Association between Intake of Sweetened Beverages with All-Cause Mortality: A Systematic Review and Meta-Analysis of Prospective Cohort Studies

2020 ◽  
Author(s):  
Hongyi Li ◽  
Huoyan Liang ◽  
Han Yang ◽  
Xiaojuan Zhang ◽  
Xianfei Ding ◽  
...  
Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Jun Li ◽  
Marta Guasch-Ferré ◽  
Yanping Li ◽  
Frank Hu

Background: Previous studies on intake of linoleic acid (LA), a predominant n-6 fatty acid, and risk of mortality from all-cause and cardiovascular disease (CVD) have generated inconsistent results. We performed a systematic review and meta-analysis of prospective cohort studies to summarize the evidence regarding the relation of LA and all-cause and CVD mortality. Methods: We searched MEDLINE and EMBASE databases through June 2017 for prospective cohort studies reporting association of LA (assessed by dietary survey or biomarker in blood or adipose tissue) with all-cause and CVD mortality. In addition, unpublished data from pooling projects were included. We pooled the multivariate-adjusted Hazards ratios (HRs) using random-effect meta-analysis, which allowed for between-study heterogeneity. Results: 27 studies covering 37 prospective cohorts were identified; these included 274,565 individuals with dietary assessment (34,597 all-cause and 10,636 CVD deaths) and 54,794 individuals with biomarker measurements (6,767 all-cause and 5,311 CVD deaths). Comparing the highest category with the lowest, dietary LA intake was associated with a 14% lower risk of all-cause mortality (95% confidence interval [CI], 2%-25%, I 2 =71%) and a 20% lower risk of CVD mortality (95% CI, 13%-26%, I 2 =0). Baseline health status (i.e. general population, CVD/high risk for CVD, or cancer) might be a main source of heterogeneity for the association of dietary LA intake with all-cause mortality. As for biomarkers, 1 SD increment in LA was associated with a 9% lower risk of all-cause mortality (95% CI, 4%-14%, I 2 =61%) and a 10% lower risk of CVD mortality (95% CI, 5%-14%, I 2 =13%). Heterogeneity was presented across tissue types and between genders. Conclusions: In prospective cohort studies, LA intake, assessed by either dietary survey or biomarkers, was inversely associated with all-cause and CVD mortality in a dose-response manner. These data support the current recommendations on polyunsaturated fat intake for prevention of CVD and early death.


2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1432-1432
Author(s):  
Jennifer Lee ◽  
Tauseef Khan ◽  
Vasanti Malik ◽  
James Hill ◽  
Per Jeppesen ◽  
...  

Abstract Objectives Low calorie sweetened beverages (LCSBs) are associated with increased cardiometabolic diseases using prevalent exposure of LCSBs. Although this association is at high risk of reverse causality, it has led to concerns that LCSBs may not have the intended benefits, with recommendations to replace sugar-sweetened beverage (SSBs) with water and not LCSBs. To address this issue of reverse causality as part of the update of the European Association for the Study of Diabetes (EASD) clinical practice guidelines for nutrition therapy, we conducted a systematic review and meta-analysis of prospective cohort studies of the relation of LCSBs with cardiometabolic outcomes using change and substitution analyses. Methods MEDLINE, EMBASE, and the Cochrane Library were searched through June 2019. We included prospective cohort studies of ≥1 year assessing change in LCSBs or substitution of LCSBs for SSBs in relation to cardiometabolic outcomes. Independent reviewers extracted data and assessed risk of bias. Data were pooled using random effects models and expressed as mean differences (MDs) or risk ratios (RRs) with 95% confidence intervals (CI). GRADE assessed the certainty of evidence. Results Nine studies (n = 218,880) inclusive of people at risk for or with diabetes were included. An Increase of 1 serving/day of LCSBs was associated with reduced body weight (MD, −0.07 kg [95% CI, −0.10 to −0.04]) and waist circumference (−1.35 cm [−2.60 to −0.05]) in change analyses. Substitution of LCSBs for SSBs was associated with a reduction in body weight (−0.47 kg [−0.55 to - 0.39]) and risk of diabetes (RR, 0.94 [0.90 to 0.98]), cardiovascular mortality (0.95 [0.90 to 0.99]) and total mortality (0.96 [0.94 to 0.98]), while substitution of LCSBs for water was not associated with any changes. The certainty of evidence was very low for all outcomes. Conclusions Substitution of LCSBs for SSBs is associated with reductions in major cardiometabolic outcomes with similar benefits to water as a replacement strategy for SSBs. The certainty of the available evidence is very low with a high likelihood that more studies will alter our estimates in people at risk for or with diabetes.(ClinicalTrials.gov identifier, NCT04245826) Funding Sources Diabetes and Nutrition Study Group of the European Association for the Study of Diabetes, Canadian Institutes of Health Research, Diabetes Canada.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiangmei Zhao ◽  
Dongying Wang ◽  
Lijie Qin

Abstract Background This meta-analysis based on prospective cohort studies aimed to evaluate the associations of lipid profiles with the risk of major adverse cardiovascular outcomes in patients with coronary heart disease (CHD). Methods The PubMed, Embase, and Cochrane Library electronic databases were systematically searched for prospective cohort study published through December 2019, and the pooled results were calculated using the random-effects model. Results Twenty-one studies with a total of 76,221 patients with CHD met the inclusion criteria. The per standard deviation (SD) increase in triglyceride was associated with a reduced risk of major adverse cardiovascular events (MACE). Furthermore, the per SD increase in high-density lipoprotein cholesterol (HDL-C) was associated with a reduced risk of cardiac death, whereas patients with lower HDL-C were associated with an increased risk of MACE, all-cause mortality, and cardiac death. Finally, the risk of MACE was significantly increased in patients with CHD with high lipoprotein(a) levels. Conclusions The results of this study suggested that lipid profile variables could predict major cardiovascular outcomes and all-cause mortality in patients with CHD.


2021 ◽  
pp. bjsports-2020-103140
Author(s):  
Rodney K Dishman ◽  
Cillian P McDowell ◽  
Matthew Payton Herring

ObjectiveTo explore whether physical activity is inversely associated with the onset of depression, we quantified the cumulative association of customary physical activity with incident depression and with an increase in subclinical depressive symptoms over time as reported from prospective observational studies.DesignSystematic review and meta-analysis.Data sourcesMEDLINE, PsycINFO, PsycARTICLES and CINAHL Complete databases, supplemented by Google Scholar.Eligibility criteriaProspective cohort studies in adults, published prior to January 2020, reporting associations between physical activity and depression.Study appraisal and synthesisMultilevel random-effects meta-analysis was performed adjusting for study and cohort or region. Mixed-model meta-regression of putative modifiers.ResultsSearches yielded 111 reports including over 3 million adults sampled from 11 nations in five continents. Odds of incident cases of depression or an increase in subclinical depressive symptoms were reduced after exposure to physical activity (OR, 95% CI) in crude (0.69, 0.63 to 0.75; I2=93.7) and adjusted (0.79, 0.75 to 0.82; I2=87.6) analyses. Results were materially the same for incident depression and subclinical symptoms. Odds were lower after moderate or vigorous physical activity that met public health guidelines than after light physical activity. These odds were also lower when exposure to physical activity increased over time during a study period compared with the odds when physical activity was captured as a single baseline measure of exposure.ConclusionCustomary and increasing levels of moderate-to-vigorous physical activity in observational studies are inversely associated with incident depression and the onset of subclinical depressive symptoms among adults regardless of global region, gender, age or follow-up period.


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