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. 2016 Sep;104(3):809-15.
doi: 10.3945/ajcn.115.126052. Epub 2016 Jul 27.

Sugar-sweetened beverage consumption and genetic predisposition to obesity in 2 Swedish cohorts

Louise Brunkwall  1 , Yan Chen  2 , George Hindy  1 , Gull Rukh  1 , Ulrika Ericson  1 , Inês Barroso  3 , Ingegerd Johansson  4 , Paul W Franks  5 , Marju Orho-Melander  1 , Frida Renström  6
Affiliations

Sugar-sweetened beverage consumption and genetic predisposition to obesity in 2 Swedish cohorts

Louise Brunkwall et al. Am J Clin Nutr. 2016 Sep.

Abstract

Background: The consumption of sugar-sweetened beverages (SSBs), which has increased substantially during the last decades, has been associated with obesity and weight gain.

Objective: Common genetic susceptibility to obesity has been shown to modify the association between SSB intake and obesity risk in 3 prospective cohorts from the United States. We aimed to replicate these findings in 2 large Swedish cohorts.

Design: Data were available for 21,824 healthy participants from the Malmö Diet and Cancer study and 4902 healthy participants from the Gene-Lifestyle Interactions and Complex Traits Involved in Elevated Disease Risk Study. Self-reported SSB intake was categorized into 4 levels (seldom, low, medium, and high). Unweighted and weighted genetic risk scores (GRSs) were constructed based on 30 body mass index [(BMI) in kg/m(2)]-associated loci, and effect modification was assessed in linear regression equations by modeling the product and marginal effects of the GRS and SSB intake adjusted for age-, sex-, and cohort-specific covariates, with BMI as the outcome. In a secondary analysis, models were additionally adjusted for putative confounders (total energy intake, alcohol consumption, smoking status, and physical activity).

Results: In an inverse variance-weighted fixed-effects meta-analysis, each SSB intake category increment was associated with a 0.18 higher BMI (SE = 0.02; P = 1.7 × 10(-20); n = 26,726). In the fully adjusted model, a nominal significant interaction between SSB intake category and the unweighted GRS was observed (P-interaction = 0.03). Comparing the participants within the top and bottom quartiles of the GRS to each increment in SSB intake was associated with 0.24 (SE = 0.04; P = 2.9 × 10(-8); n = 6766) and 0.15 (SE = 0.04; P = 1.3 × 10(-4); n = 6835) higher BMIs, respectively.

Conclusions: The interaction observed in the Swedish cohorts is similar in magnitude to the previous analysis in US cohorts and indicates that the relation of SSB intake and BMI is stronger in people genetically predisposed to obesity.

Keywords: BMI; Sweden; gene-lifestyle interaction; genetic risk score; sugar-sweetened beverage.

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Figures

FIGURE 1
FIGURE 1
The difference in BMI (in kg/m2) associated with 1 increment in SSB intake (4 categories) in MDCS (n = 21,824), GLACIER (n = 4902), and a pooled analysis with the use of inverse variance-weighted fixed-effect meta-analysis stratified by quartiles (Q1–Q4) of the GRS. Data are β-coefficients and 95% CIs derived from linear regression models. Across the quartiles of the GRS, a 1-increment increase in SSB intake was associated with 0.19 (95% CI: 0.11, 0.28), 0.13 (95% CI: 0.05, 0.22), 0.19 (95% CI: 0.10, 0.29), and 0.22 (95% CI: 0.13, 0.31) increases in BMI in MDCS and with −0.10 (95% CI: −0.31, 0.11), −0.08 (95% CI: −0.30, 0.15), −0.001 (95% CI: −0.23, 0.23), and 0.41 (95% CI: 0.16, 0.66) changes in BMI in GLACIER. In the pooled analysis, 1 increment of SSB intake was associated with 0.15 (95% CI: 0.08, 0.24), 0.11 (95% CI: 0.03, 0.19), 0.17 (95% CI: 0.08, 0.25), and 0.24 (95% CI: 0.15, 0.32) changes in BMI (all P < 0.01). The analysis was adjusted for age, sex, alcohol consumption, smoking status, physical activity, total energy intake, and cohort-specific covariates. GLACIER, Gene-Lifestyle Interactions and Complex Traits Involved in Elevated Disease Risk; GRS, genetic risk score; MDCS, Malmö Diet and Cancer Study; SSB, sugar-sweetened beverage.
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