
Bensenor, Isabela M. [5 ,6 ]
Barreto, Sandhi M.
Goulart, Alessandra C. [5 ,6 ]
Santos, Itamar S. [5 ,6 ]
Diniz, Maria de Fatima Sander [7 ]
Schmidt, Maria Ines [1 ,2 ,3 ]
机构
[1] Univ Fed Rio Grande do Sul, Sch Med, Postgrad Program Epidemiol, Porto Alegre, RS, Brazil
[2] Univ Fed Rio Grande do Sul, Hosp Clin Porto Alegre, Porto Alegre, RS, Brazil
[3] Univ N Carolina, Dept Epidemiol, Chapel Hill, NC USA
[4] Univ N Carolina, Dept Biostat, Chapel Hill, NC USA
[5] Univ Sao Paulo, Univ Hosp, Fac Med, Dept Clin Med, Sao Paulo, Brazil
[6] Univ Sao Paulo, Univ Hosp, Ctr Clin & Epidemiol Res, Sao Paulo, Brazil
[7] Univ Fed Minas Gerais, Fac Med, Belo Horizonte, MG, Brazil
关键词
type; 2; diabetes; artificially sweetened beverage consumption; BMI; glucose intolerance; beta-cell function; METABOLIC SYNDROME; GUT MICROBIOTA; DIET BEVERAGES; RISK; DISEASE; GLUCOSE; YOUNG;
D O I
10.3945/jn.115.220194
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
Background: Recent animal studies suggest that artificially sweetened beverage (ASB) consumption increases diabetes risk. Objective: We examined the relation of ASB intake with newly diagnosed diabetes and measures of glucose homeostasis in a large Brazilian cohort of adults. Methods: We used cross-sectional data from 12,884 participants from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). ASB use was assessed by questionnaire and newly diagnosed diabetes by a 2-h 75-g oral glucose tolerance test and/or glycated hemoglobin. Logistic and linear regression analyses were performed to examine the association of ASB consumption with diabetes and continuous measures of glucose homeostasis, respectively. Results: Although ASB consumption was not associated with diabetes in logistic regression analyses after adjustment for body mass index (BMI; in kg/m(2)) overall, the association varied across BMI categories (P-interaction = 0.04). Among those with a BMI <25, we found a 15% increase in the adjusted odds of diabetes for each increase in the frequency of ASB consumption per day (P = 0.001); compared with nonusers, ASB users presented monotonic increases in the adjusted ORs (95% Cls) of diabetes with increased frequency of consumption: 1.03 (0.60, 1.77), 1.43 (0.93, 2.20), 1.62 (1.08, 2.44), and 2.51 (1.40, 4.50) for infrequent, 1-2, 3-4, and >4 times/d, respectively. In linear regression analyses, among normal-weight individuals, greater ASB consumption was also associated with increased fasting glucose concentrations (P= 0.01) and poorer beta-cell function (P= 0.009). No such associations were seen for those with BMI In fact, in overweight or obese participants, greater ASB consumption was significantly associated with improved indexes of insulin resistance and 2-h postload glucose. Conclusions: Normal-weight, but not excess-weight, individuals with greater ASB consumption presented diabetes more frequently and had higher fasting glucose and poorer beta-cell function.
引用
收藏
页码:290 / 297
页数:8
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