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Abstract：
The long-term associations between the consumption of sugar-sweetened beverages (SSBs) and low-calorie sweetened beverages (LCSBs) with cardiovascular diseases (CVDs) remains inconsistent. To synthesize the evidence, we conducted a meta-analysis of prospective cohort studies published up to 1 December, 2019 on the associations between SSB and LCSB intake and the risk of CVD incidence and mortality. Out of 5301 articles retrieved from our literature search, 11 articles evaluating the consumption of SSBs (16,915 incident CVD cases, 18,042 CVD deaths) and 8 articles evaluating the consumption of LCSBs (18,077 incident CVD cases, 14,114 CVD deaths) were included in the meta-analysis. A 1 serving/d increment of SSBs was associated with an 8% (RR: 1.08; 95% CI: 1.02, 1.14, I2 = 43.0%) and 8% (RR: 1.08; 95% CI: 1.04, 1.13, I2 = 40.6%) higher risk of CVD incidence and CVD mortality, respectively. A 1 serving/d increment of LCSBs was associated with a 7% (RR: 1.07; 95% CI: 1.05, 1.10, I2 = 0.0%) higher risk of CVD incidence. The association between LCSBs and CVD mortality appeared to be nonlinear (P = 0.003 for nonlinearity) with significant associations observed at high intake levels (>2 servings/d). Under an assumption of causality, the consumption of SSBs may be linked to 9.3% (95% CI: 6.6%, 11.9%) of predicted CVD incidence in the USA from 2015 to 2025, among men and nonpregnant women, who were aged 40-79 y in 2015-2016. The habitual consumption of SSBs was associated with a higher risk of CVD morbidity and mortality in a dose-response manner. LCSBs were also associated with a higher risk of these outcomes, however, the interpretation of these findings may be complicated by reverse causation and residual confounding.
摘要：
含糖饮料（SSB）和低热量含糖饮料（LCSB）与心血管疾病（CVD）之间的长期关联仍然不一致。为了综合证据，我们对截至12月1日发表的前瞻性队列研究进行了荟萃分析，2019年SSB和LCSB摄入量与CVD发病率和死亡率风险之间的关系。从我们的文献检索中检索到的5301篇文章中，11篇文章评估了SSB的消耗(16,915例心血管疾病事件，18,042例CVD死亡）和8篇评估LCSB消费的文章（18,077例CVD事件，14,114例CVD死亡）纳入荟萃分析。SSB的1份/天增加与8%(RR:1.08;95%CI:1.02,1.14,I2=43.0%)和8%(RR:1.08;95%CI:1.04,1.13,I2=40.6%)的CVD发病率和CVD死亡率的高风险相关,分别。LCSBs增加1份/d与7％（RR：1.07；95％CI：1.05，1.10，I2=0.0％）的CVD发生率升高相关。LCSBs和CVD死亡率之间的关联似乎是非线性的（P=0.003的非线性），在高摄入水平（>2份/d）下观察到显着的关联。在因果关系的假设下，SSB的消费量可能与9.3%(95%CI：6.6%，11.9％）从2015年到2025年，在男性和未怀孕的女性中，他们在2015-2016年年龄为40-79岁。SSB的习惯性消耗以剂量反应方式与CVD发病率和死亡率的高风险相关。LCSB也与这些结果的高风险相关，然而,反向因果关系和残余混杂可能使这些结果的解释变得复杂.
