TABLE 2.
Subgroup analyses of studies investigating associations between consumption of SSBs and food sources of fructose and risk of stroke incidence and CVD mortality
| Subgroup factor | Subgroup | n | HR (95% CI) | I2 (%) | Ph1 | Ph2 | P3 |
|---|---|---|---|---|---|---|---|
| SSBs and stroke incidence | |||||||
| All included | 10 | 1.14 (1.04, 1.24) | 27 | 0.190 | |||
| Sex | Male | 3 | 1.06 (0.93, 1.21) | 76 | 0.015 | 0.374 | 0.497/0.256 |
| Female | 4 | 1.19 (1.08, 1.31) | 0 | 0.976 | |||
| Both | 3 | 1.17 (1.02, 1.36) | 0 | 0.407 | |||
| Follow-up duration (y) | <10 | 1 | 1.00 (0.65, 1.54) | NC | NC | 0.521 | 0.616 |
| ≥10 | 9 | 1.15 (1.08, 1.24) | 33 | 0.153 | |||
| Study quality | NOS <7 | 2 | 0.92 (0.75, 1.13) | 79 | 0.030 | 0.024 | 0.054 |
| NOS ≥7 | 8 | 1.18 (1.10, 1.27) | 0 | 0.922 | |||
| Validated dietary assessment | Yes | 9 | 1.15 (1.08, 1.24) | 33 | 0.153 | 0.521 | 0.526 |
| No | 1 | 1.00 (0.65, 1.54) | NC | NC | |||
| Geographic location | Europe | 3 | 1.20 (1.08, 1.33) | 0 | 0.861 | 0.071 | 0.057/0.086 |
| America | 5 | 1.16 (1.05, 1.29) | 0 | 0.724 | |||
| Asia | 2 | 0.92 (0.75, 1.13) | 79 | 0.030 | |||
| Fruit and stroke incidence | |||||||
| All included | 11 | 0.86 (0.80, 0.92) | 20 | 0.260 | |||
| Sex | Male | 2 | 0.93 (0.80, 1.08) | 44 | 0.182 | 0.513 | 0.417/0.575 |
| Female | 2 | 0.86 (0.73, 1.01) | 48 | 0.165 | |||
| Both | 7 | 0.84 (0.79, 0.90) | 19 | 0.285 | |||
| Follow-up duration (y) | <10 | 4 | 0.81 (0.74, 0.90) | 39 | 0.178 | 0.179 | 0.248 |
| ≥10 | 7 | 0.88 (0.82, 0.95) | 0 | 0.453 | |||
| Study quality | NOS <7 | 1 | 1.01 (0.68, 1.50) | NC | NC | 0.414 | 0.471 |
| NOS ≥7 | 10 | 0.85 (0.79, 0.92) | 24 | 0.226 | |||
| Validated dietary assessment | Yes | 10 | 0.87 (0.82, 0.92) | 19 | 0.270 | 0.243 | 0.251 |
| No | 1 | 0.75 (0.59, 0.95) | NC | NC | |||
| Geographic location4 | Europe | 5 | 0.85 (0.78, 0.93) | 16 | 0.314 | 0.063 | 0.248/0.051 |
| America | 3 | 0.77 (0.69, 0.86) | 0 | 0.666 | |||
| Asia | 2 | 0.94 (0.83, 1.06) | 0 | 0.660 | |||
| Fruit and CVD mortality | |||||||
| All included | 13 | 0.78 (0.70, 0.88) | 76 | 0.000 | |||
| Sex | Male | 2 | 0.84 (0.46, 1.52) | 83 | 0.016 | 0.973 | 0.999/0.920 |
| Female | 3 | 0.79 (0.62, 1.00) | 27 | 0.257 | |||
| Both | 8 | 0.78 (0.68, 0.90) | 83 | 0.000 | |||
| Follow-up duration (y) | <10 | 8 | 0.76 (0.66, 0.86) | 57 | 0.024 | 0.288 | 0.290 |
| ≥10 | 5 | 0.83 (0.73, 0.94) | 63 | 0.028 | |||
| Validated dietary assessment | Yes | 12 | 0.78 (0.68, 0.88) | 77 | 0.000 | 0.353 | 0.858 |
| No | 1 | 0.85 (0.73, 0.98) | NC | NC | |||
| Geographic location4 | Europe | 8 | 0.77 (0.69, 0.86) | 65 | 0.006 | 0.817 | 0.773 |
| Asia | 4 | 0.74 (0.55, 1.00) | 68 | 0.024 | |||
CVD, cardiovascular disease; CI, confidence interval; HR, hazard ratio; NC, not calculable; NOS, Newcastle-Ottawa Assessment Scale; SSBs, sugar-sweetened beverages.
1
P-heterogeneity within each subgroup.
2
P-heterogeneity between the subgroups.
3
P for the meta-regression analysis. For sex and geographic location, 1 of the 3 categories was defined as the reference.
4
One study with individuals from America, Europe, Asia, and Africa was excluded (84).