Sugar-Sweetened Beverage Consumption Is Associated With Change of Visceral Adipose Tissue Over 6 Years of Follow-Up

Abstract

Background: Sugar-sweetened beverage (SSB) intake has been linked to abnormal abdominal adipose tissue. We examined the prospective association of habitual SSB intake and change in visceral adipose tissue (VAT) and subcutaneous adipose tissue.

Methods and results: The quantity (volume, cm(3)) and quality (attenuation, Hounsfield Unit) of abdominal adipose tissue were measured using computed tomography in 1003 participants (mean age 45.3 years, 45.0% women) at examination 1 and 2 in the Framingham's Third Generation cohort. The 2 exams were ≈ 6 years apart. At baseline, SSB and diet soda intake were assessed using a valid food frequency questionnaire. Participants were categorized into 4 groups: none to <1 serving/mo (nonconsumers), 1 serving/mo to <1 serving/week, 1 serving/week to 1 serving/d, and ≥ 1 serving/d (daily consumers) of either SSB or diet soda. After adjustment for multiple confounders including change in body weight, higher SSB intake was associated with greater change in VAT volume (P trend<0.001). VAT volume increased by 658 cm(3) (95% confidence interval [CI], 602 to 713), 649 cm(3) (95% CI, 582 to 716), 707 cm(3) (95% CI, 657 to 757), and 852 cm(3) (95% CI, 760 to 943) from nonconsumers to daily consumers. Higher SSB intake was also associated with greater decline of VAT attenuation (P trend=0.007); however, the association became nonsignificant after additional adjustment for VAT volume change. In contrast, diet soda consumption was not associated with change in abdominal adipose tissue.

Conclusions: Regular SSB intake was associated with adverse change in both VAT quality and quantity, whereas we observed no such association for diet soda.

Keywords: obesity; subcutaneous adipose tissue; visceral adipose tissue.

Figure 1

Sex-specific analysis (552 men and 451 women) of association of sugar-sweetened intake (SSB) and change in visceral adipose tissue (VAT) volume (A) and Hounsfield Unit (B); diet soda intake and change in visceral adipose tissue (VAT) volume (C) and Hounsfield Unit (D). In analysis for linear trend, multiple linear regression model was used with adjustment for baseline VAT volume, age, smoking status (yes/no), physical activity score, energy intake, alcohol intake, saturated fat intake, diet soda intake or SSB intake, multivitamin use, whole grain, fruit, vegetable, coffee, nuts, and fish.