Dietary Sugar Consumption Research Articles

Determinants of oral health among Iranian soldiers: a structural equation modeling study

BackgroundMilitary personnel often face unique challenges in maintaining optimal oral health. This study investigated the oral health status, caries experience, and associated factors among a sample of Iranian soldiers, employing a structural equation modeling (SEM) approach to explore the complex interplay of socioeconomic and behavioral determinants.MethodsA cross-sectional study was conducted among 658 male soldiers aged 18–30 years from three military barracks in Fars province, Iran. Data were collected through a structured instrument and clinical oral examinations. The study employs the DMFT index, which measures caries experience based on decayed, missing, and filled teeth, along with the Simplified Oral Hygiene Index (OHI-S) to assess overall oral health status. Structural equation modeling was employed to analyze the complex relationships between socioeconomic factors, oral health behaviors, and oral health outcomes.ResultsThe mean DMFT score was 3.57 ± 5.91, and the mean OHIS score was 0.56 ± 1.42. SEM analysis revealed that socioeconomic status (SES) indirectly influenced DMFT and oral hygiene scores, mediated by drug use, oral hygiene practices, dietary sugar consumption, and dental visit frequency. Lower toothbrushing frequency was significantly associated with higher DMFT (Estimate = -0.064, p < 0.001) and OHIS scores (Estimate = -0.637, p < 0.001). Drug use (smoking, qalyan, alcohol) was linked to poorer oral health outcomes, while more frequent dental visits were associated with lower DMFT and OHIS scores.ConclusionThis study reveals the complex interplay between socioeconomic conditions, oral health behaviors, and oral health outcomes among Iranian soldiers. The findings highlight the need for targeted interventions to address modifiable risk factors and improve access to preventive dental care within military settings. Future longitudinal studies are warranted to elucidate further the causal pathways between these factors and oral health outcomes in military populations.

Regular Exercise Training Induces More Changes on Intestinal Glucose Uptake from Blood and Microbiota Composition in Leaner Compared to Heavier Individuals in Monozygotic Twins Discordant for BMI

Background/Objectives: Obesity impairs intestinal glucose uptake (GU) (intestinal uptake of circulating glucose from blood) and alters gut microbiome. Exercise improves intestinal insulin-stimulated GU and alters microbiome. Genetics influence the risk of obesity and gut microbiome. However, the role of genetics on the effects of exercise on intestinal GU and microbiome is unclear. Methods: Twelve monozygotic twin pairs discordant for BMI (age 40.4 ± 4.5 years, BMI heavier 36.7 ± 6.0, leaner 29.1 ± 5.7, 8 female pairs) performed a six-month-long training intervention. Small intestine and colonic insulin-stimulated GU was studied using [18F]FDG-PET and microbiota from fecal samples with 16s rRNA. Results: Ten pairs completed the intervention. At baseline, heavier twins had lower small intestine and colonic GU (p &lt; 0.05). Response to exercise differed between twins (p = 0.05), with leaner twins increasing colonic GU. Alpha and beta diversity did not differ at baseline. During the intervention, beta diversity changed significantly, most prominently at the mid-point (p &lt; 0.01). Beta diversity changes were only significant in the leaner twins when the twin groups were analyzed separately. Exercise was associated with changes at the phylum level, mainly at the mid-point (pFDR &lt; 0.05); at the genus level, several microbes increased, such as Lactobacillus and Sellimonas (pFDR &lt; 0.05). In type 1 analyses, many genera changes were associated with exercise, and fewer, such as Lactobacillus, were also associated with dietary sugar consumption (p &lt; 0.05). Conclusions: Obesity impairs insulin-stimulated intestinal GU independent of genetics. Though both twin groups exhibited some microbiota changes, most changes in insulin-stimulated colon GU and microbiota were significant in the leaner twins.

Association of sugar consumption with risk of depression and anxiety: a systematic review and meta-analysis.

