title: Soft drink consumption and risk of developing cardiometabolic risk factors and the metabolic syndrome in middle-aged adults in the community.
abstract: BACKGROUND
  Consumption of soft drinks has been linked to obesity in children and adolescents, but it is unclear whether it increases metabolic risk in middle-aged individuals.
  
  
  RESULTS
  We related the incidence of metabolic syndrome and its components to soft drink consumption in participants in the Framingham Heart Study (6039 person-observations, 3470 in women; mean age 52.9 years) who were free of baseline metabolic syndrome. Metabolic syndrome was defined as the presence of > or = 3 of the following: waist circumference > or = 35 inches (women) or > or = 40 inches (men); fasting blood glucose > or = 100 mg/dL; serum triglycerides > or = 150 mg/dL; blood pressure > or = 135/85 mm Hg; and high-density lipoprotein cholesterol < 40 mg/dL (men) or < 50 mg/dL (women). Multivariable models included adjustments for age, sex, physical activity, smoking, dietary intake of saturated fat, trans fat, fiber, magnesium, total calories, and glycemic index. Cross-sectionally, individuals consuming > or = 1 soft drink per day had a higher prevalence of metabolic syndrome (odds ratio [OR], 1.48; 95% CI, 1.30 to 1.69) than those consuming < 1 drink per day. On follow-up (mean of 4 years), new-onset metabolic syndrome developed in 717 of 4033 participants (17.8%) consuming < 1 drink/day and in 433 of 2006 persons (21.6%) [corrected] consuming > or = 1 soft drink/day [corrected] Consumption of > or = 1 soft drink per day was associated with increased odds of developing metabolic syndrome (OR, 1.44; 95% CI, 1.20 to 1.74), obesity (OR, 1.31; 95% CI, 1.02 to 1.68), increased waist circumference (OR, 1.30; 95% CI, 1.09 to 1.56), impaired fasting glucose (OR, 1.25; 95% CI, 1.05 to 1.48), higher blood pressure (OR, 1.18; 95% CI, 0.96 to 1.44), hypertriglyceridemia (OR, 1.25; 95% CI, 1.04 to 1.51), and low high-density lipoprotein cholesterol (OR, 1.32; 95% CI 1.06 to 1.64).
  
  
  CONCLUSIONS
  In middle-aged adults, soft drink consumption is associated with a higher prevalence and incidence of multiple metabolic risk factors.
authors.affiliation: Framingham Heart Study, 73 Mount Wayte Ave, Suite 2, Framingham, MA 01702-5803, USA.
authors.forename: Ravi
authors.initials: R
authors.lastname: Dhingra
authors.forename: Lisa
authors.initials: L
authors.lastname: Sullivan
authors.forename: Paul F
authors.initials: PF
authors.lastname: Jacques
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Wang
authors.forename: Caroline S
authors.initials: CS
authors.lastname: Fox
authors.forename: James B
authors.initials: JB
authors.lastname: Meigs
authors.forename: Ralph B
authors.initials: RB
authors.lastname: D'Agostino
authors.forename: J Michael
authors.initials: JM
authors.lastname: Gaziano
authors.forename: Ramachandran S
authors.initials: RS
authors.lastname: Vasan
mesh_terms: D000368:Aged; D002110:Caffeine / Q000009:adverse effects; D002253:Carbonated Beverages / Q000009:adverse effects / Q000191:economics / Q000706:statistics & numerical data*; D008078:Cholesterol, LDL / Q000097:blood; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology; D004032:Diet / Q000009:adverse effects / Q000706:statistics & numerical data; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D018149:Glucose Intolerance / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology; D015228:Hypertriglyceridemia / Q000453:epidemiology / Q000209:etiology; D015994:Incidence; D008019:Life Style; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000209:etiology; D008875:Middle Aged; D009043:Motor Activity; D009765:Obesity / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D013395:Sucrose / Q000009:adverse effects; D011795:Surveys and Questionnaires; D013549:Sweetening Agents / Q000009:adverse effects; D014481:United States / Q000453:epidemiology
chemical_list: D008078:Cholesterol, LDL; D013549:Sweetening Agents; D002110:Caffeine; D013395:Sucrose