Beverage Consumption, Genetic Predisposition, and Risk of CVD in Adults With Type 2 Diabetes
abstract
This abstract is available on the publisher's site.
Access this abstract nowBACKGROUND
The evidence regarding the relationship between different types of beverages and cardiovascular health in individuals with type 2 diabetes (T2D) is scarce.
AIMS
To prospectively examine the associations between individual beverage consumption, genetic predisposition, and risk of incident cardiovascular disease (CVD) among adults with T2D.
METHODS
We analyzed the associations of individual beverage intake with risks of CVD and ischemic heart disease (IHD) in 7315 participants with T2D, overall or stratified by genetic risk to CVD, using data from the UK Biobank study.
RESULTS
During a median follow-up of 6.1 years, 878 incident CVD cases were identified, including 517 IHD cases. Higher intakes of sugar-sweetened beverages (SSBs), artificially-sweetened beverages (ASBs), and natural juices were each linearly associated with a higher CVD (Pnonlinearity > 0.05). Comparing the highest to lowest groups of beverage consumption, the multivariable-adjusted HRs (95% CIs) of CVD were 1.54 (1.14, 2.07) for SSBs, 1.34 (1.07, 1.69) for ASBs, and 1.33 (1.01, 1.76) for natural juices. Similar results were observed for incident IHD. Moreover, no significant interactions between these beverages and the CVD genetic risk score were observed. Replacing half-unit/day of SSBs or natural juices with coffee, tea, or yogurt, but not ASBs, was associated with a 20%-46% lower risk of CVD and IHD.
INTERPRETATION
Higher intakes of SSBs, ASBs, and natural juices were each linearly associated with an increased risk of CVD among individuals with T2D, regardless of genetic predisposition. Our findings highlight the importance of selecting healthy beverage options to improve cardiovascular health in patients with T2D.
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Additional Info
Disclosure statements are available on the authors' profiles:
Beverage Consumption, Genetic Predisposition, and Risk of Cardiovascular Disease among Adults with Type 2 Diabetes
J. Clin. Endocrinol. Metab. 2024 Jan 27;[EPub Ahead of Print], K Zhu, T Geng, Z Qiu, R Li, L Li, R Li, X Chen, A Pan, JE Manson, G LiuFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
This study examined whether different types of beverage intake have associations with the incidence of CVD and ischemic heart disease (IHD) in adults with type 2 diabetes, and whether genetic predisposition to CVD modifies this association. Using UK Biobank data, researchers analyzed data from 7315 adults followed for a median of 6.1 years. They concluded that higher consumption of sugar-sweetened beverages (SSBs), artificially-sweetened beverages (ASBs), and natural juices was associated with a higher incidence of CVD and IHD in a dose-dependent manner. In mediation analyses, they found that the associations with measured outcomes were partially explained through BMI for SSBs and ASBs and through total sugar consumption for SSBs and natural juices. Additionally, they found that substituting SSBs, ASBs, or natural juices with coffee, tea, or yogurt was associated with a lower risk of CVD and IHD incidence. Genetic predisposition to CVD did not modify the relationship between intake of SSBs, ASBs, or natural juices and CVD and IHD incidence.
This study adds to the current literature linking SSBs to increased CVD risk. The study also found evidence for the association of ASBs and natural juices with CVD risk. In sensitivity analyses, to minimize potential reverse causation, the participants who lost weight or experienced CVD events during the first year were excluded; however, reverse causation still cannot be ruled out (ie, that people at increased risk of CVD opt for ASBs and natural juices). One limitation of this study is the limited racial and ethnic diversity of the sample, which makes results less generalizable as around 90% of the participants self-reported as White. While biologic differences among different populations are unlikely, there may be varying social determinants of health experienced by diverse populations, which could modify these effects. Overall, this study supports current recommendations for limiting SSB consumption through the promotion of non-sweetened alternatives (eg, coffee, tea, yogurt), but also suggests possible CVD benefits from limiting ASB and natural juice consumption for adults with type 2 diabetes.