Sugary beverages intake and risk of chronic kidney disease: the mediating role of metabolic syndrome

Xiao-Yu Dai; Xiang-Yu Chen; Li-Na Jia; Xiao-Tong Jing; Xiao-Yan Pan; Xing-Yu Zhang; Zhong Jing; Jin-Qiu Yuan; Qiang-Sheng He; Li-Ling Yang

doi:10.3389/fnut.2024.1401081

Sugary beverages intake and risk of chronic kidney disease: the mediating role of metabolic syndrome

Front Nutr. 2024 Nov 26:11:1401081. doi: 10.3389/fnut.2024.1401081. eCollection 2024.

Authors

Xiao-Yu Dai^#^{1

2}, Xiang-Yu Chen^#^{1

3}, Li-Na Jia^#⁴, Xiao-Tong Jing^#⁵, Xiao-Yan Pan¹, Xing-Yu Zhang¹, Zhong Jing⁶, Jin-Qiu Yuan^{7

8}, Qiang-Sheng He^{7

8}, Li-Ling Yang¹

Affiliations

¹ Department of Nephrology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China.
² Jiange People's Hospital, Jiange, Sichuan, China.
³ Department of Nephrology, Meishan Second People's Hospital, Meishan, Sichuan, China.
⁴ Central Sterile Supply Department, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China.
⁵ School of Nursing, Wuhan University, Wuhan, China.
⁶ Department of Nephrology, Mianyang 404 Hospital, Mianyang, China.
⁷ Clinical Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China.
⁸ Scientific Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China.

^# Contributed equally.

Abstract

Background: Although several studies linked the sugary beverages to chronic kidney disease (CKD), the role of different types of sugary beverages in the development of CKD remained inconsistent. This study aimed to examine the associations of sugar-sweetened beverages (SSBs), artificially-sweetened beverages (ASBs), and natural juices (NJs) with CKD risk, and assess the extent to which the associations were mediated through metabolic syndrome (MetS).

Methods: This is a prospective analysis of 191,956 participants from the UK Biobank. Participants with information on beverage consumption and no history of CKD at recruitment were included. Daily consumptions of SSBs, ASBs and NJs were measured via 24-h dietary recall. Cox models were fitted to calculate the hazard ratios (HRs) and confidence intervals (CIs) of sugary beverages intakes on CKD risk. The causal mediation analyses were conducted to investigate whether MetS explained the observed associations.

Results: We documented 4,983 CKD cases over a median of 10.63 years follow-up. Higher consumption of SSBs and ASBs (>1 units/d compared with none) was associated with an elevated risk of CKD (HR: 1.45; 95% CI: 1.30-1.61, P-trend < 0.001 for SSBs and 1.52, 95% CI: 1.36-1.70 for ASBs). In contrast, we observed a J-shaped association between NJs and CKD with the with lowest risk at 0-1 unit/day (0-1 unit/d vs. 0, HR 0.86; 95% CI 0.81-0.91). The proportions of the observed association of higher intakes of SSBs and ASB with CKD mediated by MetS were 12.5 and 18.0%, respectively.

Conclusions: Higher intakes of ASBs and SSBs were positively associated with the development of CKD, while moderate consumption of NJs was inversely associated with CKD risk. More intensified policy efforts are warranted to reduce intake of SSBs and ASBs for CKD prevention.

Keywords: artificially sweetened beverages; chronic kidney disease; mediation analyses; natural juices; sugar-sweetened beverages.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the Sichuan Province Youth Innovation Research Project Fund (Q22098) and Mianyang Health Committee (202314). The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.