Sugar-sweetened beverage consumption and risk of premature coronary artery disease in a multi-ethnic Iranian case-control study

Abstract

Background: The association of sugar sweetened beverages (SSBs) and coronary artery disease (CAD) has not been well-established in Asians, where SSBs are the leading ultra-processed food product. Objective: We aim to examine the association between SSBs and premature CAD (PCAD) in Iranian adults. Design: Case-control. Participants: A multi-centric study of Iranians including 2006 PCAD and 1131 healthy individuals as control group. Main outcome measures: Dietary intakes were assessed using a validated food frequency questionnaire (FFQ). SSBs consist of artificial juice and sugar -sweetened drinks. The PCAD was determined based on the results of angiography and the occlusion percent of vessels. Statistical analysis: The odds of PCAD across the quartiles of SSBs were assessed by binary logistic regression. Results: The mean (SD) age of participants and SSB consumption was 51.5 years and 46.9 g/d, respectively. In the fully-adjusted model, compared with participants in the first quartile, those in the fourth quartile had higher risk of PCAD (OR = 1.50, 95 CI: 1.12, 2.00; P trend = 0.044). Consistently, SSB consumption was directly associated with the severity of PCAD. The higher SSB consumption, the greater risk for the severe PCAD (OR Q4 vs. Q1 = 1.34, 95 CI: 1.06, 1.68; P < 0.001). Conclusion: This study demonstrated that higher consumption of SSB might be associated with higher risk of PCAD. However, more prospective cohort studies are necessary to confirm this association.