Association of sugar intake from different sources with incident dementia in the prospective cohort of UK Biobank participants

Abstract

Background Dementia is a common disease with around 55 million cases worldwide. Therefore, dietary changes and lifestyle interventions are important approaches to delay the progress of a decline in cognitive function. The study aims to explore the association of various sources of free sugars (FS) and intrinsic sugars with dementia risk in the prospective population-based UK Biobank cohort. Methods Sugar consumption was assessed in 186,622 UK Biobank participants with at least one web-based dietary questionnaire (Oxford WebQ). Over a mean follow-up of 10.6 (standard deviation 1.1) years, 1498 incident dementia cases occurred. The hazard ratios (HR) for incident dementia were assessed with Cox proportional hazard regression models including sugar intake from different sources as penalized cubic splines to allow for non-linear predictor effects. Results The intake of FS and intrinsic sugar was significantly associated with dementia risk in a J-shaped fashion with the HR-nadir observed at 9% and 8% total energy (%E), respectively. FS in beverages were significantly associated with dementia risk in an ascending approximately linear way, whereas no significant association was found for FS in solids. Assessing beverage subtypes, FS in soda/fruit drinks, milk-based drinks and to a lesser extent in juice were significantly and positively related to dementia risk, whereas no association was found for FS in tea/coffee. The association between sugar subtype consumption and dementia risk remained consistent in most sensitivity analyses but changed from a J-shape to a more linear shape when the analysis was restricted to participants with at least two Oxford WebQs. Conclusions A linear-shaped association between sugar subtype intake and dementia risk is most consistently found for FS in beverages and more specifically for FS in soda/fruit drinks, as well as in milk-based drinks. Graphical Abstract

Association of sugar intake from different sources with cardiovascular disease incidence in the prospective cohort of UK Biobank participants

“…Therefore, the associations of the intake of FS, intrinsic sugars, and various FS subtypes with incident CVD were analysed in a large, well-characterised population of 176,352 UK Biobank participants using penalised cubic splines to allow non-linear predictor effects. We hypothesised that the relationship between FS and CVD risk depends on the source of FS with a positive association found for beverages, but not for solid foods, similar to recent findings from our group studying all-cause mortality [ 18 ], incident depression [ 19 ], and incident dementia [ 20 ].…”

“…S 2 ). Seven exclusion criteria were applied similar to three recent studies from our group [ 18 – 20 ] (removed participants n = 34,593) and are depicted in Fig. S 2 .…”

“…The intake of sugar and sugar subtypes from beverages and solids was calculated using the Oxford WebQ data similar to described in three previous reports from our group [ 18 – 20 ]. In brief, the definition of sugary beverages included soda/fruit drinks, pure juice, milk-based drinks, and tea/coffee with added sugar, whereas treats, breakfast cereals, toppings, and sauces were defined as subtypes of sugary solids.…”

Associations of sugar intake, high-sugar dietary pattern, and the risk of dementia: a prospective cohort study of 210,832 participants

“…In a general population, we further detected the significant non-linear relationship between sugar intake and AD, whereby higher consumption of more than the median amount of sugar increased the risk of dementia more prominently. Several other studies also investigated the effect of sugar intake on the risk of dementia without consideration of the interaction of different nutrients contained in different food groups in a specific dietary pattern as a whole [ 16 , 31 ]. Most recently, Schaefer et al reported that two sugar subtypes (free and intrinsic sugars) from different sources were associated with the risk of dementia [ 16 ].…”

“…Sugar intake from various other sources in daily diet is also worthy of attention. Nevertheless, only a few studies evaluated the role of dietary sugar intake on dementia [ 16 , 17 ].…”