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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EThe consumption of sugar-sweetened beverages (SSBs), such as sodas, fruit drinks, sports drinks, and energy drinks, has increased considerably over the past decade, in parallel with the rising prevalence of obesity. In this session, presenters discussed the adverse cardiometabolic effects of SSB consumption and the role of healthy drinking in cardiovascular risk reduction.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiometabolic Disorder\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EObesity\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EThe consumption of sugar-sweetened beverages (SSBs), such as sodas, fruit drinks, sports drinks, and energy drinks, has increased considerably over the past decade, in parallel with the rising prevalence of obesity. In this session, presenters discussed the adverse cardiometabolic effects of SSB consumption and the role of healthy drinking in cardiovascular (CV) risk reduction.\u003C\/p\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n         \u003Ch2 class=\u0022\u0022\u003ESSBs and Cardiometabolic Risk\u003C\/h2\u003E\n         \u003Cp id=\u0022p-3\u0022\u003EWorldwide, SSBs are a major source of excess calories and glycemic load in the diet. Frank B. Hu, MD, PhD, Harvard School of Public Health, Boston, Massachusetts, USA, described the adverse effects of excess SSB consumption on cardiovascular health.\u003C\/p\u003E\n         \u003Cp id=\u0022p-4\u0022\u003EIn the Nurses\u0027 Health Study II, women who consumed 1 or more sugar-sweetened soft drinks per day were significantly more likely to develop type 2 diabetes (T2DM) than those who consumed less than 1 beverage per month, even after controlling for body mass index (BMI; p\u0026lt;0.001; \u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E) [Schulze. \u003Cem\u003EJAMA\u003C\/em\u003E 2004]. In a meta-analysis of 310,819 patients, those in the highest quartile of SSB consumption (1\u20132 servings per day) had a 26% greater risk of developing T2DM than those in the lowest quartile of SSB intake, who averaged \u0026lt;1 serving per month (RR, 1.26; 95% CI, 1.12 to 1.41). Regular SSB drinkers also had a 20% increased risk of metabolic syndrome compared with light SSB drinkers (RR, 1.20; 95% CI, 1.02 to 1.42) [Malik VS et al. \u003Cem\u003EDiabetes Care\u003C\/em\u003E 2010].\u003C\/p\u003E\n         \u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/11\/2\/13\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Relative Risk of T2DM According to Sugar-Sweetened Soft Drink Consumption.\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-1392915765\u0022 data-figure-caption=\u0022Relative Risk of T2DM According to Sugar-Sweetened Soft Drink Consumption.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/11\/2\/13\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/11\/2\/13\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/11\/2\/13\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/12246\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption attrib\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \n               \u003Cp id=\u0022p-5\u0022 class=\u0022first-child\u0022\u003ERelative Risk of T2DM According to Sugar-Sweetened Soft Drink Consumption.\u003C\/p\u003E\n            \u003Cq class=\u0022attrib\u0022 id=\u0022attrib-1\u0022\u003EReproduced with permission from F. Hu, MD, PhD.\u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n         \u003Cp id=\u0022p-6\u0022\u003EReducing SSB consumption offers a relatively simple, low-cost option for improving cardiometabolic risk profile. In a study of 810 adults with hypertension, drinking 1 less SSB per day led to a reduction of 1.8 mm Hg and 1.1 mm Hg in systolic and diastolic blood pressure, respectively, after 18 months. The beneficial effects on blood pressure were independent of any effects on body weight [Chen L et al. \u003Cem\u003ECirculation\u003C\/em\u003E 2010].\u003C\/p\u003E\n         \u003Cp id=\u0022p-7\u0022\u003EAlthough there is no convincing evidence of harm that is associated with diet soda, it may not be the best replacement for regular soda and other SSBs, Dr. Hu said. Plain water and unsweetened coffee and tea are better alternatives for individuals who are trying to reduce their consumption of SSBs.