Published Online
on July 23, 2007

A more recent version of this article appeared on July 31, 2007

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Submitted on January 12, 2007
Accepted on May 15, 2007

Soft Drink Consumption and Risk of Developing Cardiometabolic Risk Factors and the Metabolic Syndrome in Middle-Aged Adults in the Community

Ravi Dhingra MD, Lisa Sullivan PhD, Paul F. Jacques PhD, Thomas J. Wang MD, Caroline S. Fox MD, James B. Meigs MD, MPH, Ralph B. D’Agostino PhD, J. Michael Gaziano MD, MPH, and Ramachandran S. Vasan MD^*

From the National Heart, Lung, and Blood Institute’s Framingham Heart Study (R.D., T.J.W., C.S.F., R.S.V.), Framingham, Mass; Massachusetts Veterans Epidemiology Research and Information Center (R.D., J.M.G.), VA Boston Healthcare System, Boston, Mass; Division of Aging (R.D., J.M.G.), Brigham and Women’s Hospital, Harvard Medical School, Boston, Mass; Alice Peck Day Memorial Hospital (R.D.), Lebanon, NH; Department of Biostatistics (L.S., R.B.D.), Boston University School of Public Health, Boston, Mass; Jean Mayer USDA Human Nutrition Research Center on Aging (P.F.J.), Tufts University, Boston, Mass; Division of Cardiology (T.J.W.) and Department of Medicine (J.B.M.), Massachusetts General Hospital, Harvard Medical School, Boston, Mass; National Heart, Lung, and Blood Institute (C.S.F.), Bethesda, Md; Divisions of Preventive Medicine and Cardiovascular Medicine (J.M.G.), Brigham and Women’s Hospital, Boston, Mass; and Cardiology Section and the Department of Preventive Medicine and Epidemiology (R.S.V.), Boston University School of Medicine, Boston, Mass.

^* To whom correspondence should be addressed. E-mail: vasan{at}bu.edu.

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.

Key words: diabetes mellitus • metabolic syndrome • epidemiology • obesity • risk factors • carbonated beverages

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