Added Sugars Intake and Metabolic Syndrome in U.S. Hispanic/Latino Adults: Longitudinal Results From the Hispanic Community Health Study/Study of Latinos.
INTRODUCTION: Excessive sugar-sweetened beverage consumption is associated with metabolic syndrome, but few studies have evaluated the associations with added sugars from all dietary sources. The authors evaluated cross-sectional and longitudinal associations between added sugars intake and metabolic syndrome and its components in a cohort of U.S. Hispanic/Latino adults. In addition, the authors conducted a secondary analysis to evaluate whether sugar-sweetened beverages were independently associated with metabolic syndrome and its components. METHODS: The authors used baseline (n=12,484) and 6.2-year follow-up (n=5,576) data from adults aged 18-74 years without diabetes from the Hispanic Community Health Study/Study of Latinos. The authors derived added sugars and sugar-sweetened beverage intake at baseline from two 24-hour dietary recalls using the National Cancer Institute methodology and categorized participants using quintiles of added sugars percentage per day for added sugars or 8 fl oz servings per day for sugar-sweetened beverages. The authors used the National Cholesterol Education Program-Third Adult Treatment Panel definition of metabolic syndrome and metabolic syndrome components. In cross-sectional analyses, the authors used multivariate logistic and linear regression to estimate the ORs for binary outcomes and mean differences for continuous outcomes. In longitudinal analyses, the authors used Poisson regression to estimate incidence rate ratios. RESULTS: Metabolic syndrome prevalence was 24.8% at baseline, and average added sugars was 14.4%. In the cross-sectional analysis, those in the fifth quintile of added sugars had odds of metabolic syndrome (OR=1.01, 95% CI=0.74, 1.39; p-trend=0.622) similar to the odds for those in the lowest quintile. In the longitudinal analyses, there was no significant association between added sugars and metabolic syndrome incidence in minimally or fully adjusted models (overall p-trend=0.84 and 0.93, respectively). In secondary analyses, cross-sectionally, sugar-sweetened beverage intake was significantly associated with waist circumference (p-trend=0.003), high-density lipoprotein cholesterol (p-trend<0.001), and fasting glucose (p-trend<0.001). Longitudinally, among individual components, those consuming more than two 8 fl oz servings per day had a 35% higher rate of reduced high-density lipoprotein cholesterol (incidence rate ratio=1.35, 95% CI=1.02, 1.79; p-trend=0.009). CONCLUSIONS: Added sugars were not associated with prevalent or incident metabolic syndrome among U.S. Hispanic/Latino adults. However, findings from secondary analyses suggest that sugar-sweetened beverages may have a distinct metabolic impact, particularly on waist circumference, high-density lipoprotein cholesterol, and fasting glucose, warranting further investigation.
