Sugar-sweetened beverage consumption and plasma lipoprotein cholesterol, apolipoprotein, and lipoprotein particle size concentrations in U.S. adults

Authors: HASLAM, DANIELLE - Brigham & Women'S Hospital; CHASMAN, DANIEL - Brigham & Women'S Hospital; PELOSO, GINA - Boston University; HERMAN, MAK - Duke University; DUPUIS, JOSEE - Boston University; LICHTENSTEIN, ALICE - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; SMITH, CAREN - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; RIDKER, PAUL - Brigham & Women'S Hospital; JACQUES, PAUL - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; MORA, SAMINA - Brigham & Women'S Hospital; MCKEOWN, NICOLA - Boston University

Submitted to: Journal of Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 7/21/2022
Publication Date: 8/2/2022
Citation: Haslam, D.E., Chasman, D.I., Peloso, G.M., Herman, M.A., Dupuis, J., Lichtenstein, A.H., Smith, C.E., Ridker, P.M., Jacques, P.F., Mora, S., McKeown, N. 2022. Sugar-sweetened beverage consumption and plasma lipoprotein cholesterol, apolipoprotein, and lipoprotein particle size concentrations in U.S. adults. Journal of Nutrition. https://doi.org/10.1093/jn/nxac166.
DOI: https://doi.org/10.1093/jn/nxac166

Interpretive Summary: Sugary drinks are the largest source of added sugars in the U.S. diet. Sugar-sweetened beverage (SSB) consumption is linked to increased cardiometabolic risk and, specifically, increased risk of dyslipidemia, which is traditionally defined as elevated triglyceride, elevated low-density lipoprotein (LDL) cholesterol, and/or low high-density lipoprotein cholesterol (HDL) concentrations. The objective of this study was to better understand if altered plasma lipoproteins is a way by which SSB intake increases cardiometabolic risk. Our results, examining participants from the Framingham Offspring Study and from the Women's Health Study, show that higher SSB intake is adversely associated with multiple traditional and emerging measures of dyslipidemia, specifically plasma lipoprotein cholesterol and apolipoprotein profiles, and the plasma distribution of the sizes of various lipoprotein particles. Lipoprotein metabolism may be one means why which SSB intake increases cardiometabolic risk.

Technical Abstract: Background Prospective cohort studies have found a relation between sugar-sweetened beverage consumption (SSB; sodas and fruit drinks) and dyslipidemia. There is limited evidence linking SSB consumption to emerging features of dyslipidemia, which can be characterized by variation in lipoprotein particle size, remnant-like particle (RLP), and apolipoprotein concentrations. Objective To examine the association between SSB consumption and plasma lipoprotein cholesterol, apolipoprotein, and lipoprotein particle size concentrations among US adults. Methods We examined participants from the Framingham Offspring Study (FOS) (1987-1995; n = 3047) and the Women's Health Study (1992; n = 26,218). Plasma LDL-C, apolipoprotein (apo) B, HDL-C, apoA1, triglyceride (TG), non-HDL-C, total: HDL-cholesterol ratio, and apoB: apoA1 concentrations were quantified in both cohorts, and apoE, apoC3, RLP-TG, and RLP-cholesterol concentrations in FOS only. Lipoprotein particle sizes were calculated from NMR signals for lipoprotein particle subclass concentrations (triglyceride-rich lipoprotein particles [TRL-P; very large, large, medium, small, and very small], LDL-particles [LDL-P; large, medium, and small], HDL-particles [HDL-P; large, medium, and small]). SSB consumption was estimated from food frequency questionnaire data. We examined the associations between SSB consumption and all lipoprotein and apoprotein measures in linear regression models, adjusting for confounding factors, such as lifestyle, diet, and traditional lipoprotein risk factors. Results SSB consumption was positively associated with LDL-C, apoB, TG, RLP-TG, RLP-C, non-HDL-C concentrations and total: HDL cholesterol and apoB: apoA1 ratio, and negatively associated with HDL-C and apoA1 concentrations (P-trend ranges from < 0.0001 to 0.003). After adjustment for traditional lipoprotein risk factors, SSB consumers had smaller LDL-P and HDL-P sizes, lower concentrations of large LDL-P and medium HDL-P, and higher concentrations of small LDL-P, small HDL-P, and large TRL-P (P-trend ranges from < 0.0001 to 0.0009). Conclusions Higher SSB consumption was associated with multiple emerging features of dyslipidemia that have been linked to higher cardiometabolic risk in US adults.