Consumption of sweetened beverages increases risk of heart failure

iStock_000024649569XSmallSummer is coming and with sweltering heat comes a temptation to
quench thirst with sweetened beverages. However, we should carefully consider the type of fluid intake because as scientist from Karolinska Institutet report, consumption of sweetened beverage significantly increases the risk of heart failure occurrence.

Heart failure (HF) is a condition in which it comes to reduction of the cardiac output or the right cardiac output is maintained through increasing filling pressure as a result of abnormal structure or disturbances in the functioning of the heart. It leads to insufficient blood flow in relation to the requirements of the organism, decrease in oxygenation of the tissue and appearance of clinical symptoms.

Typical symptoms of left ventricular insufficiency are dyspnea, which intensifies especially at night and during lying position (orthopnoë), cough, fatigue, a decrease in physical activity tolerance, and even dizziness and confusion.

In the case of right ventricular insufficiency symptoms are swelling, mainly in area of the ankles (in the lumbar region of the lying patients), transudation liquid in a pleural cavity and abdomen cavity (ascites), hepatomegaly, nausea and constipation.

A number of people with this diagnosis is estimated to be 5,8 million patients in the United States and more than 23 million worldwide and it is still rising. Therefore, it is essential to identify factors influencing the possibility of heart failure occurrence and, if possible, eliminate them. Because it is proven that sweetened beverage consumption has a negative impact on the incidence of hypertension, metabolic syndrome, coronary heart disease and stroke, scientists decided to investigate whether there is a similar relationship in relation to heart failure (HF).

Scientists conducted a prospective population-based study on the group of 42 400 men aged 45-79 years. It lasted for 11,7 years. After filling out the FFQ form (food frequency questionnaire) participants were qualified to five groups with different amounts of sweetened beverages consumed per day, taking one 200 ml glass of beverage as a standard portion. Then, with the use of the Swedish National Patient Register, Cause of Death Register and basing on the International Statistical Classification of Diseases and Related Health Problems ICD-10 criteria, scientists identified patients with recently diagnosed heart failure (HF) or dead because of this reason.

As it turned out, the risk of heart failure development in men consuming two or more portions of sweetened beverages per day is 23% higher than in non-consumers. Researchers also noticed a relationship between sweetened beverage intake and level of education. Among patients belonging to the group of the highest level of consumption, fewer people had higher education than in other groups. Interestingly, there were no statistically significant differences in results of the investigation among smokers, people with overweight, diabetes or aged more than 60 years.

Perhaps the consumption of sweetened beverages increases the risk of heart failure by influence on gaining weight, blood pressure, concentration of insulin, glucose and C-reactive protein. High glycemic index of sweetened beverages may also be important because strict glycemic was suggested as one of the actions undertaken to prevent the occurrence of heart failure. Mechanisms explaining observed relationship might be multiple and as the authors themself admit, further studies are necessary for their clarification, including parameters such as blood pressure, concentration of insulin, glucose and C-reactive protein. It is also necessary to include younger people, women and residents of other regions of the world (sweetened beverage intake in the United States is much higher than in European countries) and also to distinguish beverages into those sweetened with sugar and its artificial substitutes.

However, there is no doubt that resignation of sweetened beverages for mineral water and natural fruit juices should become one of the elements of heart failure prevention.

Written by: Katarzyna Skarbek, Jaromir Ziomek, Patrycja Kapica

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3. Malik VS, Popkin BM, Bray GA, et al. Sugar-sweetened beverages, obesity, type 2 diabetes mellitus, and cardiovascular disease risk. Circulation 2010;121:1356-64
4. Aeberli I, Gerber PA, Hochuli M, et al. Low to moderate sugar-sweetened beverage consumption impairs glucose and lipid metabolism and promotes inflammation in healthy young men: a randomized controlled trial. Am J Clin Nutr 2011;94:479-85

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