Consumption of Artificially Sweetened Beverages are Associated with Atrial Fibrillation

by | Apr 10, 2024 | 2024, Cardiovascular Health, Recent Articles, Sweeteners

Written by Chrystal Moulton, Science Writer. Consuming > 2 liters of artificially sweetened beverages per week was significantly associated with an increased risk of developing atrial fibrillation (P ≤0.002).

sugar sweetened drinksAtrial fibrillation is a serious medical condition expected to become a significant public health issue by 20601. Various lifestyle factors have been investigated in association with prevention and management of atrial fibrillation2,3. Also, consumption of beverages sweetened with sugar, artificial sugars, and pure fruit juices have shown some the correlation with the risk of developing cardiovascular disease4,5. However, the trials did not evaluate the risk of developing atrial fibrillation. In the current study6, researchers utilized data from the UK biobank to evaluate consumption of sugar sweetened beverages, artificially sweetened beverages, and pure fruit juice with the risk of developing atrial fibrillation. Researchers also calculated the risk in combination with pre-existing genetic indicators.

The current trial is a population-based cohort study evaluating data in the UK biobank. The UK biobank consists of more than 500,000 participants between the age of 37 and 73 years old7. From 2006 to 2010, evaluators in the UK biobank collected medical, lifestyle, physical, and biological information from consenting individuals throughout the United Kingdom. For this study, participants with missing dietary recall data, a history of atrial fibrillation, and missing genetic information were excluded. Also, any individuals with kin who also completed data collection for the UK biobank were also excluded in the genetic analysis. Overall, 201,856 participants were included in the main analysis evaluating sugar sweetened beverages, artificially sweetened beverages, and pure fruit juice in correlation with atrial fibrillation. For the genetic analysis 144,864 participants were evaluated. Researchers used dietary recall data from the UK biobank and separated participants into four groups based on beverage consumption: 0 liters per week, ≤ 1 liter per week, 1 to 2 liters per week, and > 2 liters per week of pure fruit juice, artificially sweetened beverage, and sugar sweetened beverages. A wide range of confounding factors were assessed, and development of atrial fibrillation was obtained through medical records and death records up to March 8, 2022. Genetic risk factors were assessed using polygenic risk scores [PRS] standard from the UK biobank, which is a combination of genome studies conducted by the genomics PLC within the UK biobank project8. Participants were categorized into three groups based on genetic risk for atrial fibrillation: high, intermediate, and low. Follow-up was calculated from the date of the last dietary questionnaire until the development of atrial fibrillation, censoring, or death, whichever came first.

Baseline characteristics revealed that younger males in lower socioeconomic status with higher BMI and higher prevalence of coronary heart disease consumed more sugar sweetened beverages. Meanwhile, younger females with a higher BMI and high prevalence of diabetes consumed higher amounts of artificially sweetened beverages. Researchers documented 9362 incidents of atrial fibrillation during 9.9 years median follow-up time. The assessment showed that consuming > 2 liters of artificially sweetened beverages per week was significantly associated with an increased risk of developing atrial fibrillation even after controlling for all confounding factors (P ≤0.002). When > 2 liters per week of sugar sweetened beverages was consumed, there was also a significant association with development of atrial fibrillation even after adjusting for age, sex, and consumption of artificially sweetened beverages and pure fruit juice (P = 0.008). However, when additional confounders were assessed this association became non-significant. Consumption ≤ 1 liter or 1 to 2 liters per week of pure fruit juice was significantly associated with a decreased risk of developing atrial fibrillation even after controlling for age, sex, consumption of sugar sweetened beverages and artificial sweetened beverages (P= 0.007). When additional confounding factors were assessed, the correlation between decreased risk of developing atrial fibrillation and pure fruit juice was attenuated. Furthermore, although there was no significant interaction among the groups in the genetic analysis, individuals with a high genetic risk consuming > 2 liters per week of artificially sweetened beverages had the highest hazard ratios (HR = 3.51) compared to individuals with low genetic risk consuming < 1 liter a pure fruit juice per week (HR = 0.77).

Data from this analysis showed that consuming more than 2 liters of artificially sweetened beverages per week increased the risk of atrial fibrillation. Also consuming less than 1 liter per week of pure juice was associated with a modest decrease in the risk of developing atrial fibrillation. Additional studies will be needed to assess how artificially sweetened beverages could increase the risk of atrial fibrillation.

Source: Sun, Ying, Bowei Yu, Yuefeng Yu, Bin Wang, Xiao Tan, Yingli Lu, Yu Wang, Kun Zhang, and Ningjian Wang. “Sweetened beverages, genetic susceptibility, and incident atrial fibrillation: a prospective cohort study.” Circulation: Arrhythmia and Electrophysiology 17, no. 3 (2024): e012145.

© 2024 American Heart Association, Inc.

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Posted April 10, 2024.

Chrystal Moulton BA, PMP, is a 2008 graduate of the University of Illinois at Chicago. She graduated with a bachelor’s in psychology with a focus on premedical studies and is a licensed project manager. She currently resides in Indianapolis, IN.

References:

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