Artificially sweetened beverage consumption and all-cause and cause-specific mortality: an updated systematic review and dose-response meta-analysis of prospective cohort studies.

IF 4.4 2区 医学 Q1 NUTRITION & DIETETICS Nutrition Journal Pub Date : 2024-07-31 DOI:10.1186/s12937-024-00985-7
Zhangling Chen, Cheng Wei, Sander Lamballais, Kang Wang, Yuchan Mou, Yichao Xiao, Fei Luo, Wichor M Bramer, Trudy Voortman, Shenghua Zhou
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Abstract

Background: Artificially sweetened beverages (ASB) are consumed globally, but their impact on overall health remains uncertain. We summarized published associations between ASB intake with all-cause and cause-specific mortality.

Methods: We searched Medline, Embase, Web of Science, and Cochrane CENTRAL databases until August 2023. Random effect meta-analysis was conducted to calculate pooled risk ratios (RRs) and 95% confidence intervals (95%CIs) for highest versus lowest categories of ASB consumption in relation to all-cause and cause-specific mortality. Linear and non-linear dose-response analyses were also performed.

Results: Our systematic review and meta-analysis included 11 prospective cohort studies. During a median/mean follow-up period of 7.0 to 28.9 years, 235,609 deaths occurred among 2,196,503 participants. Intake of ASB was associated with higher risk of all-cause and CVD mortality with pooled RRs (95%CIs) of highest vs. lowest intake categories of 1.13 (1.06, 1.21) (I2 = 66.3%) for all-cause mortality and 1.26 (1.10, 1.44) (I2 = 52.0%) for CVD mortality. Dose-response analysis revealed a non-linear association of ASB with all-cause mortality (pnon-linearity = 0.01), but a linear positive association with CVD mortality (pnon-linearity = 0.54). No significant association was observed for ASB intake and cancer mortality. Moreover, a secondary meta-analysis demonstrated that replacing 1 serving/day of sugary sweetened beverages (SSB) with ASB was associated with 4-6% lower risk of all-cause and CVD mortality. Per NutriGrade, the evidence quality for associations between ASB intake with all-cause and CVD mortality was moderate.

Conclusions: Higher intake of ASB was associated with higher risk of all-cause and CVD mortality, albeit a lower risk than for SSB.

Systematic review registration: PROSPERO registration no. CRD42022365701.

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人工甜味饮料消费与全因和特定原因死亡率:前瞻性队列研究的最新系统综述和剂量反应荟萃分析。
背景:人工甜味饮料(ASB)的消费遍及全球,但其对整体健康的影响仍不确定。我们总结了已发表的人工甜味饮料摄入量与全因和特定原因死亡率之间的关系:我们检索了 Medline、Embase、Web of Science 和 Cochrane CENTRAL 数据库,直至 2023 年 8 月。我们进行了随机效应荟萃分析,计算了ASB摄入量最高和最低类别与全因和特定病因死亡率的风险比(RRs)和95%置信区间(95%CIs)。此外,还进行了线性和非线性剂量反应分析:我们的系统综述和荟萃分析包括 11 项前瞻性队列研究。在中位数/平均值为 7.0 至 28.9 年的随访期间,2,196,503 名参与者中有 235,609 人死亡。ASB摄入量与较高的全因和心血管疾病死亡风险相关,最高与最低摄入量类别的汇总RRs(95%CIs)分别为:全因死亡率1.13 (1.06, 1.21) (I2 = 66.3%),心血管疾病死亡率1.26 (1.10, 1.44) (I2 = 52.0%)。剂量-反应分析显示,ASB 与全因死亡率呈非线性关系(pnon-linearity = 0.01),但与心血管疾病死亡率呈线性正相关(pnon-linearity = 0.54)。在 ASB 摄入量与癌症死亡率之间没有观察到明显的关联。此外,一项二次荟萃分析表明,用 ASB 取代每天 1 份含糖甜饮料 (SSB) 可使全因和心血管疾病死亡风险降低 4-6%。根据营养评级,ASB 摄入量与全因死亡率和心血管疾病死亡率之间关系的证据质量为中等:ASB摄入量越高,全因死亡率和心血管疾病死亡率风险越高,尽管风险低于SSB:系统综述注册:PROSPERO 注册号CRD42022365701。
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来源期刊
Nutrition Journal
Nutrition Journal NUTRITION & DIETETICS-
CiteScore
9.80
自引率
0.00%
发文量
68
审稿时长
4-8 weeks
期刊介绍: Nutrition Journal publishes surveillance, epidemiologic, and intervention research that sheds light on i) influences (e.g., familial, environmental) on eating patterns; ii) associations between eating patterns and health, and iii) strategies to improve eating patterns among populations. The journal also welcomes manuscripts reporting on the psychometric properties (e.g., validity, reliability) and feasibility of methods (e.g., for assessing dietary intake) for human nutrition research. In addition, study protocols for controlled trials and cohort studies, with an emphasis on methods for assessing dietary exposures and outcomes as well as intervention components, will be considered. Manuscripts that consider eating patterns holistically, as opposed to solely reductionist approaches that focus on specific dietary components in isolation, are encouraged. Also encouraged are papers that take a holistic or systems perspective in attempting to understand possible compensatory and differential effects of nutrition interventions. The journal does not consider animal studies. In addition to the influence of eating patterns for human health, we also invite research providing insights into the environmental sustainability of dietary practices. Again, a holistic perspective is encouraged, for example, through the consideration of how eating patterns might maximize both human and planetary health.
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