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Substitution of sugar-sweetened beverages for other beverages and the risk of developing coronary heart disease: Results from the Harvard pooling project of diet and coronary disease
S346
European Congress of Epidemiology / Revue d’Épidémiologie et de Santé Publique 66S (2018) S277–S437
Session 6–Epidemiology and obesity/metabolic diseases, nutrition P6-1
Substitution of sugar-sweetened beverages for other beverages and the risk of developing coronary heart disease: Results from the Harvard pooling project of diet and coronary disease A. Keller a,∗ , E.J. O’Reilly b , V. Malik b , J.E. Buring c , I. Andersen d , L. Steffen e a Research Unit for Dietary Studies, Frederiksberg og Bispebjerg Hospital, Frederiksberg, Denmark b Department of Nutrition, Department of Epidemiology, Boston, United States c Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, United States d Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark e Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Mineapolis, United States ∗ Corresponding author. E-mail address: [email protected] (A. Keller) Background Sugar-sweetened beverage (SSB) intake is associated with metabolic disorders. The reduction of SSB intake has been promoted to prevent death and disability from chronic diseases. However, a lower SSB intake requires substitution by other fluids to maintain hydration. We investigated the association between SSB intake and the risk of coronary events and death, and assessed if substitution of coffee, tea, milk, fruit juice and artificially-sweetened beverages (ASB) for SSBs is associated with a reduced risk of coronary events and death. Methods This was a follow-up study in which data from six cohort studies were pooled. Results During the mean 5–10 years follow-up, 4248 coronary events and 1630 coronary death occurred among 284.345 individuals; 355 mL daily increase of SSB intake was associated with an increased risk of coronary events (HR: 1.08; 95% CI: 1.02, 1.14) and possibly coronary death (HR: 1.05; 95% CI: 0.96, 1.16). Substitution analyses suggested that replacing SSBs with coffee (HR: 0.93; 95% CI: 0.87, 1.00) or ASB (HR: 0.89; 95% CI: 0.83, 0.97), but not with tea (HR: 0.94; 95% CI: 0.87, 1.01), low-fat milk (HR: 0.96; 95% CI: 0.90, 1.03), whole fat milk (HR: 0.95; 95% CI: 0.87, 1.04) or fruit juice (HR: 0.97; 95% CI: 0.85, 1.07) was associated with a lower risk of developing coronary events. No associations were found for coronary death. Conclusion We found that SSB intake is associated with an increased risk of coronary events and possibly coronary death. Our findings also suggest that substituting ASBs or coffee for SSBs lowers the risk of developing CHD events. Disclosure of interest est.
The authors declare that they have no competing inter-
https://doi.org/10.1016/j.respe.2018.05.297
P6-2
Are dietary patterns at breakfast associated with abdominal obesity in a population-based survey? A. Chatelan a,∗ , K. Castetbon b , J. Pasquier a , C. Allemann a , A. Zuber a , E. Camenzind-Frey c a Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland b École de Santé Publique, Université libre de Bruxelles, Bruxelles, Belgium c Risk Assessment Division, Federal Food Safety and Veterinary Office, Bern, Switzerland ∗ Corresponding author. E-mail address: [email protected] (A. Chatelan) Introduction Abdominal obesity is a strong predictor of cardio-metabolic abnormalities. There is limited evidence about the most favorable breakfast composition. We explored the association between data-driven breakfast dietary patterns and abdominal obesity in regular breakfast eaters coming from a national population-based sample. Methods The cross-sectional nutrition survey menuCH assessed diet using two 24-hour dietary recalls (24HDR) in a representative sample of Swiss adults aged 18 to 75 years. Regular breakfast eaters were defined as people breakfasting in both 24HDR and reporting eating breakfast at least 5 days in a usual week. Among them, we derived dietary patterns using principal component analysis based on the intake of 22 breakfast-specific food groups. All regular breakfast eaters were predicted an individual score for each identified pattern, and then classified into tertiles (T1, T2, T3). We defined abdominal obesity as waist-to-hip ratio (WHR) ≥ 0.9 in men and ≥ 0.85 in women. Logistic models were adjusted for sex, age, physical activity, total energy intake, diet quality outside breakfast, alcohol intake, education, food literacy, smoking, nationality, household status, season, and linguistic region. Results Of the 2019 survey participants 1351 (67%) were regular breakfast eaters (42% of men). Among them, we identified 3 patterns: –traditional breakfast - white bread, butter, sweet spread; –prudent breakfast - fruit, natural cereal flakes, nuts/seeds, yogurt; –western breakfast - sweetened breakfast cereals, milk. After adjustment for potential cofounders, the prudent breakfast pattern was negatively associated with abdominal obesity (OR: 0.65 T3 vs. T1, 95% CI: 0.43 to 0.97, P for trend = 0.03). People taking a prudent breakfast (in T3) had 1.4% lower WHR compared to people taking a breakfast distant from prudent (in T1). We found no association for traditional and western breakfast patterns (T3 vs. T1: OR: 1.00, 95% CI: 0.67 to 1.50 and OR: 1.20, 95% CI: 0.82 to 1.76, respectively). Findings were similar when defining abdominal obesity with other anthropometric parameters, such as waist-to-height ratio. Conclusions Consuming regularly a prudent breakfast, i.e., rich in fruit, natural cereal flakes, nuts/seeds and yogurt, was associated with less abdominal obesity in a population-based sample of Swiss adults. Further longitudinal and long-term experimental research is needed to provide recommendations on the optimal breakfast. Disclosure of interest est.
