Beverage intake and metabolic syndrome risk over 14 years : the study of women's health across the nation / Bradley M. Appelhans, Ana Baylin, Mei-Hua Huang, Hong Li, Imke Janssen, Rasa Kazlauskaite, Elizabeth F. Avery, Howard M. Kravitz

Background Alcohol and energy-dense beverage consumption have been implicated in cardiometabolic disease, albeit inconsistently. Objective This study tested prospective associations between intakes of alcohol, energy-dense beverages, and low-calorie beverages and cardiometabolic risk in midlife women. Design The Study of Women's Health Across the Nation is a 14-year, multisite prospective cohort study (1996-2011). Beverage intake and cardiometabolic risk factors that define the metabolic syndrome (hypertension, abdominal obesity, impaired fasting glucose, low high-density lipoprotein cholesterol, and hypertriglyceridemia) were assessed throughout follow-up. Participants/setting Participants (N=1,448) were African-American, Chinese, Japanese, and non-Hispanic white midlife women from six U.S. cities. Main outcome measures The primary outcomes were incident metabolic syndrome and the individual metabolic syndrome components. Statistical analyses performed Generalized linear mixed models tested associations between intakes within each beverage category and odds of meeting criteria for metabolic syndrome and each of the metabolic syndrome components. Results Energy-dense beverage consumption was highest among African-American women, and lowest among women with college degrees. Non-Hispanic white women consumed the largest quantities of alcohol. Independent of energy intake and potential confounders, each additional 355 ml of energy-dense beverages consumed per day was associated with higher odds of developing metabolic syndrome in each successive year of follow-up (OR=1.05, 95%CI: 1.02, 1.08). Greater energy-dense beverage intake was associated with more rapidly increasing odds of developing hypertension (OR=1.06, 95%CI: 1.02, 1.11) and abdominal obesity (OR=1.10, 95%CI: 1.03, 1.16) over time, but not with the other metabolic syndrome components. Intakes of alcohol and low-calorie coffees, teas, and diet cola were not associated with metabolic syndrome risk. Conclusions Over 14 years of follow-up, energy-dense non-alcoholic beverage consumption was associated with incident metabolic syndrome in midlife women. The observed differences in intakes by ethnicity/race and education suggest that consumption of these beverages may contribute to disparities in risk factors for diabetes and cardiovascular disease.

Nutrition.