Consumption of sugar-sweetened and artificially sweetened beverages and prevalence of hypertension in adults: a population- based study

Systemic Arterial Hypertension is a multifactorial clinical condition associated with severe outcomes such as stroke and death. One of the main modifiable risk factor for hypertension is an unhealthy diet, often characterized by the consumption of ultraprocessed foods such as sweetened beverages. We aimed to investigate the relationship between the consumption of sweetened beverages, both sugar-sweetened and artificially sweetened, and the prevalence of hypertension in adults. A cross-sectional, household, population-based study with 1,162 adults from two Brazilian cities were carried out. The consumption of food groups and sweetened beverages was obtained by food frequency questionnaire and other data were self-reported. Weight, height, and waist circumference were measured. The association between sweetened beverages consumption and hypertension was analyzed using Poisson regression models, expressed as Prevalence Ratio. The prevalence of hypertension was 16.7%, with no significant difference between genders. The prevalence of consumption of sweetened beverages was 70.3% in men and 54.6% in women, being significantly higher in men. Women who consumed sugar-sweetened and artificially sweetened beverages 6 to 7 days per week had 92% higher prevalence of hypertension compared to those who did not consume or consumed at a lower frequency. Furthermore, women who consumed artificially sweetened beverages at least 1 time per week had 3.36 times higher prevalence of hypertension. The habitual consumption of sweetened beverages may be an important risk factor for hypertension, especially the consumption of diet beverages, which are often marketed as healthier than sugar-sweetened beverages.

La Hipertensión Arterial Sistémica es una condición clínica multifactorial asociada a resultados graves como el ictus y la muerte. Uno de los principales factores de riesgo modificables de la hipertensión es una dieta poco saludable, a menudo caracterizada por el consumo de alimentos ultraprocesados como las bebidas endulzadas. Nuestro objetivo fue investigar la relación entre el consumo de bebidas endulzadas, tanto azucaradas como edulcoradas artificialmente, y la prevalencia de hipertensión en adultos. Se realizó un estudio transversal, domiciliario y poblacional con 1,162 adultos de dos ciudades brasileñas. El consumo de grupos de alimentos y bebidas endulzadas se obtuvo mediante cuestionario de frecuencia de alimentos y los demás datos fueron autoinformados. Se midieron el peso, la talla y el perímetro de la cintura. La asociación entre el consumo de bebidas endulzadas y la hipertensión se analizó mediante modelos de regresión de Poisson, expresados como Ratio de Prevalencia. La prevalencia de hipertensión fue del 16,7%, sin diferencias significativas entre géneros. La prevalencia de consumo de bebidas endulzadas fue del 70,3% en los hombres y del 54,6% en las mujeres, siendo significativamente mayor en los hombres. Las mujeres que consumían bebidas azucaradas y edulcoradas artificialmente entre 6 y 7 días a la semana tenían 92% mayor prevalencia de hipertensión que las que no consumían o consumían con una frecuencia menor. Además, las mujeres que consumían bebidas edulcoradas al menos 1 vez por semana tenían una prevalencia de hipertensión 3,36 veces mayor. Así pues, el consumo habitual de bebidas endulzadas puede ser un importante factor de riesgo de hipertensión, especialmente el consumo de bebidas dietéticas, que a menudo se comercializan como más saludables que las bebidas azucaradas.

