The Journal of Nutrition, 04/21/2014  Clinical Article

Larsson SC, et al. – The consumption of sweetened beverages such as soft drinks has been associated with adverse effects on markers of cardiovascular risk. These findings suggest that sweetened beverage consumption is positively associated with the risk of stroke.

Methods

• The authors examined the hypothesis that high consumption of sweetened beverages increases the risk of stroke.
• They followed 32,575 women aged 49-83 y and 35,884 men aged 45-79 y without cardiovascular disease, cancer, or diabetes at baseline.
• The consumption of sweetened beverages, including sugar–sweetened and artificially sweetened soft drinks and juice drinks, was assessed by using a food–frequency questionnaire.
• Stroke cases were ascertained by linkage to the Swedish Inpatient Register and the Swedish Cause of Death Register.
• The data were analyzed by using a Cox proportional hazards regression model.
• They ascertained 3510 incident cases of stroke, including 2588 cerebral infarctions, 349 intracerebral hemorrhages, 156 subarachnoid hemorrhages, and 417 unspecified strokes, during a mean follow–up of 10.3 y.

Results

• Sweetened beverage consumption was significantly positively associated with risk of total stroke and cerebral infarction but not with hemorrhagic stroke.
• The multivariable RRs comparing ≥2 (median: 2.1) servings/d (200 mL/serving) with 0.1 to <0.5 (median: 0.3) servings/d were 1.19 (95% CI: 1.04, 1.36) for total stroke and 1.22 (95% CI: 1.04, 1.42) for cerebral infarction.

1. Susanna C. Larsson^*,
2. Agneta Åkesson, and
3. Alicja Wolk

+Author Affiliations

1. 
   
   Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden

1. ↵*To whom correspondence should be addressed. E-mail: susanna.larsson@ki.se.

Abstract

The consumption of sweetened beverages such as soft drinks has been associated with adverse effects on markers of cardiovascular risk. We examined the hypothesis that high consumption of sweetened beverages increases the risk of stroke. We followed 32,575 women aged 49−83 y and 35,884 men aged 45−79 y without cardiovascular disease, cancer, or diabetes at baseline. The consumption of sweetened beverages, including sugar-sweetened and artificially sweetened soft drinks and juice drinks, was assessed by using a food-frequency questionnaire. Stroke cases were ascertained by linkage to the Swedish Inpatient Register and the Swedish Cause of Death Register. The data were analyzed by using a Cox proportional hazards regression model. We ascertained 3510 incident cases of stroke, including 2588 cerebral infarctions, 349 intracerebral hemorrhages, 156 subarachnoid hemorrhages, and 417 unspecified strokes, during a mean follow-up of 10.3 y. Sweetened beverage consumption was significantly positively associated with risk of total stroke and cerebral infarction but not with hemorrhagic stroke. The multivariable RRs comparing ≥2 (median: 2.1) servings/d (200 mL/serving) with 0.1 to <0.5 (median: 0.3) servings/d were 1.19 (95% CI: 1.04, 1.36) for total stroke and 1.22 (95% CI: 1.04, 1.42) for cerebral infarction. These findings suggest that sweetened beverage consumption is positively associated with the risk of stroke.