Sugar consumption has increased dramatically around the world, and at the same time, the prevalence of mental illnesses such as depression and anxiety continues to increase. While previous research has explored the impact of various dietary factors on mental health, the specific impact of dietary sugar consumption on the risk of depression and anxiety disorders remains elusive. This study aimed to comprehensively assess this relationship through a systematic review and meta-analysis. PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Network (CNKI), and WangFang were systematically searched for studies of the association between total dietary sugar intake and risk of depression and/or anxiety. The articles that meet the criteria are screened and included in the systematic review, and the data are extracted after assessing their quality. Stata 18.0 software was used for the meta-analysis. Forty studies with 1,212,107 participants were included in the analysis. Results showed that sugar intake increased the risk of depression by 21% (OR = 1.21, 95% CI: 1.14, 1.27), while the overall association between sugar intake and anxiety risk was not statistically significant (OR = 1.11, 95% CI: 0.93, 1.28). Despite high heterogeneity (I 2 = 99.7%), the results were statistically significant (p < 0.000). Subgroup analyses showed that the association between sugar consumption and depression risk remains consistent across different study designs (cross-sectional, cohort, and case-control studies) and different sample sizes (<5,000, 5,000-10,000, >10,000). Women have a higher risk of depression than men (OR = 1.19, 95% CI: 1.04, 1.35). Among the different exposure measures, the Food Frequency Questionnaire (FFQ) showed the most significant effect (OR = 1.32, 95% CI: 1.08, 1.67, I 2 = 99.7%, p < 0.000). The measuring tool of subgroup analysis showed that there was a significant correlation between sugar intake and risk of depression, PHQ-9 (OR = 1.29, 95% CI: 1.17, 1.42, I2 = 86.5%, p < 0.000), and CES-D (OR = 1.28, 95% CI: 1.14, 1.44, I 2 = 71.3%, p < 0.000). High-quality cross-sectional and cohort studies showed a significant association between sugar intake and depression risk, with most results being robust. While the overall analysis of sugar intake and anxiety risk was not significant, some subgroups approached significance, particularly in studies with a sample size of <5,000 (OR = 1.14, 95% CI: 0.89, 1.46) and studies using the FFQ questionnaire (OR = 1.31, 95% CI: 0.90, 1.89). Total dietary sugar consumption was significantly associated with increased risk of depression in the general population, whereas the association with risk of anxiety was not significant. Further high-quality studies are needed to verify these associations and ensure their reliability. This study highlights the impact of dietary sugar intake on mental health, identifies potentially high-risk groups through subgroup analysis, and provides new insights into the prevention of depression and anxiety. CRD42024540548.

Glycaemic sugar metabolism and the gut microbiota: past, present and future.

Non-communicable diseases (NCDs), such as type 2 diabetes (T2D) and metabolic dysfunction-associated fatty liver disease, have reached epidemic proportions worldwide. The global increase in dietary sugar consumption, which is largely attributed to the production and widespread use of cheap alternatives such as high-fructose corn syrup, is a major driving factor of NCDs. Therefore, a comprehensive understanding of sugar metabolism and its impact on host health is imperative to rise to the challenge of reducing NCDs. Notably, fructose appears to exert more pronounced deleterious effects than glucose, as hepatic fructose metabolism induces de novo lipogenesis and insulin resistance through distinct mechanisms. Furthermore, recent studies have demonstrated an intricate relationship between sugar metabolism and the small intestinal microbiota (SIM). In contrast to the beneficial role of colonic microbiota in complex carbohydrate metabolism, sugar metabolism by the SIM appears to be less beneficial to the host as it can generate toxic metabolites. These fermentation products can serve as a substrate for fatty acid synthesis, imposing negative health effects on the host. Nevertheless, due to the challenging accessibility of the small intestine, our knowledge of the SIM and its involvement in sugar metabolism remains limited. This review presents an overview of the current knowledge in this field along with implications for future research, ultimately offering potential therapeutic avenues for addressing NCDs.

