Sweetened beverages and risk of frailty among older women in the nurses' health study

Background Consumption of sugar-sweetened beverages (SSBs) has been consistently associated with a higher risk of obesity, type 2 diabetes, cardiovascular disease, and premature mortality, whereas evidence for artificially sweetened beverages (ASBs) and fruit juices on health is less solid. The aim of this study was to evaluate the consumption of SSBs, ASBs, and fruit juices in association with frailty risk among older women. Methods and findings We analyzed data from 71,935 women aged ≥60 (average baseline age was 63) participating in the Nurses’ Health Study (NHS), an ongoing cohort study initiated in 1976 among female registered nurses in the United States. Consumption of beverages was derived from 6 repeated food frequency questionnaires (FFQs) administered between 1990 and 2010. Frailty was defined as having at least 3 of the following 5 criteria from the FRAIL scale: fatigue, poor strength, reduced aerobic capacity, having ≥5 chronic illnesses, and weight loss ≥5%. The occurrence of frailty was assessed every 4 years from 1992 to 2014. During 22 years of follow-up, we identified 11,559 incident cases of frailty. Consumption of SSBs was associated with higher risk of frailty after adjustment for diet quality, body mass index (BMI), smoking status, and medication use, specifically, the relative risks (RRs) and 95% confidence interval (95% CI) for ≥2 serving/day versus no SSB consumption was 1.32 (1.10, 1.57); p-value <0.001. ASBs were also associated with frailty [RR ≥2 serving/day versus no consumption: 1.28 (1.17, 1.39); p-value <0.001]. Orange juice was associated with lower risk of frailty [RR ≥1 serving/day versus no consumption: 0.82 (0.76, 0.87); p-value <0.001], whereas other juices were associated with a slightly higher risk [RR ≥1 serving/day versus no consumption: 1.15 (1.03, 1.28); p-value <0.001]. A limitation of this study is that, due to self-reporting of diet and frailty, certain misclassification bias cannot be ruled out; also, some residual confounding may persist. Conclusions In this study, we observed that consumption of SSBs and ASBs was associated with a higher risk of frailty. However, orange juice intake showed an inverse association with frailty. These results need to be confirmed in further studies using other frailty definitions.

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Interaction between apolipoprotein E genotype and hypertension on cognitive function in older women in the Nurses’ Health Study

PLoS ONE ◽

10.1371/journal.pone.0224975 ◽

2019 ◽

Vol 14 (11) ◽

pp. e0224975 ◽

Cited By ~ 2

Author(s):

Iris Y. Kim ◽

Francine Grodstein ◽

Peter Kraft ◽

Gary C. Curhan ◽

Katherine C. Hughes ◽

...

Keyword(s):

Cognitive Function ◽

Apolipoprotein E ◽

Older Women ◽

Health Study ◽

Apolipoprotein E Genotype

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Abstract 846: Associations of dietary and lifestyle oxidative balance scores with all-cancer, all-CVD, and all-cause mortality risk among older women: The Iowa Women's Health Study

10.1158/1538-7445.am2021-846 ◽

2021 ◽

Author(s):

Ziling Mao ◽

Anna E. Prizment ◽

DeAnn Lazovich ◽

Boberd M. Bostick

Keyword(s):

Women’S Health ◽

Women's Health ◽

Older Women ◽

Mortality Risk ◽

Health Study ◽

Oxidative Balance ◽

All Cause Mortality ◽

Iowa Women's Health Study

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Vitamin D intake and mental health-related quality of life in older women: The Iowa Women's Health Study

Maturitas ◽

10.1016/j.maturitas.2011.12.005 ◽

2012 ◽

Vol 71 (3) ◽

pp. 267-273 ◽

Cited By ~ 15

Author(s):

Sarah Motsinger ◽

DeAnn Lazovich ◽

Richard F. MacLehose ◽

Carolyn J. Torkelson ◽

Kim Robien

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Older Women ◽

Health Study ◽

Health Related Quality ◽

Vitamin D Intake ◽

Related Quality ◽

Health Related ◽

Iowa Women's Health Study

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Abstract P196: Insomnia Symptoms And Ideal Cardiovascular Health In Older Women: Data From The Women’S Health Study

Circulation ◽

10.1161/circ.143.suppl_1.p196 ◽

2021 ◽

Vol 143 (Suppl_1) ◽

Author(s):

Cameron Hicks ◽

Jonathan Butler ◽

Natalie B Slopen ◽

David Williams ◽

Dayna A Johnson ◽

...

