Association between sucrose intake and risk of overweight and obesity in a prospective sub-cohort of the European Prospective Investigation into Cancer in Norfolk (EPIC-Norfolk)

Abstract

ObjectiveThe objective of the present study was to investigate associations between sugar intake and overweight using dietary biomarkers in the Norfolk cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Norfolk).DesignProspective cohort study.SettingEPIC-Norfolk in the UK, recruitment between 1993 and 1997.SubjectsMen and women (n 1734) aged 39–77 years. Sucrose intake was assessed using 7 d diet diaries. Baseline spot urine samples were analysed for sucrose by GC-MS. Sucrose concentration adjusted by specific gravity was used as a biomarker for intake. Regression analyses were used to investigate associations between sucrose intake and risk of BMI>25·0 kg/m2 after three years of follow-up.ResultsAfter three years of follow-up, mean BMI was 26·8 kg/m2. Self-reported sucrose intake was significantly positively associated with the biomarker. Associations between the biomarker and BMI were positive (β=0·25; 95 % CI 0·08, 0·43), while they were inverse when using self-reported dietary data (β=−1·40; 95 % CI −1·81, −0·99). The age- and sex-adjusted OR for BMI>25·0 kg/m2 in participants in the fifth v. first quintile was 1·54 (95 % CI 1·12, 2·12; P trend=0·003) when using biomarker and 0·56 (95 % CI 0·40, 0·77; P trend<0·001) with self-reported dietary data.ConclusionsOur results suggest that sucrose measured by objective biomarker but not self-reported sucrose intake is positively associated with BMI. Future studies should consider the use of objective biomarkers of sucrose intake.

Adherence to WCRF/AICR cancer prevention recommendations and metabolic syndrome in breast cancer patients

“…When prospective studies began to be published, it became clear that the negative association was due to reverse causation, because many overweight and obese people tend to avoid the consumption of sugar, or to declare to consume less sugar than what is actually consumed. In the EPIC‐Norfolk study the consumption of sugar estimated on the basis of dietary questionnaire was negatively associated with the development of obesity, but the analysis based on a validated biomarker (urinary sucrose) demonstrated that sugar consumption is a significant determinant of obesity, with a clear dose‐effect …”

New markers of dietary added sugar intake

“…PABA excretion is assessed in urine samples using a colorimetric analysis [30], and urine samples with ≥85% PABA recovery are generally considered complete and acceptable for inclusion in biomarker analyses (30). Spot urine samples have also been evaluated for urinary sugar excretion [29**,31*]. …”

“…Studies published within the past 1–2 years are presented in Table 2. Both studies included large sample sizes of adults, and reported associations of biomarker values with self-reported sugar intake [31*,32]. Tasevska and colleagues [32] utilized a biomarker-based calibration equation to predict total sugar intake, and compared this to self-reported intake in a US sample.…”

“…Tasevska and colleagues [32] utilized a biomarker-based calibration equation to predict total sugar intake, and compared this to self-reported intake in a US sample. Kuhnle and colleagues [31*] collected spot urine samples from a UK sample. In general, associations appear low to modest (i.e., r=0.2).…”

A Systematic Review of Methods for Increasing Vegetable Consumption in Early Childhood

“…As a calorific compound, excess sugar consumption is a major contributor towards overweight and obesity [13], as well as type two diabetes. Furthermore, some research suggests that fructose consumption activates the digestive system in a different way to glucose, so that it does not stimulate insulin or leptin release [14].…”