The authors declare that they have no competing inter-
https://doi.org/10.1016/j.respe.2018.05.298
European Congress of Epidemiology / Revue d’Épidémiologie et de Santé Publique 66S (2018) S277–S437
Session 6–Epidemiology and obesity/metabolic diseases, nutrition P6-1
Substitution of sugar-sweetened beverages for other beverages and the risk of developing coronary heart disease: Results from the Harvard pooling project of diet and coronary disease A. Keller a,∗ , E.J. O’Reilly b , V. Malik b , J.E. Buring c , I. Andersen d , L. Steffen e a Research Unit for Dietary Studies, Frederiksberg og Bispebjerg Hospital, Frederiksberg, Denmark b Department of Nutrition, Department of Epidemiology, Boston, United States c Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, United States d Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark e Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Mineapolis, United States ∗ Corresponding author. E-mail address: [email protected] (A. Keller) Background Sugar-sweetened beverage (SSB) intake is associated with metabolic disorders. The reduction of SSB intake has been promoted to prevent death and disability from chronic diseases. However, a lower SSB intake requires substitution by other fluids to maintain hydration. We investigated the association between SSB intake and the risk of coronary events and death, and assessed if substitution of coffee, tea, milk, fruit juice and artificially-sweetened beverages (ASB) for SSBs is associated with a reduced risk of coronary events and death. Methods This was a follow-up study in which data from six cohort studies were pooled. Results During the mean 5–10 years follow-up, 4248 coronary events and 1630 coronary death occurred among 284.345 individuals; 355 mL daily increase of SSB intake was associated with an increased risk of coronary events (HR: 1.08; 95% CI: 1.02, 1.14) and possibly coronary death (HR: 1.05; 95% CI: 0.96, 1.16). Substitution analyses suggested that replacing SSBs with coffee (HR: 0.93; 95% CI: 0.87, 1.00) or ASB (HR: 0.89; 95% CI: 0.83, 0.97), but not with tea (HR: 0.94; 95% CI: 0.87, 1.01), low-fat milk (HR: 0.96; 95% CI: 0.90, 1.03), whole fat milk (HR: 0.95; 95% CI: 0.87, 1.04) or fruit juice (HR: 0.97; 95% CI: 0.85, 1.07) was associated with a lower risk of developing coronary events. No associations were found for coronary death. Conclusion We found that SSB intake is associated with an increased risk of coronary events and possibly coronary death. Our findings also suggest that substituting ASBs or coffee for SSBs lowers the risk of developing CHD events. Disclosure of interest est.
The authors declare that they have no competing inter-
https://doi.org/10.1016/j.respe.2018.05.297
P6-2
Are dietary patterns at breakfast associated with abdominal obesity in a population-based survey? A. Chatelan a,∗ , K. Castetbon b , J. Pasquier a , C. Allemann a , A. Zuber a , E. Camenzind-Frey c a Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland b École de Santé Publique, Université libre de Bruxelles, Bruxelles, Belgium c Risk Assessment Division, Federal Food Safety and Veterinary Office, Bern, Switzerland ∗ Corresponding author. E-mail address: [email protected] (A. Chatelan) Introduction Abdominal obesity is a strong predictor of cardio-metabolic abnormalities. There is limited evidence about the most favorable breakfast composition. We explored the association between data-driven breakfast dietary patterns and abdominal obesity in regular breakfast eaters coming from a national population-based sample. Methods The cross-sectional nutrition survey menuCH assessed diet using two 24-hour dietary recalls (24HDR) in a representative sample of Swiss adults aged 18 to 75 years. Regular breakfast eaters were defined as people breakfasting in both 24HDR and reporting eating breakfast at least 5 days in a usual week. Among them, we derived dietary patterns using principal component analysis based on the intake of 22 breakfast-specific food groups. All regular breakfast eaters were predicted an individual score for each identified pattern, and then classified into tertiles (T1, T2, T3). We defined abdominal obesity as waist-to-hip ratio (WHR) ≥ 0.9 in men and ≥ 0.85 in women. Logistic models were adjusted for sex, age, physical activity, total energy intake, diet quality outside breakfast, alcohol intake, education, food literacy, smoking, nationality, household status, season, and linguistic region. Results Of the 2019 survey participants 1351 (67%) were regular breakfast eaters (42% of men). Among them, we identified 3 patterns: –traditional breakfast - white bread, butter, sweet spread; –prudent breakfast - fruit, natural cereal flakes, nuts/seeds, yogurt; –western breakfast - sweetened breakfast cereals, milk. After adjustment for potential cofounders, the prudent breakfast pattern was negatively associated with abdominal obesity (OR: 0.65 T3 vs. T1, 95% CI: 0.43 to 0.97, P for trend = 0.03). People taking a prudent breakfast (in T3) had 1.4% lower WHR compared to people taking a breakfast distant from prudent (in T1). We found no association for traditional and western breakfast patterns (T3 vs. T1: OR: 1.00, 95% CI: 0.67 to 1.50 and OR: 1.20, 95% CI: 0.82 to 1.76, respectively). Findings were similar when defining abdominal obesity with other anthropometric parameters, such as waist-to-height ratio. Conclusions Consuming regularly a prudent breakfast, i.e., rich in fruit, natural cereal flakes, nuts/seeds and yogurt, was associated with less abdominal obesity in a population-based sample of Swiss adults. Further longitudinal and long-term experimental research is needed to provide recommendations on the optimal breakfast. Disclosure of interest est.
The authors declare that they have no competing inter-
https://doi.org/10.1016/j.respe.2018.05.298