Sugar-Sweetened Beverage Consumption and Calcified Atherosclerotic Plaques in the Coronary Arteries: The NHLBI Family Heart Study

Nutrients. 2021 May 22;13(6):1775. doi: 10.3390/nu13061775.

Abstract

Background: Sugar-sweetened beverage (SSB) intake is associated with higher risk of weight gain, diabetes, hypertension, cardiovascular disease, and cardiovascular mortality. However, the association of SSB with subclinical atherosclerosis in the general population is unknown.

Objective: Our primary objective was to investigate the association between SSB intake and prevalence of atherosclerotic plaque in the coronary arteries in The National Heart, Lung, and Blood Institute (NHLBI) Family Heart Study.

Methods: We studied 1991 participants of the NHLBI Family Heart Study without known coronary heart disease. Intake of SSB was assessed through a semi-quantitative food frequency questionnaire. Coronary artery calcium (CAC) was measured by cardiac Computed Tomography (CT) and prevalent CAC was defined as an Agatston score ≥100. We used generalized estimating equations to calculate adjusted prevalence ratios of CAC. A sensitivity analysis was also performed at different ranges of cut points for CAC.

Results: Mean age and body mass index (BMI) were 55.0 years and 29.5 kg/m2, respectively, and 60% were female. In analysis adjusted for age, sex, BMI, smoking, alcohol use, physical activity, energy intake, and field center, higher SSB consumption was not associated with higher prevalence of CAC [prevalence ratio (95% confidence interval) of: 1.0 (reference), 1.36 (0.70-2.63), 1.69 (0.93-3.09), 1.21 (0.69-2.12), 1.05 (0.60-1.84), and 1.58 (0.85-2.94) for SSB consumption of almost never, 1-3/month, 1/week, 2-6/week, 1/day, and ≥2/day, respectively (p for linear trend 0.32)]. In a sensitivity analysis, there was no evidence of association between SSB and prevalent CAC when different CAC cut points of 0, 50, 150, 200, and 300 were used.

Conclusions: These data do not provide evidence for an association between SSB consumption and prevalent CAC in adult men and women.

Keywords: atherosclerosis; coronary calcium; nutrition; soda consumption; sugar-sweetened beverages.

MeSH terms

  • Adult
  • Aged
  • Atherosclerosis / epidemiology
  • Calcium / metabolism
  • Coronary Artery Disease / epidemiology*
  • Coronary Vessels / pathology
  • Cross-Sectional Studies
  • Energy Intake
  • Female
  • Humans
  • Male
  • Middle Aged
  • National Heart, Lung, and Blood Institute (U.S.)
  • Nutrition Surveys
  • Plaque, Atherosclerotic / epidemiology*
  • Prevalence
  • Risk Factors
  • Smoking
  • Sugar-Sweetened Beverages / adverse effects*
  • United States
  • Vascular Calcification / epidemiology*

Substances

  • Calcium