Introduction: Dyslipidemia, characterized by high triglyceride (TG) and low HDL concentrations, is a risk factor for cardiovascular disease (CVD). Decreasing dietary sugar consumption is one dietary modification that may influence dyslipidemia risk to reduce the risk for CVD. Two major sources of dietary sugar in the US are sugar-sweetened beverages (SSB) and 100% fruit juices, and both can contribute to excess caloric intake. Based on current observational data, there is limited evidence linking these dietary exposures to lipid levels in population-based studies.
Hypothesis: We hypothesize that SSB and 100% fruit juices may differentially associate with TG and HDL concentrations in adults due to differences in both beverage consumption patterns and nutrient content.
Methods: We conducted a cross-sectional analysis of data from the Framingham Heart Study (1998-2005; n=6,802). Fasting plasma TG and HDL concentrations were measured using standard assays. Consumption of SSB (sodas and fruit drinks; 1 serving = 12 oz.) and 100% fruit juice (1 serving = 8 oz.) was estimated using the Harvard-Food Frequency Questionnaire. Participants were grouped by category of intake. Using mixed-effect linear regression models accounting for family structure, we examined the associations between SSB intake and 100% fruit juice intake with TG and HDL concentrations, adjusting for potential confounding factors related to demographics, lifestyle, and diet.
Results: After multivariate adjustment for potential confounding factors, SSB intake was positively associated with TG concentrations [ β ± SE: 0.12 ± 0.03 [ln] mg/dl comparing the highest category of intake (median = 8.5 servings/week) with the lowest category (median = 0 servings/day); p for trend < 0.0001] and inversely associated with HDL concentrations ( β ± SE: -2.90 ± 0.69 mg/dl comparing the highest category of intake with the lowest category; p for trend < 0.0001). Fruit juice intake was not significantly associated with TG concentrations [ β ± SE: 0.04 ± 0.02 [ln] mg/dl comparing highest category of intake (median = 11 servings/week) with the lowest category (median = 0 servings/day); p for trend = 0.15] or HDL concentrations ( β ± SE: -0.18 ± 0.60 mg/dl comparing the highest category of intake with the lowest category; p for trend = 0.73).
Conclusions: Higher intakes of SSB are significantly associated with lower HDL and higher TG concentrations, which supports dietary recommendations to limit SSB intake. Fruit juice consumption patterns, up to 1.5 servings/day, were not significantly associated with TG and HDL concentrations in this study.