Associations of Dietary Sugar Types with Coronary Heart Disease Risk: a Prospective Cohort Study

Overview

Journal Am J Clin Nutr

Publisher Elsevier

Specialty Nutritional Sciences

Date 2023 Sep 2

PMID 37659725

Authors

Kristine K Dennis

Fenglei Wang

Yanping Li

JoAnn E Manson

Eric B Rimm

Frank B Hu

Walter C Willett

Meir J Stampfer

Dong D Wang

Affiliations

Soon will be listed here.

Abstract

Background: Higher intake of total sugar has been linked with coronary heart disease (CHD) risk, but the role of individual sugars, particularly fructose, is uncertain.

Objectives: This study aimed to investigate the associations of individual dietary sugars with CHD risk.

Methods: In prospective cohort studies, we followed 76,815 women (Nurses' Health Study, 1980-2020) and 38,878 men (Health Professionals Follow-up Study, 1986-2016). Sugar and carbohydrate intake, including total fructose equivalents ([TFE] from fructose monosaccharides and sucrose), total glucose equivalents ([TGE] from glucose monosaccharides, disaccharides, and starch), and other sugar types, was measured every 2 to 4 y by semiquantitative food frequency questionnaires.

Results: We documented 9,723 incident CHD cases over 40 years. In isocaloric substitution models with total fat as a comparison nutrient, comparing extreme quintiles of intake, hazard ratios (HRs), 95% confidence interval [CI]) for CHD risk were 1.31 (1.20 to 1.42; P < 0.001) for TGE and 1.03 (0.94 to 1.11; P = 0.25) for TFE. TFE from fruits and vegetables was not associated with CHD risk (P = 0.70), but TFE from added sugar and juice was associated with CHD risk (HR: 1.12, 95% CI: 1.04 to 1.20; P < 0.01). Intakes of total sugars and added sugar were positively associated with CHD risk (HRs: 1.16, 95% CI: 1.07 to 1.26, P < 0.001; 1.08, 95% CI: 0.99 to 1.16, P = 0.04).

Conclusions: Intakes of TGE, total sugar, added sugar, and fructose from added sugar and juice were associated with higher CHD risk, but TFE and fructose from fruits and vegetables were not.

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