Fatores de risco dos beneficiários do gerenciamento clínico por telemonitoramento da saúde suplementar: estudo transversal / Risk factors of the beneficiaries of clinical management through telemonitoring of supplementary health: a cross-sectional study / Factores de riesgo de los beneficiarios del seguimiento clínico por telemonitorización de la salud complementaria: estudio transversal

OBJETIVO: Identificar a prevalência dos fatores de risco modificáveis para doença crônica não transmissível de beneficiários hipertensos e diabéticos. MÉTODO: Estudo transversal, de 2019, com dados do prontuário eletrônico de 109 adultos, independentes para as atividades cotidianas, do gerenciamento clínico por telemonitoramento de operadora de plano de saúde, Paraná-PR. Realizou­se estatística descritiva, teste qui­quadrado e regressão logística binária bruta. RESULTADOS: Homens tiveram menor consumo inadequado de refrigerante (OR =0,37) e peso elevado como fator de risco (OR =3,57). Fatores de proteção dos adultos foram hipertensão arterial (OR =0,14) e boa prontidão para mudança comportamental (OR =0,21) e, dos idosos, hipertensão arterial concomitante ao diabetes mellitus (OR =0,16). Houve associação entre idade, hipertensão arterial (p =0,001; OR =0,14; IC =0,04-0,51) e boa prontidão para a mudança comportamental (p =0,023; OR =0,21; IC =0,06-0,76). CONCLUSÃO: Predominaram idosas com estilo de vida saudável, para as quais são recomendadas intervenções de prevenção secundária.

OBJECTIVE: To identify the prevalence of the modifiable risk factors for chronic non-communicable disease in hypertensive and diabetic beneficiaries. METHOD: A cross-sectional study, from 2019, with data from the electronic medical records of 109adults, independent for the daily activities, of clinical management through telemonitoring of a health plan operator, Paraná-PR. Descriptive statistics, chi-square test and unadjusted binary logistic regression were performed. RESULTS: Men had lower inadequate consumption ofsoft drinks (OR=0.37) and overweight as a risk factor (OR=3.57). Protective factors for adults were arterial hypertension (OR=0.14) and good readiness for behavioral change (OR=0.21) and, for older adults, arterial hypertension concomitant with diabetes mellitus(OR=0.16). There was an association between age, arterial hypertension (p=0.001; OR=0.14; CI=0.04-0.51) and good readiness for behavioral change(p=0.023; OR=0.21; CI=0.06-0.76). CONCLUSION: Aged women with a healthy lifestyle predominated, for whom secondary prevention interventions are recommended.

OBJETIVO: Identificar la prevalencia de factores de riesgo modificables de enfermedades crónicas no transmisibles en beneficiarios hipertensos y diabéticos. MÉTODO: Estudio transversal, de 2019, con datos de historias clínicas electrónicas de 109 adultos, con independencia para las actividades diarias, de seguimiento clínico por telemonitorización de un operador de plan de salud, Paraná-PR. Se realizó estadística descriptiva, prueba de chi-cuadrado y regresión logística binaria bruta. RESULTADOS: Los hombres presentaron menor consumo inadecuado de gaseosas (OR =0,37) y alto peso como factor de riesgo (OR =3,57). Los factores de protección para los adultos fueron hipertensión arterial (OR =0,14) y buena disposición para el cambio de comportamiento (OR =0,21), y para los adultos mayores, hipertensión arterial concomitante con diabetes mellitus (OR =0,16). Hubo una asociación entre edad, hipertensión (p =0,001; OR =0,14; IC =0,04-0,51) y buena disposición para el cambio de comportamiento (p =0,023; OR =0,21; IC =0,06-0,76). CONCLUSIÓN: Predominaron los adultos mayores del sexo femenino con estilo de vida saludable, para quienes se recomiendan intervenciones de prevención secundaria.

[Consumption of soft, sports, and energy drinks in adolescents. The BEENIS study]. / Consumo de bebidas refrescantes, deportivas y energéticas en adolescentes. Estudio BEENIS.

