title: The relationship between sugar-sweetened beverages and liver enzymes among healthy premenopausal women: a prospective cohort study.
abstract: OBJECTIVE
  To prospectively assess the association between sugar-sweetened beverages (SSB), added sugar, and total fructose and serum concentrations of liver enzymes among healthy, reproductive-age women.
  
  
  METHODS
  A prospective cohort of 259 premenopausal women (average age 27.3 ± 8.2 years; BMI 24.1 ± kg/m(2)) were followed up for up to two menstrual cycles, providing up to eight fasting blood specimens/cycle and four 24-h dietary recalls/cycle. Women with a history of chronic disease were excluded. Alanine and aspartate aminotransferases (ALT and AST, respectively) were measured in serum samples. Linear mixed models estimated associations between average SSB, added sugar, and total fructose intake and log-transformed liver enzymes adjusting for age, race, body mass index, total energy and alcohol intake, and Mediterranean diet score.
  
  
  RESULTS
  For every 1 cup/day increase in SSB consumption and 10 g/day increase in added sugar and total fructose, log ALT increased by 0.079 U/L (95 % CI 0.022, 0.137), 0.012 U/L (95 % CI 0.002, 0.022), and 0.031 (0.012, 0.050), respectively, and log AST increased by 0.029 U/L (-0.011, 0.069), 0.007 U/L (0.000, 0.014), and 0.017 U/L (0.004, 0.030), respectively. Women who consumed ≥1.50 cups/day (12 oz can) SSB versus less had 0.127 U/L (95 % CI 0.001, 0.254) higher ALT [percent change 13.5 % (95 % CI 0.1, 28.9)] and 0.102 (95 % CI 0.015, 0.190) higher AST [percent change 10.8 % (95 % CI 1.5, 20.9)].
  
  
  CONCLUSIONS
  Sugar-sweetened beverages were associated with higher serum ALT and AST concentrations among healthy premenopausal women, indicating that habitual consumption of even moderate SSB may elicit hepatic lipogenesis.
authors: Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6100 Executive Boulevard, 7B03M, Rockville, MD, 20852, USA.|Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA.
authors: Maya K
authors: MK
authors: Shimony
authors: Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6100 Executive Boulevard, 7B03M, Rockville, MD, 20852, USA.
authors: Karen C
authors: KC
authors: Schliep
authors: Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6100 Executive Boulevard, 7B03M, Rockville, MD, 20852, USA.
authors: Enrique F
authors: EF
authors: Schisterman
authors: Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6100 Executive Boulevard, 7B03M, Rockville, MD, 20852, USA.
authors: Katherine A
authors: KA
authors: Ahrens
authors: Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6100 Executive Boulevard, 7B03M, Rockville, MD, 20852, USA.
authors: Lindsey A
authors: LA
authors: Sjaarda
authors: Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Rockville, MD, USA.
authors: Yaron
authors: Y
authors: Rotman
authors: Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6100 Executive Boulevard, 7B03M, Rockville, MD, 20852, USA.
authors: Neil J
authors: NJ
authors: Perkins
authors: Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, VA, USA.
authors: Anna Z
authors: AZ
authors: Pollack
authors: Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA.
authors: Jean
authors: J
authors: Wactawski-Wende
authors: Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6100 Executive Boulevard, 7B03M, Rockville, MD, 20852, USA. mumfords@mail.nih.gov.
authors: Sunni L
authors: SL
authors: Mumford
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001628:Beverages / Q000032:analysis*; D015992:Body Mass Index; D004032:Diet; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D008099:Liver / Q000201:enzymology*; D011939:Mental Recall; D015596:Nutrition Assessment; D064427:Nutritive Sweeteners / Q000008:administration & dosage*; D017697:Premenopause; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D064427:Nutritive Sweeteners; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase
keywords: Dietary sucrose; Fructose; Liver enzymes; Menstrual cycle; Sugar-sweetened beverages