Abstract

Introduction: Sugar-sweetened beverages (SSBs) remain the top contributor to added sugar intake and contribute to significant cardiometabolic disease burdens. However, associations of SSB intake with gut microbiota and blood metabolites, a potential pathway linking SSB intake to cardiometabolic risks, are unclear. Hypothesis: Higher SSB intake alters gut microbial composition and blood metabolites which contribute to higher cardiometabolic risks. Methods: We assessed associations of SSB intake with gut microbiome (metagenomics, n=2970) and 653 serum metabolites (untargeted metabolomics, n=6115) among US Hispanic/Latino adults. We examined cross-sectional associations of gut microbiota with cardiometabolic traits and metabolites, and prospective associations of metabolites with risks of cardiovascular disease (i.e., myocardial infarction, stroke, and heart failure) and diabetes over median follow-ups of 7.6 and 10.5 years, respectively. Results: Higher SSB intake (median=0.9 servings/d) was related to the enrichment of 2 microbial species and depletion of 7 species with multivariable adjustment ( Fig. 1 ). A gut microbiota score, calculated based on the 9 SSB-related species, was related to poorer glycemic, triglyceride, and renal traits ( Fig. 1 ). Among 64 metabolites related to both SSB intake and gut microbiota score ( Fig. 1 ), 7 metabolites (e.g., 5-aminovaleric acid betaine) were associated with cardiovascular disease risk, and 30 metabolites were associated with diabetes risk, including those in the branch-chained amino acid metabolism (e.g., 2-hydroxyisovaleric acid), tryptophan metabolism (indole-3-propionic acid), and ursodeoxycholic acid, which were reported to closely relate to gut microbiota. Conclusion: Among US Hispanics/Latinos, higher SSB intake was associated with unfavorable gut microbiota and circulating metabolites for cardiometabolic risks, suggesting a potential role of gut microbiota and related metabolites in the link of SSB intake with cardiometabolic diseases.

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