INTRODUCTION: The wide range of non-alcoholic drinks are currently grouped as soft (carbonated), sports, and energy drinks, and all of them have a high sugar content, along with their known risk of obesity. Their consumption is increasing and in inadvisable circumstances, as well as an elevated health risk. The real consumption of sports and energy drinks is not well known. OBJECTIVE: To determine the habits and consumption of soft, sports, and energy drinks in adolescents. MATERIAL AND METHODS: A descriptive, cross-sectional study was performed in which questionnaires were obtained from 4,769 schoolchildren from 13 to 18years-old from de Sabadell, Barcelona, Spain. RESULTS: The prevalence of consuming soft drinks was observed in 92.9% of the adolescents, and was predominantly done during leisure time, during meals, or any time during the day. In sports it was 61.7%, mainly on practising the sport and in leisure time. In energy drinks, it was 49.2%, mainly in leisure time (they were mixed with alcohol in 49%) and on practising sport. The simultaneous consumption of the three types was 38%, and soft drinks were the most common. DISCUSSION: A description is presented on the consumption of sports drinks, normally included as soft drinks, as well as the simultaneous consumption of the three types of drinks, and the time in which they are consumed. We have a diagnostic tool of consumption of these drinks by adolescents in our setting that will enable us to design and evaluate educational interventions in order to make the adolescent population and their families aware.

Consumption of soft, sports, and energy drinks in adolescents. The BEENIS study.

INTRODUCTION: The wide range of non-alcoholic drinks are currently grouped as soft (carbonated), sports, and energy drinks, and all of them have a high sugar content, along with their known risk of obesity. Their consumption is increasing and in inadvisable circumstances also an elevated health risk. The real consumption of sports and energy drinks is not well known. OBJECTIVE: To determine the habits and consumption of soft, sports, and energy drinks in adolescents. MATERIAL AND METHODS: A descriptive, cross-sectional study was performed in which questionnaires were obtained from 4769 schoolchildren from 13-18 years-old from Sabadell, Barcelona, Spain. RESULTS: The prevalence of consuming soft drinks was observed in 92.9% of the adolescents, and was predominantly done during leisure time, during meals, or any time during the day. In sports it was 61.7%, mainly on practising the sport and in leisure time. In energy drinks, it was 49.2%, mainly in leisure time (they were mixed with alcohol in 49%) and on practising sport. The simultaneous consumption of the three types was 38%, and soft drinks were the most common. DISCUSSION: A description is presented on the consumption of sports drinks, normally included as soft drinks, as well as the simultaneous consumption of the three types of drinks, and the time in which they are consumed. We have a diagnostic tool of consumption of these drinks by adolescents in our setting that will enable us to design and evaluate educational interventions in order to make the adolescent population and their families aware.

Potencial erosivo de jugos naturales, jugos industrializados y gaseosas: Revisión de Literatura / Erosive potential of natural juices, industrialized and carbonated beverages: Literature review

El estudio de las lesiones dentales de origen no carioso ha ganado un gran terreno en el último siglo, siendo cada vez más frecuente encontrar lesiones como erosión, abfracción, atrición, y abrasión. El consumo cotidiano de jugos naturales, jugos industrializados o de gaseosas postula como un factor preponderante en la etiología de la erosión dental. Existe literatura muy amplia que aborda supotencial erosivo, características de estas bebidas, la frecuencia de ingesta, edad de la persona, entre otros. El objetivo de esta revisión de literatura es presentar evi- dencia científica sobre el potencial erosivo en la dentición humana de los jugos naturales, jugos industrializados y gaseosas.

The study of dental lesions of non-carious origin has gained a lot of ground in the last century, being increasingly frequent to find injuries such as erosion, abfraction, attrition, and abrasion. The daily consumption of natural juices, industrialized juices orcarbonated juices postulates as a preponderant factor in the etiology of dental erosion. There is a very broad literature that addresses its erosive potential, characteristics of these drinks, the frequency of intake, age of the person, among others. The objective of this literature review is to present scien- tific evidence on the erosive potential in human dentition of natural juices, industrialized and carbonated juices.

