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  • Original Article
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Dietary sugar intake was associated with increased body fatness but decreased cardiovascular mortality in Chinese elderly: an 11-year prospective study of Mr and Ms OS of Hong Kong

Abstract

Background/Objectives:

Epidemiological studies suggest that sugar intake contributes to weight gain and increased risk of cardiovascular diseases (CVDs). However, this association is largely undefined in the elderly population. Our aim was to investigate the effect of sugar consumption on the subsequent changes in body fatness and CVD mortality in Chinese elderly.

Methods:

A total of 2000 men and 2000 women aged 65 years were recruited from 2001 to 2003. Dietary sugar intake was estimated based on a validated 329-item food frequency questionnaire and a local sugar database. Adiposity was measured using dual-energy X-ray absorptiometry at baseline and follow-up after 4 years. Mortality was ascertained by local death registry until March 2014. Multivariable linear and Cox regression were conducted to evaluate the association of sugar consumption on the changes in body fatness and CVD mortality.

Results:

A total of 174 CVD deaths were documented within the total 37 999 person-years’ follow-up. Significant positive association between sugar intake and increase in body fatness at follow-up after 4 years was found in men but not in women. After adjustment for potential confounders, men who consumed 1% increase in added sugar had an increase in whole body fat by 0.043 kg (P=0.006), central fat by 0.029 kg (P=0.016) and peripheral fat by 0.026 kg (P=0.006). However, in both genders, after an average of 11.1-year follow-up, compared with the lowest quintile, the highest intakes of added sugar were associated with significantly lowered CVD mortality by 74.9% (hazard ratio (HR) (95% confidence interval (CI)): 0.251(0.070, 0.899)) in a dose–response manner (Ptrend=0.011). This association was attenuated to non-significance by further adjustment of the change in body fatness (Ptrend=0.055).

Conclusions:

Thus higher sugar intake of the Chinese elderly was associated with increased adiposity in men but decreased CVD mortality. The current World Health Organization recommendation for the elderly should be reviewed.

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Acknowledgements

The study was supported by the National Institutes of Health R01 grant AR049439-01A1 and the Research Grants Council Earmarked Grant CUHK4101/02 M. The funders had no role in the study design, data collection and analysis, interpretation of the data, as well as in writing the manuscript.We thank all participants for their participation and Dr Edith Lau for her contribution in setting up the cohort.

Author contributions

Z-mL conceptualized the study, analyzed the data, interpreted the results and drafted the manuscript. All the coauthors critically commented and revised the manuscript.

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Correspondence to Z-m Liu or S Y S Wong.

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Liu, Zm., Tse, L., Chan, D. et al. Dietary sugar intake was associated with increased body fatness but decreased cardiovascular mortality in Chinese elderly: an 11-year prospective study of Mr and Ms OS of Hong Kong. Int J Obes 42, 808–816 (2018). https://doi.org/10.1038/ijo.2017.292

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