Journal of
Public Health and Epidemiology

  • Abbreviation: J. Public Health Epidemiol.
  • Language: English
  • ISSN: 2141-2316
  • DOI: 10.5897/JPHE
  • Start Year: 2009
  • Published Articles: 494

Full Length Research Paper

The association between sugary food and drinks intake and the risk of stroke mortality in the adventist health study-2

Alsanussi Elsherif
  • Alsanussi Elsherif
  • Center for Nutrition, Healthy Lifestyle and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, California, 92350, USA.
  • Google Scholar
Raymond Knutsen
  • Raymond Knutsen
  • Center for Nutrition, Healthy Lifestyle and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, California, 92350, USA.
  • Google Scholar
Lawrence W. Beeson
  • Lawrence W. Beeson
  • Center for Nutrition, Healthy Lifestyle and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, California, 92350, USA.
  • Google Scholar
Keiji Oda
  • Keiji Oda
  • Center for Nutrition, Healthy Lifestyle and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, California, 92350, USA.
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Sujatha Rajaram
  • Sujatha Rajaram
  • Center for Nutrition, Healthy Lifestyle and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, California, 92350, USA.
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David Shavlik
  • David Shavlik
  • Center for Nutrition, Healthy Lifestyle and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, California, 92350, USA.
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Gary E. Fraser
  • Gary E. Fraser
  • Center for Nutrition, Healthy Lifestyle and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, California, 92350, USA.
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Synnove Knutsen
  • Synnove Knutsen
  • Center for Nutrition, Healthy Lifestyle and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, California, 92350, USA.
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  •  Received: 10 October 2018
  •  Accepted: 28 November 2018
  •  Published: 31 December 2018

Abstract

A high consumption of added sugar has been associated with several cardiovascular risk factors, including obesity, type 2 diabetes mellitus and dyslipidemia. The main goal was to assess the association of sugary food and drink intake on the risk of stroke mortality. The Adventist Health Study-2 (AHS-2) is a prospective study with approximately 96,000 participants from the United States and Canada.  Subjects were recruited from 2002 to 2007 at which time they completed a comprehensive food frequency questionnaire including intake of sugar added sweet foods and drinks. Subjects were followed with respect to National Death Index (NDI) mortality information through 2015. This is a low sugar consuming cohort where about 50% also adhere to a vegetarian dietary pattern. After applying exclusion criteria, the final analytical sample consisted of 53,482 study subjects. Cox Proportional hazard regression was used in the analyses adjusting for important demographic, lifestyle and medical variables. Four hundred and seventy two fatal strokes occurred during an average of 9.5 years or 509, 119 person-years of follow-up. Compared to the lowest quartile of sugary food intake (0 to 1.6 times/week), the hazard ratio of fatal stroke for the highest quartile (> 7 times/week) of sugary food intake was 0.86 (95% CI: 0.65 to 1.13), after adjusting for covariates. The hazard ratios did not change significantly when stratifying on gender and race. Consumption of added sugar was not associated with fatal stroke in this low sugar consuming population. Further research is needed in populations with higher intakes of sugar-sweetened foods and with diverse backgrounds and dietary patterns.

Key words: Diet, sugar, stroke, cardiovascular diseases.