Evaluación in vitro de la rugosidad superficial y la alteración de color de dos tipos de ionómeros de vidrio, luego de ser sometidos a diferentes bebidas / Avaliação in vitro da rugosidade superficial e alteração de cor de dois tipos de ionômeros de vidro, depois de ter sido submetido a bebidas diferentes / in vitro evaluation of surface roughness and color alteration of two types of glass ionomers, after being subjected to different beverages

El objetivo de este estudio in vitro fue analizar la rugosidad superficial y la alteración de color de dos tipos de ionómeros vítreos luego de ser sometidos a diferentes soluciones. En una matriz de teflón (8x2mm), fueron confeccionados 60 cuerpos de prueba con 2 tipos de ionómeros fotopolimerizables: 30 para el Fuji II LC (M1) y otros 30 para el Ketac N100 (M2). El aparato utilizado fue el Elipar Freelight 2 3M Espe. La fotopolimerización se realizó por 20 segundos cada cuerpo de prueba. Luego de la confección, los sesenta cuerpos de prueba fueron mantenidos en gasa humedecida por 24 hs en estufa a 37ºC y luego se clasificaron y luego se dividieron en tres grupos de 10 cada uno para ser sometidos a 3 tipos diferentes de soluciones: agua destilada (S1), bebida carbonatada (S2) y jugo cítrico (S3) por 90 segundos diariamente durante 14 días. Las lecturas de la alteración de color, obtenidas a través de un colorímetro, y las de rugosidad superficial, realizadas por medio del rugosímetro, fueron realizadas a las 48 hs. (T0) y luego a los 14 días (T1). Los resultados obtenidos fueron sometidos al test ANOVA y Tukey (p≤0.05). Los resultados mostraron que; a) La bebida carbonatada (S2) tuvo mayor media de alteración de color (ΔE*) en relación a las otras soluciones, b) que Ketac N100 (M2) tuvo mayor media con respecto a la rugosidad superficial en la interacción material por solución. Por tanto, se concluyó que trascurrido determinado período de tiempo las propiedades estéticas y físico-mecánicas de los materiales estudiados se ven afectados.

O objetivo deste estudo in vitro foi analisar a rugosidade superficial e a alteraçã o de cor de dois tipos de ionômeros de vidrio após serem submetidos a diferentes bebidas. Em uma matriz de te ón (8x2mm), foram confeccionados 60 corpos de prova com 2 tipos de ionômeros fotopolimerizáveis: 30 para o Fuji II LC (M1) e outros 30 para o Ketac N100 (M2). O aparelho utilizado foi o Elipar Freelight 2 3M Espe. A fotopolimerização foi realizada por 20 segundos em cada corpo de prova. Após a confecçã o, os 60 corpos de prova foram mantidos em gaze umedecida por 24 hrs em estufa a 37o C e divididos em 3 grupos de 10 cada um, para ser submetidos a 3 tipos diferentes de soluçõ es: água destilada (S1), bebida carbonatada (S2) e suco cítrico (S3) por 90 segundos diariamente durante 14 dias. As leituras de alteraçã o de cor, obtidas através de um colorímetro, e das de rugosidades superficial, realizadas por meio do rugosímetro, foram realizadas após 48 hs. (T0) e após 14 dias (T1). Os resultados obtidos foram submetidos à test ANOVA e Tukey (p≤0.05). Os resultados mostraram que; a) a bebida carbonatada (S2) teve maior media de alteraçã o de cor (ΔE*) em relaçã o às outras soluçõ es, b) que Ketac N100 (M2) teve maior media com respeito a rugosidade superficial na interaçã o material pela soluçã o. Podemos concluir que a partir de determinado período de tempo as propriedades estéticas e físico-mecânicas dos materiais estudados são afetadas.