Influence of different types of dietary sugars on the intestinal mucosa and hepatic lipid metabolism in germ-free mice

The excessive consumption of dietary sugar induces changes in gut microbiota, which is associated with obesity and metabolic dysregulation. This study investigated the effects of monosaccharide and fructooligosaccharide (FOS) intake on metabolic function and intestinal environment in germ-free (GF) mice lacking gut microbiota. GF mice were provided with a chow diet and administered a water solution containing 15 % glucose, fructose, or FOS for 4 weeks. Compared with FOS, glucose, and fructose induced increased hepatic lipid accumulation, increased adipocyte size in white adipose tissue, and upregulated hepatic lipogenic gene expression. FOS exhibited notably higher activation of hepatic AMP-activated protein kinase compared with those consuming glucose or fructose. Moreover, the number of goblet cells in the intestinal mucosa increased significantly with FOS consumption. Collectively, these findings indicate that while monosaccharides caused metabolic disorders in GF mice, FOS alleviated these disorders and increased the number of goblet cells in the intestinal mucosa. These results provide evidence for the occurrence of these effects independently of the gut microbiota.

A Preschool based intervention to reduce Early Childhood Caries in a District of Sri Lanka: A Quasi-experimental Study.

Early Childhood Caries (ECC) is prevalent among preschool children. The aim was to assess the effectiveness of an intervention to modify family-level determinants of caries (i.e. maternal parenting style, oral health-related self-efficacy and oral health-related knowledge) via preschool teachers, to improve the child level determinants of ECC (dietary sugar consumption, oral hygiene pattern, dental attendance pattern). Quasi-experimental study. Preschools in Gampaha District, Sri Lanka. Preschoolers and their mothers/caregivers. Delivered via preschool teachers to 200 children and their caregivers. Maternal parenting style, oral health related self-efficacy and oral health related knowledge, parentally reported dietary sugar consumption, oral hygiene pattern, dental attendance pattern and ECC. Maternal oral health related knowledge, authoritative parenting, authoritarian parenting and oral health related self-efficacy, maternally reported sugar consumption, sweetened drink consumption, tooth brushing frequency, dental visiting during the past six months and receipt of treatment better in the intervention group than the control group post-intervention. The intervention shows potential in modifying family level determinants of ECC.

The relationship between dietary sugar consumption and anxiety disorders: A systematic review.

High-sugar intake is a risk factor for chronic diseases such as cardiovascular disease and type 2 diabetes, but less is known about its role in anxiety disorders. This systematic review aimed to systematically synthesise and assess the existing evidence regarding the association between dietary sugars intake and anxiety disorders. Following PRISMA guidelines, a systematic search of PubMed, MEDLINE, Embase, APA PsycArticles and APA PsycINFO was conducted up to 19th August 2022. Study quality was assessed by the Newcastle-Ottawa scale (NOS) and the Cochrane risk of bias tool. Eleven studies (10 cross-sectional and 1 randomised controlled trial [RCT]) were included. Seven cross-sectional studies had very good quality or good quality, and the quality of the RCT was at low risk of bias. These studies examined sugar-sweetened beverages (n = 7), sugar-sweetened foods (n = 4) and/or added sugar (n = 5). The findings suggest a possible positive relationship of added sugar consumption with anxiety disorders, with age as a potential moderator in such association. No conclusions can be drawn on the associations between sugar-sweetened beverages, sugar-sweetened foods consumption and anxiety disorders. Due to the included studies being mostly cross-sectional, the conclusions drawn from the existing evidence should be interpreted with caution. The longitudinal design is warranted to investigate any causal relationship and the potential mechanisms underlying these heterogeneous results. The potential difference in effect at different ages observed in this review should be further examined.