Keyword(s):

Women’S Health ◽

Women's Health ◽

Older Women ◽

Sleep Duration ◽

Cardiovascular Health ◽

Health Study ◽

Lower Odds ◽

Ideal Cardiovascular Health ◽

The Relationship ◽

Insomnia Symptoms

Introduction: While insomnia is associated with an increased risk of incident cardiovascular disease (CVD), its relationship with ideal cardiovascular health (ICH) is less certain. Given that sleep disturbances increase with age, we examined the relationship between insomnia symptoms and ICH in older women. Methods: Among women participating in the ongoing Women’s Health Study stress cohort with no apparent history of CVD [N= 2588; Mean age= 72.5 ± 6.3], insomnia symptoms were characterized as self-reported difficulty falling asleep or waking up multiple times a night, three or more times per week. Ideal cardiovascular health, as defined by the American Heart Association’s 2020 Impact goals, included standard optimal targets for blood pressure, total cholesterol, glucose, body mass index, physical activity, diet, and smoking. We examined the relationship between insomnia symptoms and ICH using logistic regression, adjusting for clinical and demographic variables. Results: Of the 26588 participants, 52% reported insomnia symptoms, and 38% had ICH. Women with insomnia symptoms had significantly lower odds of ICH after full adjustment for age, race/ethnicity, education, income, depression/anxiety, marital status, and sleep duration (OR [95% CI]: 0.73 [0.64-0.83]). Moreover, compared to women without insomnia symptoms, those with insomnia symptoms were significantly more likely to have hypertension, diabetes, hypercholesterolemia, depression, anxiety, currently smoke, drink one or more alcoholic beverages per day, have a BMI >30, or exercise less frequently. Conclusion: In older women, insomnia symptoms were significantly associated with lower odds of ideal cardiovascular health even after adjusting for socioeconomic status, psychosocial factors, and sleep duration. These results suggest insomnia screening may be an important component of cardiovascular health promotion in this patient population. Further research is needed to evaluate the effects of sleep behavioral interventions on improving ICH.

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Abstract MP49: Sugar Sweetened and Artificially Sweetened Beverages and risk of Mortality in US adults

Circulation ◽

10.1161/circ.129.suppl_1.mp49 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Vasanti S Malik ◽

An Pan ◽

Lawrence de Koning ◽

Eva Schernhammer ◽

Walter C Willett ◽

...

Keyword(s):

Proportional Hazards ◽

Total Mortality ◽

Cox Proportional Hazards ◽

Health Study ◽

Sweetened Beverages ◽

Risk Of Mortality ◽

Regular Consumption ◽

Increased Risk ◽

Artificially Sweetened Beverages ◽

Cvd Mortality

Background: Sugar sweetened beverages (SSBs) are the single largest source of calories and added sugars in the US diet and regular consumption has been associated with weight gain and risk of chronic diseases. Artificially sweetened beverages (ASBs) are often suggested as alternatives to SSB but little is known about their long-term health effects. Whether consumption of SSBs or ASBs is associated with risk of mortality is unknown. Methods: We prospectively followed 38,602 men from the Health Professional’s Follow-up study (1986-2010) and 82,592 women from the Nurses’ Health study (1980-2010) who were free from cardiovascular disease (CVD) and cancer at baseline. Diet was assessed using validated food frequency questionnaires every 4 years and Cox Proportional Hazards regression was used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI). Results: We documented 27,691 deaths (6,631 CVD and 10,447 cancer deaths) during 3.14 million person-years. After adjusting for major dietary and lifestyle risk factors, and BMI, baseline diabetes, hypertension and hypercholesterolemia, consumption of SSBs was associated with an increased risk of total mortality, which was mainly driven by CVD mortality among individuals consuming at least 2 servings per day; pooled HRs (95% CIs) across categories (<1/month, 1-4/month, 2-6/week, 1-<2/day and ≥2/day) were 1.00, 0.95 (0.91, 0.98), 0.96 (0.93, 0.99), 1.02 (0.96, 1.08), and 1.18 (1.04, 1.33), respectively (P-trend= 0.0001) for total mortality, and 1.00, 0.97 (0.90, 1.02), 0.96 (0.90, 1.02), 1.04 (0.93, 1.16) and 1.28 (1.09, 1.51), respectively (P-trend=0.007) for CVD mortality. In contrast, ASBs were not associated with mortality; pooled HR’s (95% CIs) across categories (<1/month, 1-4/month, 2-6/week, 1-<2/day and ≥2/day) were 1.00, 0.92 (0.89, 0.95), 0.91 (0.86, 0.97), 0.91 (0.86, 0.95) and 0.99 (0.85, 1.15), respectively (P-trend=0.50) for total mortality and 1.00, 0.86 (0.80, 0.92), 0.87 (0.81, 0.94), 0.96 (0.88, 1.06) and 0.96 (0.74, 1.25), respectively (P-trend=0.99) for CVD mortality. No associations were observed with cancer mortality for either SSBs or ASBs in multi-variable adjusted models. Conclusion: Regular consumption of SSBs is associated with an increased risk of total and CVD mortality, providing additional support for recommendations and policies to limit intake of these beverages.

