TABLE 2.
Multivariable HRs (95% CIs) for all-cause and cause-specific mortality by quintile of intake of sugars in 147,381 women and 206,370 men in the NIH-AARP Diet and Health Study1
| Multivariable HRs (95% CIs) by quintile2 of intake | |||||
| Q2 | Q3 | Q4 | Q5 | P-trend | |
| Women | |||||
| All-cause (no. of cases =15,062)3 | |||||
| Total sugars | 0.99 (0.94, 1.04) | 1.05 (1.00, 1.11) | 1.05 (0.99, 1.11) | 1.13 (1.06, 1.20) | <0.0001 |
| Added sugars | 0.96 (0.91, 1.01) | 0.93 (0.89, 0.98) | 0.97 (0.92, 1.02) | 1.00 (0.95, 1.06) | 0.30 |
| Fructose | 0.96 (0.91, 1.01) | 1.00 (0.95, 1.05) | 1.03 (0.97, 1.09) | 1.10 (1.04, 1.17) | <0.0001 |
| Added fructose | 0.98 (0.93, 1.03) | 1.02 (0.97, 1.07) | 1.01 (0.96, 1.07) | 1.07 (1.01, 1.13) | 0.005 |
| Sucrose | 0.97 (0.92, 1.02) | 0.95 (0.90, 1.00) | 0.97 (0.92, 1.03) | 1.00 (0.94, 1.05) | 0.89 |
| Added sucrose | 0.99 (0.94, 1.05) | 0.99 (0.94, 1.05) | 0.98 (0.92, 1.03) | 1.00 (0.94, 1.05) | 0.86 |
| Cancer (no. of cases = 6318)4 | |||||
| Total sugars | 1.00 (0.92, 1.08) | 0.99 (0.91, 1.08) | 1.02 (0.93, 1.11) | 1.04 (0.94, 1.15) | 0.40 |
| Added sugars | 0.94 (0.86, 1.01) | 0.93 (0.86, 1.01) | 0.94 (0.87, 1.02) | 0.99 (0.91, 1.08) | 0.63 |
| Fructose | 0.95 (0.88, 1.03) | 0.99 (0.91, 1.07) | 0.98 (0.90, 1.07) | 1.03 (0.94, 1.13) | 0.40 |
| Added fructose | 1.00 (0.92, 1.08) | 0.97 (0.89, 1.05) | 0.96 (0.89, 1.05) | 0.99 (0.90, 1.08) | 0.71 |
| Sucrose | 0.98 (0.90, 1.06) | 0.95 (0.88, 1.03) | 0.98 (0.90, 1.07) | 1.00 (0.91, 1.08) | 0.90 |
| Added sucrose | 0.97 (0.90, 1.05) | 0.98 (0.90, 1.06) | 0.97 (0.89, 1.06) | 0.97 (0.89, 1.06) | 0.59 |
| CVD (no. of cases = 3406)5 | |||||
| Total sugars | 0.91 (0.82, 1.02) | 0.97 (0.86, 1.08) | 0.97 (0.86, 1.09) | 1.10 (0.96, 1.25) | 0.09 |
| Added sugars | 0.94 (0.84, 1.04) | 0.82 (0.73, 0.92) | 0.94 (0.84, 1.05) | 0.96 (0.86, 1.08) | 0.94 |
| Fructose | 0.90 (0.81, 1.00) | 0.89 (0.79, 0.99) | 0.97 (0.86, 1.08) | 1.07 (0.95, 1.21) | 0.08 |
| Added fructose | 0.90 (0.81, 1.00) | 0.93 (0.83, 1.03) | 0.97 (0.87, 1.08) | 1.05 (0.93, 1.18) | 0.12 |
| Sucrose | 0.96 (0.87, 1.07) | 0.86 (0.77, 0.96) | 0.88 (0.79, 0.98) | 0.95 (0.85, 1.06) | 0.36 |
| Added sucrose | 0.99 (0.89, 1.10) | 1.00 (0.89, 1.11) | 0.88 (0.79, 0.99) | 0.97 (0.86, 1.09) | 0.33 |
| Other causes (no. of cases = 4461)1 | |||||
| Total sugars | 0.95 (0.86, 1.04) | 1.05 (0.96, 1.15) | 0.98 (0.89, 1.08) | 1.04 (0.95, 1.15) | 0.29 |
| Added sugars | 0.96 (0.87, 1.06) | 0.97 (0.88, 1.07) | 0.99 (0.90, 1.09) | 0.97 (0.88, 1.08) | 0.86 |
| Fructose | 0.97 (0.89, 1.07) | 0.98 (0.89, 1.07) | 1.00 (0.91, 1.10) | 1.05 (0.96, 1.16) | 0.16 |