Associations of sugar intake, high-sugar dietary pattern, and the risk of dementia: a prospective cohort study of 210,832 participants

BackgroundLimited evidence demonstrated the potential relationship between dietary sugar intake and dementia. This association demands further clarification in a large-scale population.MethodsA total of 210,832 participants from the UK Biobank cohort were included in this prospective cohort study. Absolute and relative sugar intake and high-sugar dietary scores were utilized to reflect dietary sugar intake. Absolute sugar intake was identified by the Oxford WebQ in the UK Biobank. Relative sugar intake was calculated by dividing the absolute sugar intake by total diet energy. High-sugar dietary pattern was identified using the method of reduced rank regression. Cox proportional hazards regression analyses and restricted cubic splines were performed to examine the longitudinal associations between dietary sugar intake and all-cause dementia and its main subtype, Alzheimer’s disease. Explorative mediation analyses were conducted to explore underlying mechanisms.ResultsIncreased absolute sugar intake (g/day) was significantly associated with a higher risk of all-cause dementia (HR = 1.003, [95%CI: 1.002–1.004], p < 0.001) and Alzheimer’s disease (1.002, [1.001–1.004], 0.005). Relative sugar intake (%g/kJ/day) also demonstrated significant associations with all-cause dementia (1.317, [1.173–1.480], p < 0.001) and Alzheimer’s disease (1.249, [1.041–1.500], 0.017), while the high-sugar dietary score was only significantly associated with a higher risk of all-cause dementia (1.090, [1.045–1.136], p < 0.001). In addition, both sugar intake and high-sugar dietary score demonstrated significant non-linear relationships with all-cause dementia and Alzheimer’s disease (all p values for non-linearity < 0.05).ConclusionsOur study provided evidence that excessive sugar intake was associated with dementia. Controlling the excess consumption of dietary sugar may be of great public health implications for preventing dementia.

Photo-Enhanced Health Promotion Messages to Target Reduction in Dietary Sugar among Residents of Public Housing.

Interventions intended to reduce the consumption of dietary sugars among those population groups demonstrating disproportionately greater and more frequent consumption of sugar-sweetened beverages and foods (SSBF) would benefit from intervention strategies that are tailored to population-specific barriers and facilitators. The objective of this study was to develop and evaluate the acceptability of photo-enhanced and theory-based health promotion messages that target the reduction in SSBF among adult residents of public housing developments, a population known for their high rates of chronic disease. Using the message development tool as a framework, we developed a series of 15 SSBF reduction messages, using an iterative process with community member input. We then evaluated the acceptability of the messages and compared three delivery mechanisms: print, text, and social media. We recruited participants who were residents of urban public housing developments, and who spoke either English or Spanish. A majority of participants identified as being of Hispanic ethnicity (73%). The message acceptability scoring did not appear to differ according to the assigned delivery mechanism, despite some imbalances in participants' characteristics across delivery mechanisms. The messages that targeted motivation were least likely to be accepted. In conclusion, our findings suggest that engaging members of the community at all phases of the development process was a feasible method to develop SSBF reduction messages with a high perceived acceptability.

Impact of Dietary Sugars on β-Cell Function

Regular consumption of dietary sugars can cause significant damage to the β-cells. Almost a century after the discovery of insulin, it has been suggested that the frequent consumption of certain carbohydrates can damage pancreatic β-cells, causing disturbances in the regulation of insulin secretion. Most noncommunicable diseases, such as diabetes, obesity, and hypertension have a common origin, metabolic dysfunction, which is partly due to β-cell malfunction. In this article, we believed that sugars can lead to an imbalance in cellular metabolism, causing insulin exocytosis to dangerously increase or decrease blood insulin concentrations. In this study, we describe the major mechanism of insulin secretion and discuss the effects of sugar on pancreatic β-cells. Although many environmental factors strongly influence β-cells, occidental diet, including excess sugar, has been found to be the predominant factor that kills or disrupts the functioning of the unique cells that produce, store, and secrete insulin.

Dietary sugar consumption and health: umbrella review

ObjectiveTo evaluate the quality of evidence, potential biases, and validity of all available studies on dietary sugar consumption and health outcomes.DesignUmbrella review of existing meta-analyses.Data sourcesPubMed, Embase, Web of Science,...

