Abstract
The relationship between added sugar and arterial stiffness in youth with type 1 diabetes (T1D) has not been well-described. We used data from the SEARCH for Diabetes in Youth Study (SEARCH), an ongoing observational cohort study, to determine the association between added sugar and arterial stiffness in individuals diagnosed with T1D <20 years of age (n = 1539; mean diabetes duration of 7.9 ± 1.9 years). Added sugar intake was assessed by a food frequency questionnaire, and arterial stiffness measures included pulse wave velocity (PWV) and augmentation index. Separate multivariate linear regression models were used to evaluate the association between added sugar and arterial stiffness. Separate interaction terms were included to test for effect modification by body mass index (BMI) z-score and physical activity (PA). Overall, there was no association between added sugar and arterial stiffness (P > 0.05); however, the association between added sugar and arterial stiffness differed by BMI z-score (P for interaction = 0.003). For participants with lower BMI z-scores, added sugar intake was positively associated with PWV trunk measurements, whereas there was no association for those who had a higher BMI z-score. PA did not significantly modify the association between added sugar and arterial stiffness. Further research is needed to determine the longitudinal relationship and to confirm that obesity differentially affects this association.
Highlights
Current recommendations from the Dietary Guidelines for Americans and the World HealthOrganization advise individuals to consume less than 10% of their total caloric intake from added sugars [1], while the American Heart Association recommends that children (2–18 years of age) should consume less than 100 calories of added sugar per day [2]
Added sugar intake was significantly related to race/ethnicity, maximum parental education, household income, total calorie consumption, and HbA1c
Given our interest in examining the potentially heterogeneous effects of diet on cardiovascular disease, we examined whether body mass index (BMI) z-score and physical activity modified the relationship between added sugar intake and arterial stiffness measures using our full sample
Summary
Organization advise individuals to consume less than 10% of their total caloric intake from added sugars [1], while the American Heart Association recommends that children (2–18 years of age) should consume less than 100 calories of added sugar per day [2]. Higher added sugar or SSB intake is associated with lower high-density (HDL) lipoprotein cholesterol [7,8], increased triglyceride levels [8], and higher blood pressure [9], independent of adiposity [10]. In youth with type 1 diabetes (T1D), SSB consumption was positively associated with total cholesterol and low-density lipoprotein (LDL) cholesterol [13]. Among U.S adolescents, added sugars were associated with HDL cholesterol and triglycerides, but not LDL cholesterol [5]
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