A prospective study of artificially sweetened beverage intake and cardiometabolic health among women at high risk

Research output: Contribution to journalJournal article – Annual report year: 2019Researchpeer-review



  • Author: Hinkle, Stefanie N.

    National Cancer Institute United States

  • Author: Rawal, Shristi

    Rutgers - The State University of New Jersey, Newark

  • Author: Bjerregaard, Anne Ahrendt

    Statens Serum Institut

  • Author: Halldorsson, Thor I.

    Statens Serum Institut

  • Author: Li, Mengying

    National Cancer Institute United States

  • Author: Ley, Sylvia H.

    Tulane University

  • Author: Wu, Jing

    Glotech, Inc.

  • Author: Zhu, Yeyi

    Kaiser Permanente

  • Author: Chen, Liwei

    University of California at Los Angeles

  • Author: Liu, Aiyi

    National Institutes of Health

  • Author: Grunnet, Louise Groth

    University of Copenhagen

  • Author: Rahman, Mohammad L.

    National Cancer Institute United States

  • Author: Kampmann, Freja Bach

    Research group for Risk Benefit, National Food Institute, Technical University of Denmark, Kemitorvet, 2800, Kgs. Lyngby, Denmark

  • Author: Mills, James L.

    National Cancer Institute United States

  • Author: Olsen, Sjurdur F.

    Statens Serum Institut

  • Author: Zhang, Cuilin

    National Cancer Institute United States

View graph of relations

Background: Artificially sweetened beverages (ASBs) are commonly consumed and recommended for individuals at high risk for cardiometabolic diseases; however, the health effects of ASBs remain contradictory. Given that cross-sectional analyses are subject to reverse causation, prospective studies with long-term follow-up are needed to evaluate associations between ASBs and cardiometabolic health, especially among high-risk individuals. Objective: The aim of this studywas to examine associations of ASB intake and cardiometabolic health among high-riskwomenwith prior gestational diabetes mellitus (GDM). Methods: We included 607 women with GDM from the Danish National Birth Cohort (DNBC; 1996-2002) who completed a clinical exam 9-16 y after the DNBC pregnancy for the Diabetes & Women's Health (DWH) Study (2012-2014). We assessed ASB intake using FFQs completed during the DNBC pregnancy and at the DWH Study clinical exam. We examined cardiometabolic outcomes at the DWH clinical exam. We estimated percentage differences in continuous cardiometabolic markers and RRs for clinical endpoints in association with ASB intake both during pregnancy and at follow-up adjusted for prepregnancy BMI, diet, and lifestyle factors. Sensitivity analyses to account for reverse causation were performed. Results: In pregnancy and at follow-up, 30.4% and 36.4% of women regularly (≥2 servings/wk) consumed ASB, respectively. Consumption of ASBs, both during pregnancy and at follow-up, was associated with higher glycated hemoglobin (HbA1c), insulin, HOMA-IR, triglycerides, liver fat, and adiposity and with lower HDL at follow-up. After adjustment for covariates, particularly prepregnancy BMI, the majority of associations between ASB intake in pregnancy and outcomes at follow-up became null with the exception of HbA1c. ASB intake at follow-up (≥1 serving/d compared with <1 serving/mo) was associated with higher HbA1c (6.5%; 95% CI: 1.9, 11.3; P-trend = 0.007); however, associations were not upheld in sensitivity analyses for reverse causation. Conclusions: Among Danish women with a history of GDM, ASB intake was not significantly associated with cardiometabolic profiles.

Original languageEnglish
Article numbernzq094
JournalThe American Journal of Clinical Nutrition
Issue number1
Pages (from-to)221-232
Publication statusPublished - 2019
CitationsWeb of Science® Times Cited: No match on DOI

    Research areas

  • Artificially sweetened beverages, Cardiometabolic health, Diabetes, Diet, Gestational diabetes, Nonnutritive sweeteners, Obesity, Soda

Download statistics

No data available

ID: 186728979