The Bitter Side of Sugar Consumption: A Mitochondrial Perspective on Diabetes Development

Type 2 diabetes (T2D) has increased worldwide at an alarming rate. Metabolic syndrome (MetS) is a major risk factor for T2D development. One of the main reasons for the abrupt rise in MetS incidence, besides a sedentary lifestyle, is the westernized diet consumption, with high content of industrialized foods, rich in added dietary sugars (DS), mainly sucrose and fructose. It has been suggested that a higher intake of DS could impair metabolic function, inducing MetS, and predisposing to T2D. However, it remains poorly explored how excessive DS intake modulates mitochondrial function, a key player in metabolism. This review explores the relationship between increased consumption of DS and mitochondrial dysfunction associated with T2D development, pointing to a contribution of the diet-induced accumulation of advanced glycation end-products (AGEs), with brief insights on the impact of maternal high-sugar diet and AGEs consumption during gestation on offspring increased risk of developing T2D later in life, contributing to perpetuate T2D propagation.

Dietary fructose as a metabolic risk factor

Over the past decades, the role of the intestinal microbiota in metabolic diseases has come forward. In this regard, both composition and function of our intestinal microbiota is highly variable and influenced by multiple factors, of which diet is one of the major elements. Between 1970 and 1990, diet composition has changed and consumption of dietary sugars has increased, of which fructose intake rose by more than 10-fold. This increased intake of sugars and fructose is considered as one of the major risk factors in the developments of obesity and several metabolic disturbances. In this review, we describe the association of dietary fructose intake with insulin resistance, nonalcoholic fatty liver disease (NAFLD) and lipid metabolism. Moreover, we will focus on the potential causality of this altered gut microbiota using fecal transplantation studies in human metabolic disease and whether fecal microbial transplant can reverse this phenotype.

Sugar Consumption Is Negatively Associated with Semen Quality.

Recently, in parallel to decrease in semen quality, the consumption of sugar has risen sharply. This provided the rationale to study the association between whole dietary sugar consumption and semen quality. Our aim was to investigate the association between sugar consumption and semen quality. The final cross-sectional study population (n = 280 of initial n = 593, after applying inclusion and exclusion criteria) attending routine semen analysis at sperm bank laboratory was subject to semen quality analysis according to WHO criteria (volume, sperm concentration, total sperm count, percentage total motility, and percentage normal morphology) and filled food frequency questionnaire (FFQ) and lifestyle questionnaire. Associations between consumed sugars and semen quality were analyzed using multivariate regression adjusted to relevant cofounders for 2 food components containing sugar including soft drinks (SoftD) and total added sugar to food products (SugProd). We found negative association between higher consumption of dietary sugar in all 2 dietary sub-categories and sperm concentration. Significant sperm concentration decrements of 18% and 23% were associated with SoftD median consumption of 0.2 drinks/day (IQR; 0.1-0.5 drinks/day). Significant sperm concentration decrements of 15% and 17% were associated with median SugProd consumption of 25 teaspoons of added sugar/day (IQR; 19-31 teaspoons of added sugar/day). In conclusion, our study findings demonstrate that sugar consumption is negatively associated with sperm concentration.

Evaluating the effectiveness of ‘mentoring to be active’ for rural Appalachian middle school youth on physical activity and dietary sugar consumption during ‘out of school’ time

ABSTRACT Appalachian youth are highconsumers of added dietary sugar and are very sedentary. Mentoring to be Active trains teens to deliver atheoretically based program to promote home-based physical activity (PA) and reduce dietary sugar among rural Appalachian youth. For this pre-test/post-test pilot study, 52 seventh graders from two Appalachian schools participated as mentees. Twenty-two 10th grade students served as peer mentors. The study estimated sedentary activity,and physical activity by accelerometers and dietary sugars (snacks, beverages) during ‘out of school’ time. Descriptive statistics and effect sizes (ES) were calculated. When the pre-post standard deviations differed, Hedge’s g were reported. Sedentary activity decreased 36.7% (ES = .798). Moderate activity levels increased 16.5% (ES = .359). Vigorous activity increased 88% (ES = .359). Sugary- beverages declined over 4 ½ servings. Sugary snacks declined 2 ¼ servings. Peer mentoring is a strategy to promote social support for healthier behaviors among youth at risk for obesity and co-morbidities. Accelerometers rigorously assessed physical activity during ‘out of school’ time in rural youth.

