Total sugar, added sugar, fructose, and sucrose intake and all-cause, cardiovascular, and cancer mortality: a systematic review and dose-response meta-analysis of prospective cohort studies
A partir d'une revue systématique de la littérature publiée jusqu'en mai 2022, cette étude analyse l'association entre la quantité consommée de sucres, sucres ajoutés, fructose ou saccharose et la mortalité toutes causes confondues, par maladie cardiovasculaire et par cancer
Objective: This study performed a systematic review and dose–response meta-analysis to assess the associations of total sugars, added sugars, fructose, and sucrose with all-cause, cardiovascular disease (CVD), and cancer mortality. Methods: We searched PubMed, EMBASE, and Web of Science for prospective cohort studies up to 10 May 2022. Pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated by random-effect models, and the linear/nonlinear dose–response associations were explored by restricted cubic splines. Results: Comparing the highest with the lowest category of total sugars, the summary RR was 1.09 (95% CI 1.02-1.15; I2 71.9%) for all-cause mortality, 1.10 (1.02-1.18; I2 12.7%) for CVD mortality, and 1.00 (0.94-1.05; I2 0.0%) for cancer mortality. For fructose, the summary RR was 1.09 (1.03-1.16; I2 58.4%) for all-cause mortality, 1.11 (1.03-1.20; I2 37.4%) for CVD mortality, and 1.00 (0.95-1.06; I2 0.0%) for cancer mortality. Restricted cubic splines showed nonlinear associations of total sugars and fructose with all-cause and CVD mortality (P nonlinearity<0.001). A significant increment in risk of all-cause and CVD mortality was observed greater than 10 - 20 %E intake for total sugars and fructose. No association was found for the added sugars and sucrose with all-cause, CVD, and cancer mortality. Conclusions: Increased intake of total sugars and fructose is associated with all-cause and CVD mortality but not associated with cancer mortality, which could have implications for guideline recommendations regarding the risk of mortality related to sugar intake.