| Added fructose | 1.00 (0.91, 1.10) | 1.11 (1.01, 1.22) | 1.02 (0.92, 1.12) | 1.10 (1.00, 1.22) | 0.05 |
| Sucrose | 0.95 (0.86, 1.04) | 0.97 (0.88, 1.06) | 0.95 (0.87, 1.05) | 0.91 (0.83, 1.00) | 0.09 |
| Added sucrose | 1.01 (0.91, 1.11) | 0.97 (0.88, 1.06) | 1.01 (0.92, 1.11) | 0.96 (0.87, 1.06) | 0.47 |
| Men | |||||
| All-cause (no. of cases = 28,617)3 | |||||
| Total sugars | 0.93 (0.90, 0.97) | 0.94 (0.90, 0.98) | 0.97 (0.93, 1.01) | 1.03 (0.99, 1.08) | 0.03 |
| Added sugars | 0.94 (0.90, 0.97) | 0.94 (0.90, 0.97) | 0.92 (0.89, 0.96) | 0.95 (0.91, 0.99) | 0.19 |
| Fructose | 0.95 (0.92, 0.99) | 0.97 (0.94, 1.01) | 0.97 (0.93, 1.01) | 1.06 (1.01, 1.10) | 0.002 |
| Added fructose | 0.96 (0.92, 0.99) | 0.94 (0.90, 0.97) | 0.94 (0.91, 0.98) | 1.02 (0.97, 1.06) | 0.24 |
| Sucrose | 0.95 (0.92, 0.99) | 0.95 (0.91, 0.98) | 0.94 (0.91, 0.98) | 0.98 (0.94, 1.02) | 0.72 |
| Added sucrose | 0.96 (0.93, 1.00) | 0.93 (0.89, 0.97) | 0.93 (0.89, 0.96) | 0.97 (0.93, 1.01) | 0.24 |
| Cancer (no. of cases = 11,412)4 | |||||
| Total sugars | 0.96 (0.90, 1.01) | 0.94 (0.88, 1.00) | 0.96 (0.90, 1.03) | 0.97 (0.90, 1.04) | 0.51 |
| Added sugars | 0.94 (0.89, 1.00) | 0.96 (0.90, 1.02) | 0.98 (0.92, 1.04) | 0.97 (0.91, 1.03) | 0.87 |
| Fructose | 0.96 (0.90, 1.01) | 0.98 (0.93, 1.04) | 0.97 (0.91, 1.03) | 1.00 (0.93, 1.07) | 0.80 |
| Added fructose | 0.96 (0.90, 1.01) | 0.96 (0.90, 1.02) | 0.94 (0.89, 1.00) | 0.98 (0.92, 1.05) | 0.24 |
| Sucrose | 0.95 (0.90, 1.01) | 0.95 (0.89, 1.01) | 0.94 (0.89, 1.00) | 1.01 (0.95, 1.08) | 0.45 |
| Added sucrose | 0.94 (0.89, 1.00) | 0.93 (0.88, 0.99) | 0.91 (0.85, 0.96) | 1.01 (0.95, 1.08) | 0.53 |
| CVD (no. of cases = 7488)5 | |||||
| Total sugars | 0.97 (0.90, 1.04) | 0.96 (0.89, 1.04) | 0.95 (0.88–1.03) | 1.08 (0.99, 1.18) | 0.08 |
| Added sugars | 0.91 (0.85, 0.98) | 0.87 (0.82, 0.95) | 0.87 (0.81, 0.94) | 0.91 (0.84, 0.98) | 0.07 |
| Fructose | 0.97 (0.90, 1.04) | 0.98 (0.91, 1.06) | 0.94 (0.87, 1.01) | 1.08 (1.00, 1.18) | 0.08 |
| Added fructose | 0.97 (0.90, 1.04) | 0.91 (0.84, 0.98) | 0.95 (0.88, 1.02) | 1.01 (0.94, 1.10) | 0.62 |
| Sucrose | 0.96 (0.89, 1.03) | 0.93 (0.86, 1.00) | 0.91 (0.85, 0.99) | 0.93 (0.86, 1.00) | 0.06 |
| Added sucrose | 1.01 (0.94, 1.08) | 0.93 (0.86, 1.00) | 0.92 (0.85, 0.99) | 0.93 (0.86, 1.01) | 0.02 |
| Other causes (no. of cases = 8161)1 | |||||
| Total sugars | 0.85 (0.79, 0.91) | 0.88 (0.82, 0.94) | 0.92 (0.85, 0.98) | 0.94 (0.88, 1.01) | 0.71 |
| Added sugars | 0.92 (0.86, 0.99) | 0.93 (0.86, 0.99) | 0.88 (0.82, 0.94) | 0.91 (0.84, 0.98) | 0.04 |
| Fructose | 0.90 (0.84, 0.96) | 0.89 (0.83, 0.95) | 0.92 (0.85, 0.98) | 0.95 (0.88, 1.02) | 0.50 |