Current perspectives on global sugar consumption: definitions, recommendations, population intakes, challenges and future direction.

Currently, there is considerable emphasis on the relationship between dietary sugar consumption and various health outcomes, with some countries and regions implementing national sugar reduction campaigns. This has resulted in significant efforts to quantify dietary sugar intakes, to agree on terms to describe dietary sugars and to establish associated recommendations. However, this information is infrequently collated on a global basis and in a regularised manner. The present review provides context regarding sugar definitions and recommendations. It provides a global review of the available data regarding dietary sugar intake, considering forms such as total, free and added sugars. A comprehensive breakdown of intakes is provided by age group, country and sugar form. This analysis shows that free sugar intakes as a percentage of total energy (%E) are the highest for children and adolescents (12-14%E) and the lowest for older adults (8%E). This trend across lifecycle stages has also been observed for added sugars. The available data also suggest that, while some reductions in sugar intake are observed in a few individual studies, overall intakes of free/added sugars remain above recommendations. However, any wider conclusions are hampered by a lack of detailed high-quality data on sugar intake, especially in developing countries. Furthermore, there is a need for harmonisation of terms describing sugars (ideally driven by public health objectives) and for collaborative efforts to ensure that the most up-to-date food composition data are used to underpin recommendations and any estimates of intake or modelling scenarios.

Dysbiosis of the Human Oral Microbiome During the Menstrual Cycle and Vulnerability to the External Exposures of Smoking and Dietary Sugar.

Physiological hormonal fluctuations exert endogenous pressures on the structure and function of the human microbiome. As such, the menstrual cycle may selectively disrupt the homeostasis of the resident oral microbiome, thus compromising oral health. Hence, the aim of the present study was to structurally and functionally profile the salivary microbiome of 103 women in reproductive age with regular menstrual cycle, while evaluating the modifying influences of hormonal contraceptives, sex hormones, diet, and smoking. Whole saliva was sampled during the menstrual, follicular, and luteal phases (n = 309) of the cycle, and the participants reported questionnaire-based data concerning their life habits and oral or systemic health. No significant differences in alpha-diversity or phase-specific clustering of the overall microbiome were observed. Nevertheless, the salivary abundances of genera Campylobacter, Haemophilus, Prevotella, and Oribacterium varied throughout the cycle, and a higher species-richness was observed during the luteal phase. While the overall community structure maintained relatively intact, its functional properties were drastically affected. In particular, 11 functional modules were differentially abundant throughout the menstrual cycle, including pentose phosphate metabolism, and biosynthesis of cobalamin and neurotransmitter gamma-aminobutyric acid. The menstrual cycle phase, but not oral contraceptive usage, was accountable for greater variations in the metabolic pathways of the salivary microbiome. Further co-risk factor analysis demonstrated that Prevotella and Veillonella were increased in current smokers, whereas high dietary sugar consumption modified the richness and diversity of the microbiome during the cycle. This is the first large study to systematically address dysbiotic variations of the oral microbiome during the course of menstrual cycle, and document the additive effect of smoking and sugar consumption as environmental risk factors. It reveals the structural resilience and functional adaptability of the oral microbiome to the endogenous hormonal pressures of the menstrual cycle, while revealing its vulnerability to the exogenous exposures of diet and smoking.

