Associations Between Added Sugar Intake and Risk of Four Different Cardiovascular Diseases in a Swedish Population-Based Prospective Cohort Study

Research output: Contribution to journalJournal articleResearchpeer-review

  • Suzanne Janzi
  • Ramne, Stina
  • Esther González-Padilla
  • Linda Johnson
  • Emily Sonestedt

Aims: Although diet is one of the main modifiable risk factors of cardiovascular disease, few studies have investigated the association between added sugar intake and cardiovascular disease risk. This study aims to investigate the associations between intake of total added sugar, different sugar-sweetened foods and beverages, and the risks of stroke, coronary events, atrial fibrillation and aortic stenosis. Methods: The study population consists of 25,877 individuals from the Malmö Diet and Cancer Study, a Swedish population-based prospective cohort. Dietary data were collected using a modified diet history method. National registers were used for outcome ascertainment. Results: During the mean follow-up of 19.5 years, there were 2,580 stroke cases, 2,840 coronary events, 4,241 atrial fibrillation cases, and 669 aortic stenosis cases. Added sugar intakes above 20 energy percentage were associated with increased risk of coronary events compared to the lowest intake category (HR: 1.39; 95% CI: 1.09–1.78), and increased stroke risk compared to intakes between 7.5 and 10 energy percentage (HR: 1.31; 95% CI: 1.03 and 1.66). Subjects in the lowest intake group for added sugar had the highest risk of atrial fibrillation and aortic stenosis. More than 8 servings/week of sugar-sweetened beverages were associated with increased stroke risk, while ≤2 servings/week of treats were associated with the highest risks of stroke, coronary events and atrial fibrillation. Conclusion: The results indicate that the associations between different added sugar sources and cardiovascular diseases vary. These findings emphasize the complexity of the studied associations and the importance of considering different added sugar sources when investigating health outcomes.

Original languageEnglish
Article number603653
JournalFrontiers in Nutrition
Volume7
ISSN2296-861X
DOIs
Publication statusPublished - 2020
Externally publishedYes

Bibliographical note

Funding Information:
The authors wish to thank all the participants and research staff of the Malm? Diet and Cancer Study. Funding. This study was funded by the Swedish Research Council (2016-01501), the Heart and Lung Foundation (2016-0267 and 2019-0555), and the Albert P?hlsson Foundation. We also acknowledge the support provided by the Swedish Foundation for Strategic Research (IRC15-0067). LJ is supported by governmental funding within the Swedish National Health Services, the Swedish Society of Medicine (Grant number SLS-888281), the Swedish Society of Cardiology, the Swedish Heart and Lung Association (Grant number FA 2018:50 and FA 2019:21), the Bergqvist Foundation (Grant number 139645) and the Swedish Heart and Lung Foundation (Grant numbers 20180211, 20190354, and 20190294).

Publisher Copyright:
© Copyright © 2020 Janzi, Ramne, González-Padilla, Johnson and Sonestedt.

    Research areas

  • added sugar intake, cardiometabolic risk factors, cardiovascular diseases, dietary sugar, sugar-sweetened beverages

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