Sugar sweetened beverages, fruit juice, and low calorie beverages, and all cause mortality risk among dutch adults:The lifelines cohort study within the sweet project
Objectives To examine prospective associations between intakes of sugar-sweetened beverages (SSB), fruit juice, and low-calorie beverages (LCB), and all-cause mortality among Dutch adults participating in the Lifelines Cohort Study. Methods A total of 118,439 participants aged 45 ± 13 years (60% women) were included in a prospective cohort analysis. Dietary intake at baseline was assessed using an extensive semi-quantitative food frequency questionnaire (FFQ). Uni- and multivariate Cox proportional hazard regression analyses, including substitution analyses, were performed adjusted for demogra... Mehr ...
Objectives To examine prospective associations between intakes of sugar-sweetened beverages (SSB), fruit juice, and low-calorie beverages (LCB), and all-cause mortality among Dutch adults participating in the Lifelines Cohort Study. Methods A total of 118,439 participants aged 45 ± 13 years (60% women) were included in a prospective cohort analysis. Dietary intake at baseline was assessed using an extensive semi-quantitative food frequency questionnaire (FFQ). Uni- and multivariate Cox proportional hazard regression analyses, including substitution analyses, were performed adjusted for demographics, self-reported diseases and lifestyle, and dietary factors. The association was modelled continuously in each 1 glass (or 150 mL)/day intake increment and in four categories of each beverages intake (no intake, ≤2 glass/week, >2--<7 glass/week, and ≥1 glass/day). Results Of the total participants, 63% were SSB consumers, 76% were fruit juice consumers, and 56% were LCB consumers. The median intake among consumers was 0.4 [0.2–1.0] glass/day for SSB, 0.3 [0.1–0.7] glass/day for fruit juice, and 0.5 [1.2–1.1] glass/day for LCB. During a follow-up period of 8.3 [7.5–9.3] y, 2,023 (1.8%) deaths were recorded. Compared to no intake, ≥1 glass SSB/day was associated with a higher risk of mortality (HR 1.24, 95% CI 1.05, 1.46), whereas LCB intake was not associated with all-cause mortality risk. Theoretical replacement of 1 glass/day of SSB with the same amount of LCB was associated with a lower risk of all-cause mortality (HR 0.90, 95% CI 0.83, 0.98). Finally, compared to no intake, moderate fruit juice intake (≤2 glass/week and >2--<7 glass/week) was inversely associated with all-cause mortality (HR 0.80, 95% CI 0.72, 0.90 and HR 0.85, 95% CI 0.76, 0.95 respectively). Conclusions SSB intake was associated with a higher risk of all-cause mortality in the general Dutch adult population, whereas moderate fruit juice intake showed the opposite. Replacing SSB with LCB was associated with a lower risk of all-cause ...