Drinking sugary sodas was associated with more fat around the belly, according to a new analysis of the Framingham Heart Study.
Based on measurements of visceral adipose tissue and subcutaneous adipose tissue in more than 1,000 middle-aged adults, higher intake of sugar-sweetened beverages, as reported at baseline, was associated with a greater change in visceral adipose tissue volume over 6 years (P<0.001 for trend), according to Caroline Fox, MD, MPH, of the National Heart, Lung, and Blood Institute (NHLBI) in Framingham, Mass., and colleagues.
They noted that visceral adipose tissue volume increased differently depending on how much soda the participant consumed:
But there was no association between visceral fat and diet soda, they wrote in Circulation, and no association between sugar-sweetened beverage (SSB) intake and a change in total body weight (P=0.26 for trend) despite the belly fat findings.
"The present study supports current dietary recommendations that limiting SSB consumption may be helpful to prevent cardiometabolic diseases," the authors stated. "Taken together, these findings suggest that habitual SSB intake was associated with a long-term adverse change in visceral adiposity."
Participants were drawn from the third generation of the Framingham study, which began in 2002. Their ages ranged from 19 to 72 years, 53.3% were women, and almost all (99.7%) were white. Participants were examined by physicians and underwent laboratory tests for vascular risk factors. Only about half of the patients in the entire cohort of 4,095 ended up getting a CT scan because of the CT machine's restriction for weight.
Those who had undergone bariatric surgery, who had a history of myocardial infarction, stroke, or cancer, or who had missing information related to soda intake, physical activity, or smoking status were excluded. The Harvard semi-quantitative food frequency questionnaire was used to measure sugar-sweetened beverage intake at baseline. It asked about 126 food items, and the standard serving was defined as a glass, bottle, or can of soda.
Generally, one serving of a sugar-sweetened beverage is equivalent to 360 ml or 12 fl oz, explained co-author Jiantao Ma, PhD, in an email to MedPage Today.
To estimate sugar-sweetened beverage intake, researchers grouped four types of beverages together in the same category: caffeinated sodas with sugar, caffeine-free colas with sugar, other carbonated drinks with sugar, and fruit punch, lemonade, or other non-carbonated fruit drinks. Similarly, low calorie or diet colas, sodas, and beverages were put in the same category.
Most participants (85%) drank both sugar-sweetened beverages and diet soda, but only 1% reported being daily consumers of both. Fourteen people reported being nonconsumers of either type of beverage, and 15% drank diet soda daily.
Those who drank sugar-sweetened beverages were more likely to be men, younger, and current smokers than those who didn't drink sugar-sweetened beverages. They were also less likely to have diabetes and slightly more likely to exercise. Sugar-sweetened beverage intake was inversely correlated with diet soda intake.
Over the 6 years of the study, body weight increased by 2.4 kg (about 5 lbs) for nonconsumers and by 2.8 kg, 2.4 kg, and 1.7 kg for those in the other three consumption groups of sugar-sweetened beverages.
Over follow-up, subcutaneous adipose tissue increased by 586 cm3 (95% CI 500-672) in nonconsumers and 568 cm3 (95% CI 427-709) in daily consumers. However, sugar-sweetened beverage intake was not associated with change in subcutaneous adipose tissue volume in models that were adjusted for change in body weight(P=0.70 and P=0.77 for trend).
Diet soda consumption was also not associated with a change in body weight or in subcutaneous adipose tissue. There were no significant interactions between sugar-sweetened beverage intake and sex, body mass index, or type 2 diabetes.
A study limitation was that the authors couldn't rule out that participants changed their consumption over time. Other sugary drinks, like sports drinks, energy drinks, and iced tea were not asked about in the questionnaire. Also, most of the participants were white and the results might not be generalizable to other ethnicities.
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