| Added fructose | 0.92 (0.86, 0.98) | 0.89 (0.83, 0.95) | 0.88 (0.82, 0.95) | 0.95 (0.88, 1.02) | 0.33 |
| Sucrose | 0.93 (0.87, 1.00) | 0.92 (0.86, 0.99) | 0.90 (0.84, 0.97) | 0.92 (0.86, 0.99) | 0.03 |
| Added sucrose | 0.92 (0.86, 0.99) | 0.89 (0.83, 0.96) | 0.91 (0.85, 0.98) | 0.89 (0.83, 0.95) | 0.006 |
Cox proportional hazards regression model adjusted for age, BMI (in kg/m2; <18.5, ≥18.5 to <25, ≥25 to <30, ≥30 to <35, ≥35, or missing), marital status (married/living as married or widowed/divorced/separated/never married/unknown), smoking (never smoker, quit ≥10 y ago, quit 5–9 y ago, quit 1–4 y ago, quit <1 y ago ≤20 cigarettes/d, quit <1 y ago >20 cigarettes/d, current ≤20 cigarettes/d, current 20–40 cigarettes/d, current >40 cigarettes/d, or missing), race (white, black, Hispanic/Asian/Pacific Islander/American Indian/Alaskan native, or unknown/missing), education (less than high school, high school graduate, some college, college graduate, or unknown/missing), physical activity (never/rarely, 1–3 times/mo, 1–2 times/wk, 3–4 times/wk, ≥5 times/wk, or unknown/missing), and intake of energy (continuous), vegetables (quintiles), and alcohol (quintiles). CVD, cardiovascular disease; Q, quintile.
Medians by quintile of intake for women: 38.5, 51.5, 61.3, 72.3, and 91.1 g/1000 kcal total sugars; 10.1, 15.1, 20.6, 28.6, and 45.4 g/1000 kcal added sugars; 14.8, 20.4, 25.0, 30.3, and 40.4 g/1000 kcal total fructose; 7.4, 11.4, 15.2, 20, and 30.0 g/1000 kcal added fructose; 13.6, 18.6, 22.8, 27.9, and 37.3 g/1000 kcal sucrose; and 7.9, 12.2, 16.1, 21.5, and 31.8 g/1000 kcal added sucrose. Medians by quintile of intake for men: 33.5, 45.7, 55.2, 65.9, and 84.7 g/1000 kcal total sugars; 9.2, 14.7, 21, 29.4, and 47.0 g/1000 kcal added sugars; 12.7, 18.1, 22.5, 27.8, and 37.8 g/1000 kcal total fructose; 7.3, 11.3, 15.1, 20.0, and 29.9 g/1000 kcal added fructose; 11.8, 16.8, 21.1, 26.2, and 35.4 g/1000 kcal sucrose; and 7.5, 11.8, 15.9, 21.3, and 31.0 g/1000 kcal added sucrose. First quintile is the reference group.
Additionally adjusted for family history of cancer (yes or no/unknown), intake of saturated fat (quintiles), intake of polyunsaturated fat (quintiles), intake of red meat (quintiles), history of hypertension (no, yes, or unknown/missing), history of hypercholesterolemia (no, yes, or unknown/missing), and use of aspirin (no, monthly, weekly, daily, or missing).
Additionally adjusted for family history of cancer and intakes of total fat (quintiles) and red meat (quintiles).
Additionally adjusted for intakes of saturated and polyunsaturated fats, history of hypertension, history of hypercholesterolemia, and use of aspirin.