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Sugary drink consumption may predict risk for abnormal heart rhythm

Drinking sugar-sweetened or artificially sweetened beverages was linked to risk for atrial fibrillation.

Regina Schaffer, Healio, Mar 5, 2024

Adults who drank at least 2 L per week of sugar- or artificially sweetened beverages per week were more likely to develop atrial fibrillation during nearly 10 years of follow-up, independent of other traditional CV risk factors, data show.

"Excessive consumption of sugar-sweetened beverages and artificially sweetened beverages are both related to the increasing risk for atrial fibrillation," Ningjian Wang, MD, PhD, associate research professor and clinical fellow at Shanghai Ninth People's Hospital and Shanghai JiaoTong University School of Medicine, told Healio. "Reduce or even avoid sugar sweetened or artificially sweetened beverage consumption whenever possible and do not take it for granted that low-sugar and low-calorie artificially sweetened beverages are 'healthy,' as these drinks may pose an even greater risk for incident AF."

As Healio previously reported, AF affects 2.7 million to 6.1 million people in the U.S., according to the American Heart Association, and that burden is expected to rise substantially in the coming years. With AF comes risk for other CV conditions, including a fivefold elevated risk for stroke compared with the general population, yet many people remain undiagnosed and some people are at much higher risk for AF than others.

Wang and colleagues analyzed data from 201,856 adults aged 37 to 73 years who participated in the UK Biobank who were free from AF at baseline, had genetic data available and completed a 24-hour diet questionnaire. Participants responded to the questionnaire with how many cups (glasses/cans/250 mL/cartons) of beverages they drank the previous day, with four cups deemed equivalent to 1 L. The researchers classified respondents by four groups: nonconsumers (0 L per week), less than 1 L per week, 1 L to 2 L per week, and 2 or more L per week of sugar and artificially sweetened beverages. Analyses were also stratified by pure fruit juice consumption in the same amounts. Genetic risk for AF was based on the standard polygenic risk score and classified as high (highest polygenic risk score quartile), intermediate (middle two polygenic risk score quartiles) and low (lowest polygenic risk score quartile).

"As previously done, fizzy drinks and squash were defined as sugar-sweetened beverages, low-calorie drinks were defined as artificially sweetened beverages, and pure orange juice, pure grapefruit juice and other pure fruit or vegetable juice were defined as pure juice," the researchers wrote in Circulation: Arrhythmia and Electrophysiology. "Other drinks, such as milk, tea and coffee, were not included as sweetened beverages in the current study, as they are usually evaluated separately for their specific nutritional value or composition, not only sugar."

The researchers estimated HRs for AF with sugar- and artificially sweetened beverage consumption during a median follow-up of 9.9 years.

The researchers observed 9,362 incident AF cases during follow-up of the cohort.

Compared with adults who did not report consuming sugary drinks, those who reported consuming at least 2 L per week of sugar or artificially sweetened beverages had a 20% greater risk for developing AF after adjusting for demographic factors, cardiometabolic factors, polygenic risk for AF and other dietary components (HR = 1.2; 95% CI, 1.1-1.31). The researchers also found a negative association between consuming less than 1 L per week of pure fruit juice and AF risk (HR = 0.92; 95% CI, 0.87-0.97).

Adults at higher risk for AF were those who reported consuming at least 2 L per week of sugary drinks who also had high genetic risk for the condition, with an HR of 3.51 compared with nonconsumers (95% CI, 2.94-4.19). Adults in the cohort at lowest risk for AF were those at low genetic risk who also reported consuming less than 1 L per week of pure fruit juice (HR = 0.77; 95% CI, 0.65-0.92).

There were no interactions between consuming sugar-sweetened drinks, artificially sweetened drinks, pure fruit juice and genetic predisposition to AF, according to the researchers.

"Based on our findings, we recommend people to reduce [sugar-sweetened beverage] and [artificially sweetened beverage] consumption less than 2 L per week or even avoid whenever possible for heart health," Wang told Healio. "Individuals should be aware of the health risks associated with consuming sweetened beverages. Avoiding all sweetened beverages remains the best choice based on current knowledge. Switching to healthier alternatives such as water or moderate fruit juice consumption may help reduce sugar intake and contribute to overall better health. Moreover, it is important to not assume that low-calorie artificially sweetened beverages are automatically healthy, as they also carry potential health risks."

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