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Abstract P085: Extremes of Sleep Duration and Type II Diabetes in Older Women Participating in the Women’s Health Study

Circulation ◽

10.1161/circ.139.suppl_1.p085 ◽

2019 ◽

Vol 139 (Suppl_1) ◽

Author(s):

Jonathan Z Butler ◽

Natalie Slopen ◽

Susan Redline ◽

Mercedes Carnethon ◽

David R Williams ◽

...

Keyword(s):

Women’S Health ◽

Women's Health ◽

Older Women ◽

Sleep Duration ◽

Type Ii Diabetes ◽

Health Study ◽

Type Ii

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Abstract P209: Sugar and Artificially-sweetened Beverages and 6-year Weight Change: Results From The Hispanic Community Health Study, Study of Latinos

Circulation ◽

10.1161/circ.141.suppl_1.p209 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Samantha Schilsky ◽

Wayne D Rosamond ◽

June STEVENS ◽

Carmen R Isasi ◽

Martha L DAVIGLUS ◽

...

Keyword(s):

Community Health ◽

Daily Intake ◽

Healthy Eating Index ◽

Overweight And Obesity ◽

Health Study ◽

Sugar Intake ◽

Sweetened Beverages ◽

Hispanic Community ◽

The Us ◽

The U.S

Background: Sugar sweetened beverages (SSBs) are the largest contributor to added sugars and calories in the U.S. diet with highest intake among US Hispanics. The prevalence of obesity in adults in the US is much higher in Hispanics compared to non-Hispanic whites (47% and 38% respectively). Improving our understanding of the association between SSB and artificially sweetened beverage (ASB) consumption and measures of adiposity can inform interventions targeting overweight and obesity. Aim: Examine the independent associations of daily SSB and ASB consumption with 6-year changes in weight, waist circumference (WC) and body mass index (BMI) in Hispanics in the US. Methods: We examined 7402 adults without diabetes aged 18-74yrs at baseline (2008-11) from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a multi-site community-based cohort in the US. Baseline exposures of daily SSB and ASB consumption were estimated combining two 24-hour dietary recalls and a Food Propensity Questionnaire using the NCI method to correct for measurement error and account for episodically consumed foods. Complex survey linear regression models were used to examine associations of SSBs and ASBs with 6-year change in weight (kg), WC (cm) and BMI. Models were adjusted for age, gender, center, background, education, employment, marital status, cigarette use, physical activity, healthy eating index, depressive symptoms, non-SSB sugar intake, years in the US and years between visits. Interactions of SSB and ASB with gender and years lived in the U.S. (US born, >10yr, ≤10 yr) were assessed. Results: Overall, 3326 [male=49.7%] and 1244 [male=35.7%] reported daily intake of >2 servings of SSBs and ASBs respectively whereas 2203 [male=26.1%] and 4318 [male=41.2%] reported daily intake < 1 servings of SSBs and ASBs respectively. Daily energy intake (kcal) was higher among those with higher daily SSB consumption [means=14768 and 2008 kcals; <1 serving and >2 servings, respectively] and lower with higher ASB consumption (means=1836 and 1773 kcals; <1 serving and >2 servings, respectively). Daily sugar intake independent of SSBs was higher with daily consumption of both SSB and ASB (<1 serving vs. 2 servings). Non-significant associations were found for daily SSB and ASB intake and changes in adiposity for all measures in males and females. Interaction between years in the U.S. and ASB consumption were significant only for change in weight and BMI [p<0.05]. Among those consuming <1 serving per day of ASBs, there was a larger mean change in weight and BMI for those who spent < 10yr in the U.S. compared to U.S. born. Conclusion: In this diverse Hispanic cohort, 6-year changes in measures of adiposity are not associated with daily SSB or ASB consumption. Modification of the association of ASB and measures of adiposity by years in US suggests further exploration is needed to discern its relationship among Hispanics.

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