Z-M Liu1,2, L A Tse2, D Chan3, C Wong3, S Y S Wong3. 1. Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, China. 2. Division of Environmental and Occupational Health, Jockey Club School of Public Health and Primary Healthcare, the Chinese University of Hong Kong, Hong Kong, Hong Kong SAR. 3. Division of Family Medicine and Primary Healthcare, Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong, Hong Kong SAR.
Abstract
BACKGROUND/ OBJECTIVES: Epidemiological studies suggest that sugar intake contributes to weight gain and increased risk of cardiovascular diseases (CVDs). However, this association is largely undefined in the elderly population. Our aim was to investigate the effect of sugar consumption on the subsequent changes in body fatness and CVD mortality in Chinese elderly. METHODS: A total of 2000 men and 2000 women aged ⩾65 years were recruited from 2001 to 2003. Dietary sugar intake was estimated based on a validated 329-item food frequency questionnaire and a local sugar database. Adiposity was measured using dual-energy X-ray absorptiometry at baseline and follow-up after 4 years. Mortality was ascertained by local death registry until March 2014. Multivariable linear and Cox regression were conducted to evaluate the association of sugar consumption on the changes in body fatness and CVD mortality. RESULTS: A total of 174 CVD deaths were documented within the total 37 999 person-years' follow-up. Significant positive association between sugar intake and increase in body fatness at follow-up after 4 years was found in men but not in women. After adjustment for potential confounders, men who consumed 1% increase in added sugar had an increase in whole body fat by 0.043 kg (P=0.006), central fat by 0.029 kg (P=0.016) and peripheral fat by 0.026 kg (P=0.006). However, in both genders, after an average of 11.1-year follow-up, compared with the lowest quintile, the highest intakes of added sugar were associated with significantly lowered CVD mortality by 74.9% (hazard ratio (HR) (95% confidence interval (CI)): 0.251(0.070, 0.899)) in a dose-response manner (Ptrend=0.011). This association was attenuated to non-significance by further adjustment of the change in body fatness (Ptrend=0.055). CONCLUSIONS: Thus higher sugar intake of the Chinese elderly was associated with increased adiposity in men but decreased CVD mortality. The current World Health Organization recommendation for the elderly should be reviewed.
BACKGROUND/ OBJECTIVES: Epidemiological studies suggest that sugar intake contributes to weight gain and increased risk of cardiovascular diseases (CVDs). However, this association is largely undefined in the elderly population. Our aim was to investigate the effect of sugar consumption on the subsequent changes in body fatness and CVD mortality in Chinese elderly. METHODS: A total of 2000 men and 2000 women aged ⩾65 years were recruited from 2001 to 2003. Dietary sugar intake was estimated based on a validated 329-item food frequency questionnaire and a local sugar database. Adiposity was measured using dual-energy X-ray absorptiometry at baseline and follow-up after 4 years. Mortality was ascertained by local death registry until March 2014. Multivariable linear and Cox regression were conducted to evaluate the association of sugar consumption on the changes in body fatness and CVD mortality. RESULTS: A total of 174 CVD deaths were documented within the total 37 999 person-years' follow-up. Significant positive association between sugar intake and increase in body fatness at follow-up after 4 years was found in men but not in women. After adjustment for potential confounders, men who consumed 1% increase in added sugar had an increase in whole body fat by 0.043 kg (P=0.006), central fat by 0.029 kg (P=0.016) and peripheral fat by 0.026 kg (P=0.006). However, in both genders, after an average of 11.1-year follow-up, compared with the lowest quintile, the highest intakes of added sugar were associated with significantly lowered CVD mortality by 74.9% (hazard ratio (HR) (95% confidence interval (CI)): 0.251(0.070, 0.899)) in a dose-response manner (Ptrend=0.011). This association was attenuated to non-significance by further adjustment of the change in body fatness (Ptrend=0.055). CONCLUSIONS: Thus higher sugar intake of the Chinese elderly was associated with increased adiposity in men but decreased CVD mortality. The current World Health Organization recommendation for the elderly should be reviewed.
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