The aim of this in vitro study was to examine the surface roughness and discoloration of two types of glass ionomer had been subjected to different solutions. In a matrix of Teflon (8x2mm), 60 test bodies were prepared with 2 types of resin modified glass ionomers: 30 for Fuji II LC® (M1) and the other 30 for Ketac N100® (M2). The apparatus was Freelight two 3M ESPE Elipar. Photopolymerization was carried out for 20 second each test body. After the preparation, the seventy-two specimens were kept in gauze soaked for 24 hours in an oven at 37°C and then were sorted and divided into three groups of 12 each to be subjected, for 90 seconds each day at 3 different types of solutions: distilled water (S1), carbonated beverage (S2) and citrus juice (S3) for 14 days. Readings from discoloration, obtained through a colorimeter, and the surface roughness made using the profilometer were performed after 48 hours (T0) and after day 14 (T1). The results were submitted to ANOVA and Tukey test (p ≤ 0.05). The results showed that: a) The carbonated beverage (S2) had higher mean discoloration (ΔE *) compared to the other solutions, b) Ketac N100®(M2) had higher mean with respect to the interaction surface roughness material solution. Therefore, it was concluded that certain period of time elapsed aesthetic properties and physico-mechanical properties of the material studied are affected.

Efeito de substâncias ácidas na rugosidade de superfície e dureza knoop de materiais restauradores: estudo in situ / In situ evaluation of surface roughness and microhardness of restorative materials submited to erosive challenges

O objetivo deste trabalho in situ foi avaliar o efeito de ácidos, presentes em refrigerantes e no suco gástrico, na rugosidade de superfície e microdureza de materiais restauradores. Cento e sessenta e oito corpos-de-prova foram divididos aletoriamente em 3 grupos de estudo com 8 voluntários. Cada voluntário utilizou o dispositivo intrabucal removível contendo 7 amostras (Ketac Nano, Ketac Nano + Biscover LV, Esthet-X, Esthet-X + Biscover LV, Supreme XT, Supreme XT + Biscover LV e esmalte bovino). O grupo I foi tratado com ácido clorídrico, o grupo II foi tratado com refrigerante de limão e o grupo III foi o controle, não recebendo nenhum tratamento ácido. As variáveis de respostas foram a medida de rugosidade superficial média (Ra) e a microdureza Knoop. A ANOVA e teste de Fisher PLSD (α = 0,05) demonstraram que a resina composta Supreme XT apresentou os maiores valores de microdureza antes e após os processos de envelhecimento com diferença significante para todos os outros materiais (p<0,0001). Os menores valores foram encontrados para os materiais selados com Biscover LV em todos os períodos analisados (p<0,0001). O ionômero de vidro Ketac Nano apresentou os maiores valores de rugosidade de superfície após a exposição nas soluções ácidas. A aplicação do selante de superfície não alterou os valores de rugosidade para as resinas compostas estudadas à exceção do Esthet-X após o desafio em ácido clorídrico (p<0.0001). As soluções ácidas foram capazes de alterar a microdureza e rugosidade de superfície dos materiais restauradores, exceto dos materiais selados

The aim of this study was to evaluate the effect of different acidics solutions on the microhardness and surface roughness of restorative materials. 168 specimens were randomly divided into 3 groups with 8 volunteers. The volunteers wore palatal device with 7 specimens (Ketac Nano, Ketac Nano + Biscover LV, Esthet-X, Esthet-X + Biscover LV, Supreme XT, Supreme XT + Biscover LV and bovine enamel). The group I was immersed in HCl; the group II was immersed in soft drink and the group III was subjected to saliva only. The microhardness and surface roughness data were analyzed by ANOVA and Fisher‟s test (α = 0.05). The Supreme XT showed the highest values of microhardness before and after aging with a significant difference for the other materials (p<0.0001). The lowest values were found for the materials sealed with Biscover LV in all periods analyzed (p<0.0001). The Ketac Nano glass-ionomer cement showed the highest values of surface roughness after exposure in acidic solutions. The application of the sealant did not reduce the roughness values for the composites studied except for Esthet-X after the challenge in hydrochloric acid. The acidic solutions promoted changes in microhardness and surface roughness of restorative materials, except for the sealed materials