Sugar-sweetened Soda Consumption and Risk of Developing Rheumatoid Arthritis in Women

Am J Clin Nutr. 2014 Sep;100(3):959-67. doi: 10.3945/ajcn.114.086918. Epub 2014 Jul 16.

Abstract

Background: Sugar-sweetened soda consumption is consistently associated with an increased risk of several chronic inflammatory diseases such as type 2 diabetes and cardiovascular diseases. Whether it plays a role in the development of rheumatoid arthritis (RA), a common autoimmune inflammatory disease, remains unclear.

Objective: The aim was to evaluate the association between sugar-sweetened soda consumption and risk of RA in US women.

Design: We prospectively followed 79,570 women from the Nurses' Health Study (NHS; 1980-2008) and 107,330 women from the NHS II (1991-2009). Information on sugar-sweetened soda consumption (including regular cola, caffeine-free cola, and other sugar-sweetened carbonated soda) was obtained from a validated food-frequency questionnaire at baseline and approximately every 4 y during follow-up. Incident RA cases were validated by medical record review. Time-varying Cox proportional hazards regression models were used to calculate HRs after adjustment for confounders. Results from both cohorts were pooled by an inverse-variance-weighted, fixed-effects model.

Results: During 3,381,268 person-years of follow-up, 857 incident cases of RA were documented in the 2 cohorts. In the multivariable pooled analyses, we found that women who consumed ≥1 serving of sugar-sweetened soda/d had a 63% (HR: 1.63; 95% CI: 1.15, 2.30; P-trend = 0.004) increased risk of developing seropositive RA compared with those who consumed no sugar-sweetened soda or who consumed <1 serving/mo. When we restricted analyses to those with later RA onset (after age 55 y) in the NHS, the association appeared to be stronger (HR: 2.64; 95% CI: 1.56, 4.46; P-trend < 0.0001). No significant association was found for sugar-sweetened soda and seronegative RA. Diet soda consumption was not significantly associated with risk of RA in the 2 cohorts.

Conclusion: Regular consumption of sugar-sweetened soda, but not diet soda, is associated with increased risk of seropositive RA in women, independent of other dietary and lifestyle factors.

Publication types

  • Comparative Study
  • Observational Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Arthritis, Rheumatoid / blood
  • Arthritis, Rheumatoid / epidemiology
  • Arthritis, Rheumatoid / etiology*
  • Arthritis, Rheumatoid / immunology
  • Autoantibodies / analysis
  • Autoantibodies / blood
  • Carbonated Beverages / adverse effects*
  • Cohort Studies
  • Dietary Sucrose / adverse effects*
  • Energy Intake
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Middle Aged
  • Nurses
  • Proportional Hazards Models
  • Rheumatoid Factor / analysis
  • Risk Factors
  • Self Report
  • United States / epidemiology

Substances

  • Autoantibodies
  • Dietary Sucrose
  • Rheumatoid Factor