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Dhingra et al

Soft Drink Consumption and Metabolic Risk

485

TABLE 2.

Cross-Sectional Relationships of Soft Drink Consumption With Prevalence of Metabolic Syndrome

Diet or regular, 1/wk

650

2129

Referent

Referent

Diet, 1 to 6/wk

359

882

1.72 (1.45 to 2.03)

1.81 (1.48 to 2.22)

Diet, 1/d

328

819

1.87 (1.57 to 2.23)

1.80 (1.45 to 2.25)

Regular, 1 to 6/wk

235

671

1.33 (1.09 to 1.61)

1.20 (0.94 to 1.53)

Diet and regular 1 to 6/wk

106

239

1.79 (1.35 to 2.38)

1.99 (1.40 to 2.83)

Regular, 1/d

130

291

2.31 (1.77 to 3.01)

1.81 (1.28 to 2.56)

Metabolic Syndrome, n

No. at Risk*

Age- and Sex-Adjusted OR (95% CI)

Multivariable Adjusted OR (95% CI)†

1697 618 462 1080

5840 1918 1239 3157

Referent 1.18 (1.06 to 1.33) 1.43 (1.24 to 1.66) 1.26 (1.14 to 1.40)

Referent 1.38 (1.19 to 1.61) 1.67 (1.38 to 2.01) 1.48 (1.30 to 1.69)

Soft Drink Consumption, Servings/d

Model I: any soft drink (regular or diet); data from all 3 examinations (4, 5, and 6; n8997)

None 1

  • 2

  • 1

*No. of people represents person-observations. FFQ indicates food frequency questionnaire; OR, odds ratio; and CI, confidence interval.

  • Multivariable model adjusts for age, sex, physical activity index, smoking, dietary consumption of saturated fat, trans fat, fiber, magnesium, total calories, and

glycemic index (No. eligible for multivariable models: model I, any soft drink, n5350; model II, for regular vs diet soft drink, n3493).

  • Individuals who reported drinking both diet and regular soft drinks 1/d (n16) were included in the regular 1/d category.

Model II: regular vs diet soft drink; d at examinations 5 and 6 (n5031)‡

ata from FFQ

investigators believe that intake of sugar-sweetened bev- erages induces less compensation than intake of artificially sweetened soft drinks,33 but others disagree.34 The high sweetness of diet or regular soft drinks may lead to conditioning for a greater preference for intake of sweet- ened items,35 although this explanation also has been questioned by some experts.13 The caramel content of both regular and diet drinks may be a potential source of advanced glycation end products,5 which may promote insulin resistance36 and can be proinflammatory.37

Dietary behavior among individuals consuming soft drinks may account in part for the clustering of metabolic

risk factors in these people.13 Individuals with greater intake of soft drinks also have a dietary pattern character- ized by greater intake of calories and saturated and trans fats, lower consumption of fiber38 and dairy products,39 and a sedentary life.40 These observations were corrobo- rated by the our findings of increased consumption of saturated and trans fat, lower consumption of dietary fiber, and higher rates of smoking in those with greater intake of soft drinks. Nonetheless, in the present investigation, we adjusted for saturated fat and trans fat intake, dietary fiber consumption, smoking, and physical activity in multivari- able analyses and still observed a significant association of

Diet or regular, 1/wk

253

1456

Referent

Referent

Diet, 1 to 6/wk

98

518

1.17 (0.90 to 1.52)

1.32 (0.96 to 1.81)

Diet, 1/d

106

486

1.42 (1.10 to 1.84)

1.53 (1.10 to 2.15)

Regular, 1 to 6/wk

79

434

1.01 (0.76 to 1.35)

1.13 (0.79 to 1.62)

Diet and regular 1 to 6/wk

29

130

1.21 (0.78 to 1.89)

1.41 (0.80 to 2.50)

Regular, 1/d

34

160

1.33 (0.88 to 2.02)

1.62 (0.96 to 2.75)

*No. of people represents person-observations. FFQ indicates food frequency questionnaire; OR, odds ratio; and CI, confidence interval.

  • Multivariable models adjust for age, sex, physical activity index, smoking, dietary consumption of saturated fat, trans fat, fiber, magnesium, total calories, and

glycemic index (No. eligible for multivariable models: any soft drink, n3655; for regular vs diet soft drink, n1864).

  • Individuals who reported drinking both diet and regular soft drinks 1/d (n7) were included in the regular 1/d category.

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717

4033

Referent

Referent

267

1259

1.34 (1.14 to 1.58)

1.53 (1.24 to 1.89)

166

747

1.46 (1.20 to 1.78)

1.29 (0.98 to 1.70)

433

2006

1.39 (1.21 to 1.59)

1.44 (1.20 to 1.74)

Model II: regular vs diet soft drink: data from FFQ at examinations 5 and 6 (n3184)‡

Model I: any soft drink (regular or diet): data from all 3 examinations (4, 5, and 6; n6154)

None 1

  • 2

  • 1

TABLE 3.

Multiple Logistic Regression Examining Soft Drink Consumption and Incidence of Metabolic Syndrome (n6154)

Soft Drink Consumption, Servings/d

Metabolic Syndrome, n

Age- and Sex-Adjusted OR

Multivariable-Adjusted OR

No. at Risk*

(95% CI)

(95% CI)†

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