Breath 13CO2—evidence for a noninvasive biomarker to measure added refined sugar uptake

Increased consumption of added sucrose and high-fructose corn syrup in the human diet has been associated with increasing incidence of obesity and metabolic disease. There are currently no reliable, objective biomarkers for added sugar intake that could be used in individuals or population settings. 13C is a stable isotope of carbon, and measurement of blood 13C content has been proposed as a marker of added sugar consumption. This study aimed to determine if breath 13CO2 could represent an alternative, noninvasive biomarker to monitor added sugar intake. We undertook retrospective analyses of eight preclinical and human 13C-breath studies to define baseline breath 13CO2 characteristics. All samples were analyzed using isotope ratio mass spectrometry, and breath 13CO2 was expressed as the delta value, δ expressed as parts per thousand (‰). All data are expressed as mean ± SEM, with statistical significance considered at P < 0.05. Breath δ13CO2 was significantly elevated in a cumulative manner in rats and mice that consumed a diet containing at least 15% sucrose. Mice fed an American rodent chow diet containing 50% sucrose and 15% corn starch had a significantly higher breath δ13CO2 compared with rodents consuming an Australian rodent chow diet. Furthermore, breath δ13CO2 was significantly increased in a dose-dependent manner in humans that ingested a bolus dose of sucrose. These findings suggest application for baseline breath δ13CO2 as a noninvasive biomarker for added sugar consumption, with broad application for longitudinal assessment of population sugar intake and obesity management strategies.NEW & NOTEWORTHY We have found that breath 13CO2 is increased in rats and mice consuming diets high in sucrose. We also found that human breath 13CO2 is increased in humans consuming increasing amounts of sucrose. Our collective findings suggest that breath 13CO2 represents a potential marker of added dietary sugar consumption.

Dietary Intake of Free Sugars is Associated with Disease Activity and Dyslipidemia in Systemic Lupus Erythematosus Patients.

Diet has been closely associated with inflammatory autoimmune diseases, including systemic lupus erythematosus (SLE). Importantly, the consumption of dietary sugars has been positively linked to elevated levels of some inflammation markers, but the potential role of their consumption on the prognosis of autoimmune diseases has not yet been examined. The aim of this study was to evaluate the association between the dietary intake of free sugars and clinical parameters and cardiovascular (CVD) risk markers in patients with SLE. A cross-sectional study including a total of 193 patients with SLE (aged 48.25 ± 12.54 years) was conducted. The SLE Disease Activity Index (SLEDAI-2K) and the SDI Damage Index were used to asses disease activity and disease-related damage, respectively. Levels of C-reactive protein (CRP; mg/dL), homocysteine (Hcy; µmol/L), anti-double stranded DNA antibodies (anti-dsDNA) (IU/mL), complement C3 (mg/dL), and complement C4 (mg/dL), among other biochemical markers, were measured. The main factors we considered as risk factors for CVD were obesity, diabetes mellitus, hypertension, and blood lipids. The dietary-intrinsic sugar and added-sugar content participants consumed were obtained via a 24-h patient diary. Significant differences were observed in dietary sugar intake between patients with active and inactive SLE (in grams: 28.31 ± 24.43 vs. 38.71 ± 28.87; p = 0.035) and free sugar intake (as a percentage: 6.36 ± 4.82 vs. 8.60 ± 5.51; p = 0.020). Linear regression analysis revealed a significant association between free sugars intake (by gram or percentage) and the number of complications (β (95% CI) = 0.009 (0.001, 0.0018), p = 0.033)); (β (95% CI) = 0.046 (0.008, 0.084), p = 0.018)), and SLEDAI (β (95% CI) = 0.017 (0.001, 0.034), p = 0.043)); (β (95% CI) = 0.086 (0.011, 0.161), p = 0.024)) after adjusting for covariates. Free sugars (g and %) were also associated with the presence of dyslipidaemia (β (95% CI) = −0.003 (−0.005, 0.000), p = 0.024)) and (β (95% CI) = −0.015 (−0.028, −0.002), p = 0.021)). Our findings suggest that a higher consumption of free sugars might negatively impact the activity and complications of SLE. However, future longitudinal research on SLE patients, including dietary intervention trials, are necessary to corroborate these preliminary data.

Consequences of dietary sugar consumption: A historical perspective.

The US industrial revolution led to a significant increase in the amount of dietary sugar consumed annually. The impact has become a public health crisis over the past several decades. The consequences are seen in the dramatic rise in rates of obesity, type 2 diabetes mellitus, and cardiovascular disease.