TABLE 3.
Diet soda consumption |
|||||
<1 serving/mo | 1–4 servings/mo | 2–6 servings/wk | ≥1 servings/d | P-trend2 | |
All RA | |||||
NHS | |||||
No. of cases/person-years | 185/641,158 | 70/232,725 | 216/670,981 | 88/315,326 | |
Age-adjusted model | 1 (Reference) | 1.05 (0.80, 1.39) | 1.10 (0.90, 1.35) | 0.98 (0.75, 1.26) | 0.78 |
Multivariable-adjusted model3 | 1 (Reference) | 1.02 (0.77, 1.35) | 1.02 (0.83, 1.26) | 0.87 (0.66, 1.13) | 0.24 |
NHS II | |||||
No. of cases/person-years | 96/496,498 | 17/116,205 | 89/464,631 | 96/443,760 | |
Age-adjusted model | 1 (Reference) | 0.72 (0.43, 1.21) | 0.92 (0.69, 1.23) | 1.09 (0.82, 1.44) | 0.27 |
Multivariable-adjusted model3 | 1 (Reference) | 0.79 (0.46, 1.34) | 0.96 (0.70, 1.31) | 1.03 (0.75, 1.41) | 0.57 |
NHS and NHS II pooled4 | |||||
Age-adjusted model | 1 (Reference) | 0.97 (0.76, 1.23) | 1.04 (0.88, 1.23) | 1.02 (0.85, 1.24) | 0.52 |
Multivariable-adjusted model3 | 1 (Reference) | 0.96 (0.75, 1.23) | 1.00 (0.84, 1.19) | 0.93 (0.76, 1.14) | 0.71 |
Seropositive RA | |||||
NHS | |||||
No. of cases/person-years | 125/600,741 | 39/219,366 | 133/631,367 | 52/295,609 | |
Age-adjusted model | 1 (Reference) | 0.87 (0.61, 1.25) | 1.00 (0.78, 1.28) | 0.85 (0.61, 1.18) | 0.42 |
Multivariable adjusted model3 | 1 (Reference) | 0.84 (0.58, 1.21) | 0.93 (0.71, 1.20) | 0.75 (0.53, 1.05) | 0.14 |
NHS II | |||||
No. of cases/person-years | 62/486,459 | 10/114,690 | 63/457,377 | 59/434,053 | |
Age-adjusted model | 1 (Reference) | 0.64 (0.33, 1.25) | 0.98 (0.68, 1.39) | 1.04 (0.73, 1.49) | 0.54 |
Multivariable-adjusted model3 | 1 (Reference) | 0.70 (0.35, 1.38) | 1.03 (0.70, 1.51) | 0.99 (0.67, 1.46) | 0.87 |
NHS and NHS II pooled4 | |||||
Age-adjusted model | 1 (Reference) | 0.81 (0.59, 1.12) | 0.99 (0.81, 1.21) | 0.93 (0.73, 1.19) | 0.95 |
Multivariable-adjusted model3 | 1 (Reference) | 0.81 (0.58, 1.11) | 0.96 (0.77, 1.19) | 0.84 (0.65, 1.09) | 0.38 |
Seronegative RA | |||||
NHS | |||||
No. of cases/person-years | 60/639,122 | 31/232,061 | 83/668,876 | 36/314,328 | |
Age-adjusted model | 1 (Reference) | 1.42 (0.92, 2.21) | 1.34 (0.96, 1.89) | 1.26 (0.83, 1.91) | 0.51 |
Multivariable-adjusted model3 | 1 (Reference) | 1.39 (0.89, 2.17) | 1.23 (0.87, 1.75) | 1.11 (0.72, 1.71) | 0.99 |
NHS II | |||||
No. of cases/person-years | 34/495,617 | 7/116,014 | 26/463,798 | 37/442,836 | |
Age-adjusted model | 1 (Reference) | 0.88 (0.39, 2.00) | 0.80 (0.48, 1.34) | 1.17 (0.73, 1.86) | 0.30 |
Multivariable-adjusted model3 | 1 (Reference) | 0.97 (0.42, 2.25) | 0.84 (0.48, 1.46) | 1.12 (0.67, 1.88) | 0.45 |
NHS and NHS II pooled4 | |||||
Age-adjusted model | 1 (Reference) | 1.28 (0.87, 1.88) | 1.15 (0.87, 1.53) | 1.22 (0.89, 1.66) | 0.23 |
Multivariable-adjusted model3 | 1 (Reference) | 1.29 (0.87, 1.90) | 1.10 (0.82, 1.48) | 1.11 (0.80, 1.55) | 0.58 |
1HRs were calculated by using time-varying Cox proportional hazards models. Diet soda included low-calorie cola, low-calorie caffeine-free cola, and other low-calorie carbonated beverages. NHS, Nurses’ Health Study; RA, rheumatoid arthritis.
2P values for trend were derived from tests of linear trend across categories of soda consumption by treating the median value of each category as a continuous variable.
3Adjusted for age, census tract median family income (quartiles), cigarette smoking status (never; past; current, 1–14 cigarettes/d; or current, ≥15 cigarettes/d), alcohol consumption (<5.0, 5.0–15.0, or >15 g/d), age at menarche (<12, 12, or >12 y), parity and breastfeeding (nulliparous, parous/no breastfeeding, parous/1–12 mo breastfeeding, or parous/>12 mo breastfeeding), hormone use (premenopausal, postmenopausal with never use, current use, or past use), physical activity (0–2.9, 3–8.9, 9–17.9, 18–26.9, or ≥27 metabolic equivalent task-hours/wk), BMI (in kg/m2; <20, 20–22.9, 23–24.9, 25–29.9, or ≥30), multivitamin use, Alternate Healthy Eating Index (quintiles), diabetes history, and total energy (kcal, quintiles).
4The results from 2 cohorts were pooled by using an inverse-variance–weighted, fixed-effects meta-analysis.