Sugar-sweetened beverage consumption and risk of premature coronary artery disease in a multi-ethnic Iranian case–control study

Abstract Background The association of sugar sweetened beverages (SSBs) and coronary artery disease (CAD) has not been well-established in Asians, where SSBs are the leading ultra-processed food product. Objective We aim to examine the association between SSBs and premature CAD (PCAD) in Iranian adults. Design Case-control. Participants A multi-centric study of Iranians including 2006 PCAD and 1131 healthy individuals as control group. Main outcome measures Dietary intakes were assessed using a validated food frequency questionnaire (FFQ). SSBs consist of artificial juice and sugar -sweetened drinks. The PCAD was determined based on the results of angiography and the occlusion percent of vessels. Statistical analysis The odds of PCAD across the quartiles of SSBs were assessed by binary logistic regression. Results The mean (SD) age of participants and SSB consumption was 51.5 years and 46.9 g/d, respectively. In the fully-adjusted model, compared with participants in the first quartile, those in the fourth quartile had higher risk of PCAD (OR = 1.50, 95% CI: 1.12, 2.00; P trend = 0.044). Consistently, SSB consumption was directly associated with the severity of PCAD. The higher SSB consumption, the greater risk for the severe PCAD (OR Q4 vs. Q1 = 1.34, 95% CI: 1.06, 1.68; P < 0.001). Conclusion This study demonstrated that higher consumption of SSB might be associated with higher risk of PCAD. However, more prospective cohort studies are necessary to confirm this association.