Sweetened Beverage Consumption Is Associated with Increased Risk of Stroke in Women and Men1,2

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Abstract

The consumption of sweetened beverages such as soft drinks has been associated with adverse effects on markers of cardiovascular risk. We examined the hypothesis that high consumption of sweetened beverages increases the risk of stroke. We followed 32,575 women aged 49−83 y and 35,884 men aged 45−79 y without cardiovascular disease, cancer, or diabetes at baseline. The consumption of sweetened beverages, including sugar-sweetened and artificially sweetened soft drinks and juice drinks, was assessed by using a food-frequency questionnaire. Stroke cases were ascertained by linkage to the Swedish Inpatient Register and the Swedish Cause of Death Register. The data were analyzed by using a Cox proportional hazards regression model. We ascertained 3510 incident cases of stroke, including 2588 cerebral infarctions, 349 intracerebral hemorrhages, 156 subarachnoid hemorrhages, and 417 unspecified strokes, during a mean follow-up of 10.3 y. Sweetened beverage consumption was significantly positively associated with risk of total stroke and cerebral infarction but not with hemorrhagic stroke. The multivariable RRs comparing ≥2 (median: 2.1) servings/d (200 mL/serving) with 0.1 to <0.5 (median: 0.3) servings/d were 1.19 (95% CI: 1.04, 1.36) for total stroke and 1.22 (95% CI: 1.04, 1.42) for cerebral infarction. These findings suggest that sweetened beverage consumption is positively associated with the risk of stroke.

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1

Supported by research grants fromthe Swedish Research Council and the Swedish Research Council for Health, Working Life, and Welfare (Forte). The funders had no role in the design, implementation, analysis, or interpretation of the data.

2

Author disclosures: S. C. Larsson, A. Åkesson, and A. Wolk, no conflicts of interest.