(P31-077-23) Relation of Food Sources of Fructose Containing Sugars With Incident Obesity Outcomes: A Systematic Review and Meta-Analysis of Prospective Cohort Studies

Objectives: Sugars have been implicated in the epidemic of obesity. It is unclear whether food sources of fructose-containing sugars other than sugar-sweetened beverages (SSBs) are associated with increased risk of obesity. To assess the evidence of the relation of food sources of fructose-containing sugars with incident overweight or obesity, we undertook a systematic review and meta-analysis of prospective cohort studies.

Methods: We searched MEDLINE, EMBASE and Cochrane Library through April 2023. We included prospective cohort studies of ≥ 1 year. Two reviewers extracted data and assessed the risk of bias. The primary outcome was incident overweight/obesity. Data were pooled using generic-inverse variance method (random effects) and expressed as relative risks (RR) for incident outcomes and ß-coefficients for WC with 95% confidence intervals (CI). GRADE assessed the certainty of evidence.

Results: We included 23 prospective cohorts involving 375,243 adults. Five food sources of fructose-containing sugars were identified: SSBs, 100% fruit juice, fruit, yogurt and sweets. SSBs were associated with increased incident OW/OB (RR, 1.22 [95% CI, 1.03 to 1.45]) and incident abdominal obesity (1.15 [1.05 to 1.25]) but were not significantly associated with change in WC (ß, 0.48 cm [-0.08 to 1.05]). There was no association between fruit juice and incident abdominal obesity or WC, and no data was available on incident OW/OB. Fruit was associated with decreased incident OW/OB (0.87 [0.80 to 0.95]), decreased incident abdominal obesity (0.68 [0.58 to 0.80]) and decreased WC (-0.23 cm [-0.33 to -0.13]). Yogurt was associated with decreased incident abdominal obesity (0.76 [0.61 to 0.95]), but there was no association with incident OW/OB and no data was available on WC. There was no association between sweets and incident OW/OB or change in WC, and no data was available on incident abdominal obesity. The certainty of the evidence was graded as “very low” to “moderate”.

Conclusions: Current evidence indicates that the relation between fructose-containing sugars and obesity outcomes differs by food sources. More research of more food sources of sugars is needed to improve our certainty in the evidence. (ClinicalTrials.gov, NCT02558920)

Funding Sources: American Society for Nutrition, Diabetes Canada, Banting and Best Diabetes Centre, Canadian Institutes of Health Research