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Cited by 509Diet, Metabolism, and DiseaseNutritional Studies and DietDiabetes, Cardiovascular Risks, and Lipoproteins

Dietary sugars and cardiometabolic risk: systematic review and meta-analyses of randomized controlled trials of the effects on blood pressure and lipids

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Te Morenga, Lisa A, Howatson, Alex J, Jones, Rhiannon M, Mann, Jim·2014·The American Journal of Clinical Nutrition
DOI 10.3945/ajcn.113.081521
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Abstract

BACKGROUND: Dietary sugars have been suggested as a cause of obesity, several chronic diseases, and a range of cardiometabolic risk factors, but there is no convincing evidence of a causal relation between sugars and risk factors other than body weight. OBJECTIVE: We conducted a systematic review and meta-analysis of randomized controlled trials that examined effects of the modification of dietary free sugars on blood pressure and lipids. DESIGN: Systematic searches were conducted in OVID Medline, Embase, Scopus, Cumulative Index to Nursing and Allied Health Literature, and Web of Science databases (to August 2013) to identify studies that reported intakes of free sugars and at least one lipid or blood pressure outcome. The minimum trial duration was 2 wk. We pooled data by using inverse-variance methods with random-effects models. RESULTS: A total of 39 of 11,517 trials identified were included; 37 trials reported lipid outcomes, and 12 trials reported blood pressure outcomes. Higher compared with lower sugar intakes significantly raised triglyceride concentrations [mean difference (MD): 0.11 mmol/L; 95% CI: 0.07, 0.15 mmol/L; P < 0.0001], total cholesterol (MD: 0.16 mmol/L; 95% CI: 0.10, 0.24 mmol/L; P < 0.0001), low-density lipoprotein cholesterol (0.12 mmol/L; 95% CI: 0.05, 0.19 mmol/L; P = 0.0001), and high-density lipoprotein cholesterol (MD: 0.02 mmol/L; 95% CI: 0.00, 0.03 mmol/L; P = 0.03). Subgroup analyses showed the most marked relation between sugar intakes and lipids in studies in which efforts were made to ensure an energy balance and when no difference in weight change was reported. Potential explanatory factors, including a weight change, in most instances explained <15% of the heterogeneity between studies (I(2) = 36-75%). The effect of sugar intake on blood pressure was greatest in trials ≥8 wk in duration [MD: 6.9 mm Hg (95% CI: 3.4, 10.3 mm Hg; P < 0.001) for systolic blood pressure and 5.6 mm Hg (95% CI: 2.5, 8.8 mm Hg; P = 0.0005) for diastolic blood pressure]. CONCLUSIONS: Dietary sugars influence blood pressure and serum lipids. The relation is independent of effects of sugars on body weight. Protocols for this review were registered separately for effects of sugars on blood pressure and lipids in the PROSPERO International prospective register of systematic reviews as PROSPERO 2012: CRD42012002379 and 2012: CRD42012002437, respectively.

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Authors
Te Morenga, L. A., Howatson, A. J., Jones, R. M., & Mann, J.
Affiliations
Riddet Institute (NZ)
ORCID
Venue
The American Journal of Clinical Nutrition
Publisher
Elsevier BV
Published
2014-07
Volume
100
Issue
1
Pages
65-79
ISSN
0002-9165 (ISSN-L)
DOI
10.3945/ajcn.113.081521
OpenAlex
W2161807797
Cited by
509
References
8
Citations by year
2026: 18 · 2025: 24 · 2024: 23 · 2023: 38 · 2022: 57 · 2021: 57 · 2020: 62 · 2019: 61 · 2018: 44 · 2017: 40 · 2016: 46 · 2015: 29 · 2014: 9 · 2013: 1
FWCI
6.57
Type
journal article
Language
en
Open access
Licence
Locations
  • American Journal of Clinical Nutrition (publishedVersion, other-oa)
  • PubMed (publishedVersion)
Funders
  • University of Otago and the Riddet Institute
  • New Zealand National Centre of Research Excellence
  • University of Otago Graduate Research Committee
  • University of Otago Postgraduate Publishing Bursary
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
cardiometabolic risk, blood pressure, serum lipids, triglycerides, total cholesterol, LDL cholesterol, HDL cholesterol, energy balance, weight change, sugar consumption, obesity
MeSH terms
Blood Pressure, Cardiovascular Diseases, Humans, Cholesterol, HDL, Cholesterol, LDL, Risk Factors, Triglycerides, Randomized Controlled Trials as Topic, Databases, Factual, Dietary Sucrose

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