The relationship between sugar-sweetened beverages, sleep disorders, and diabesity

Abstract

BackgroundDiabetes and obesity in adults are global issues. Obesity and type 2 diabetes mellitus (T2DM) are increasingly categorized under the umbrella term “diabesity.” Health risk factors (HRFs), which include altering sleep habits and reducing sugar-sweetened beverages (SSBs) consumption, have emerged as relatively novel and crucial strategies for preventing and treating diabetes.ObjectiveWe aimed to explore: 1) whether SSBs could affect diabesity in China’s community; 2) whether HRFs could moderate this relationship; and 3) whether a three-way interaction exists between HRFs, SSBs, and diabesity.MethodsOn December 10, 2018, we investigated diabetes complications in four cities in Anhui Province and obtained basic and lifestyle information using a detailed questionnaire. The primary exposure was SSBs and outcomes were body mass index (BMI) and waist circumference (WC), while glycated hemoglobin (HbA1c) and sleep patterns (including duration and disorders) were considered moderators.ResultsOverall, 1920 participants were enrolled, and those who did not complete the questionnaire were excluded. Finally, this study included 1765 participants, with a response rate of 92.0%. The mean age was (57.10 ± 10.0) years. Patients with lower educational levels were more likely to have a lower prevalence of WC (χ2 = 2.73) and BMI (χ2 = 3.47), and some HRFs were positively correlated with WC and BMI. Additionally, SSBs were significantly associated with BMI (β = 1.29) and WC (β = 2.97), and there was also differences based on sex, some HRFs, such as HbA1c, FBG and TG, showed higher levels in male participants, whereas TC level was higher in female participants. In the moderation analysis, sleep patterns were also associated with total cholesterol, triglyceride, and BMI. Furthermore, there were three-way interaction effects among HbA1c, sleep patterns, and SSBs on total cholesterol, triglyceride, BMI, and WC. Moreover, sensitivity analysis demonstrated that our results were robust.ConclusionSSBs positively correlated with patterns dose-dependently. Moreover, SSBs could also be associated with sleep patterns, and blood glucose levels were correlated with diabesity. A three-way interaction effect was discovered between SSBs, sleep patterns, blood glucose levels, and patterns. Therefore, understanding the diabesity caused by SSBs and other HRFs can help prevent its occurrence.

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“…Sleep disturbance is a prevalent symptom in patients with diabetes (39,40), and consistent with previous observational studies, our study revealed a 17% elevated risk of CAD among individuals with diabetes with insomnia. A meta-analysis of 13 prospective studies totaling 120,000 participants additionally demonstrated a 45% increased risk of cardiovascular disease incidence and/or mortality during the follow-up period among individuals with insomnia (OR = 1.45, 95% CI: 1.29-1.62) (41).…”

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“…Fruit juices may include lower average concentrations of certain beneficial elements, such as fiber, polyphenols, and other phytochemicals, which are largely lost during the juicing process, in addition to having comparatively greater simple sugar contents as compared to whole fruits [ 54 ]. The association between beverage intake and poor sleep quality may relate to the high fructose content in liquid form, providing only “empty” calories with little nutritional value, which may increase the glucose level and influence the normal circadian rhythm system that regulates the normal metabolic process of the body, and so lead to poor sleep [ 55 ].…”

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