title: Consumption of sugar-sweetened beverages in relation to the metabolic syndrome among Iranian adults.
abstract: BACKGROUND
  Few data are available linking intake of sugar-sweetened beverages (SSBs) with the metabolic syndrome. Furthermore, findings from these studies are inconsistent and most are from Western societies; no information is available in this regard from Middle Eastern populations.
  
  
  OBJECTIVE
  This study was conducted to assess the relationship between SSB consumption and metabolic syndrome in an Iranian adult population.
  
  
  METHODS
  In this cross-sectional study, data from 1,752 people (782 men and 970 women) that were selected with the multistage cluster random sampling method from three counties of Isfahan, Najafabad and Arak were used. A validated food frequency questionnaire was used to assess participants' usual dietary intakes. Consumption of SSBs was calculated by summing up the consumption of 'soft drinks' and 'artificially sweetened fruit juices'. To categorize participants, we used three levels of SSB consumption: <1 time/week, 1-3 times/week, and >3 times/week. Biochemical assessments were done after an overnight fasting. Metabolic syndrome was defined according to the guidelines of Adult Treatment Panel III.
  
  
  RESULTS
  Subjects with high consumption of SSBs (>3 times/week) were younger than those with low consumption (<1 time/week). Mean BMI was not significantly different across SSB categories. High consumption of SSBs was associated with greater intakes of energy and almost all food groups. We found a significant difference in serum triglyceride levels between men consuming SSBs 1-3 times/week and those consuming <1 time/week. However, after controlling for potential confounders, this association disappeared. In crude models, no significant associations were found between SSB intake and prevalence of the metabolic syndrome in either gender. After adjustment for potential confounders including BMI, we found that men in the top category of SSB intake were 17% more likely to have the metabolic syndrome (odds ratio (OR) 1.17; 95% confidence interval (95% CI) 0.56-2.46), while women in the highest category were 20% less likely to have the syndrome (OR 0.80; 95% CI 0.46-1.42) as compared with those in the bottom category. However, these associations were not significant in either men or women.
  
  
  CONCLUSIONS
  Our results do not support the previous findings on the association between SSB consumption and metabolic syndrome. Prospective studies are needed to further explore for this association.
authors.affiliation: Cardiac Rehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan, Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Khosravi-Boroujeni
authors.forename: Nizal
authors.initials: N
authors.lastname: Sarrafzadegan
authors.forename: Noushin
authors.initials: N
authors.lastname: Mohammadifard
authors.forename: Hasan
authors.initials: H
authors.lastname: Alikhasi
authors.forename: Firouzeh
authors.initials: F
authors.lastname: Sajjadi
authors.forename: Sedigheh
authors.initials: S
authors.lastname: Asgari
authors.forename: Ahmad
authors.initials: A
authors.lastname: Esmaillzadeh
mesh_terms: D000328:Adult; D000367:Age Factors; D001628:Beverages / Q000009:adverse effects; D015992:Body Mass Index; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D004032:Diet; D004034:Diet Surveys; D019422:Dietary Sucrose / Q000009:adverse effects; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D005638:Fruit; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013549:Sweetening Agents / Q000009:adverse effects; D014280:Triglycerides / Q000097:blood; D055815:Young Adult
chemical_list: D019422:Dietary Sucrose; D013549:Sweetening Agents; D014280:Triglycerides