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-2\u0022\u003E\n         \u003Ch2 class=\u0022\u0022\u003EMetabolic Effects of Excess Fructose Intake\u003C\/h2\u003E\n         \u003Cp id=\u0022p-8\u0022\u003EThe worldwide epidemic of obesity stems largely from increased caloric intake as well as reduced physical activity. In the United States and other Western countries, half or more of the caloric intake in beverages is consumed in the form of fructose. George A. Bray, MD, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA, described the detrimental metabolic changes that are associated with increased fructose intake.\u003C\/p\u003E\n         \u003Cp id=\u0022p-9\u0022\u003EFructose is more biologically active than glucose. Compared with glucose, fructose stimulates a greater degree of oxygen consumption and thermogenesis per gram, although it has a smaller effect on insulin secretion. Fructose is also associated with a greater increase in postprandial triglyceride levels compared with glucose [Teff KL et al. \u003Cem\u003EJ Clin Endocrinol Metab\u003C\/em\u003E 2009]. This association with triglyceride levels is disconcerting, Dr. Bray said, given that elevated triglyceride levels are known predictors for cardiovascular disease (CVD).\u003C\/p\u003E\n         \u003Cp id=\u0022p-10\u0022\u003EExcess fructose intake may be particularly detrimental for overweight and obese individuals. In a study of 32 overweight and obese patients, the consumption of fructose-sweetened beverages specifically promoted dyslipidemia, decreased insulin sensitivity, and increased visceral adiposity [Stanhope KL et al. \u003Cem\u003EJ Clin Invest\u003C\/em\u003E 2009]. By comparison, the consumption of glucose-sweetened beverages did not increase the accumulation of visceral fat. Fructose consumption has also been shown to increase blood pressure levels; increase systemic inflammatory markers, such as C-reactive protein; and increase uric acid production in the liver.\u003C\/p\u003E\n         \u003Cp id=\u0022p-11\u0022\u003E\u201cIn my judgment, fructose in the amounts now consumed is hazardous to the health of some people,\u201d Dr. Bray said. Reduced consumption of fructose-sweetened beverages is an important goal for CV risk reduction.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-3\u0022\u003E\n         \u003Ch2 class=\u0022\u0022\u003EHealthy Drinking As a Therapeutic Lifestyle Modification\u003C\/h2\u003E\n         \u003Cp id=\u0022p-12\u0022\u003EOccasional or moderate consumption of caloric beverages, including SSBs, milk, and alcohol, can be part of a healthy diet. However, excess or habitual consumption of caloric beverages can have detrimental metabolic effects. Barry M. Popkin, MD, University of North Carolina, Chapel Hill, North Carolina, USA, described the role of healthy drinking as an important therapeutic lifestyle modification for persons at risk for obesity, diabetes, and CVD.\u003C\/p\u003E\n         \u003Cp id=\u0022p-13\u0022\u003EFor most people, beverage consumption does not influence food intake. When individuals drink less water in favor of caloric beverages, there is no compensation in terms of reduced food intake. Therefore, the sharp increase in SSB consumption in recent decades has contributed to the global obesity epidemic.\u003C\/p\u003E\n         \u003Cp id=\u0022p-14\u0022\u003EHealth care providers should suggest that patients increase their water intake and reduce their SSB consumption as part of a strategy to prevent excess weight gain, Prof. Popkin said. Several epidemiological studies suggest that replacing SSBs with water has the potential to reduce total caloric intake by 200 calories or more per day. In one study, replacing vending machines that offered SSBs with filtered-water fountains reduced the risk of obesity by 31% [Muckelbauer R, L Libuda et al. \u003Cem\u003EPediatrics\u003C\/em\u003E 2009]. More studies are needed to demonstrate the effects of replacing SSBs with water on cardiometabolic outcomes and CVD risk, Prof. Popkin said.\u003C\/p\u003E\n         \u003Cdiv id=\u0022F2\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/11\/2\/13\/F2.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-1392915765\u0022 data-figure-caption=\u0022\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure2\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/11\/2\/13\/F2.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/11\/2\/13\/F2.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure2\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/11\/2\/13\/F2.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/12247\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption attrib\u0022\u003E\u003Cq class=\u0022attrib\u0022 id=\u0022attrib-2\u0022\u003E\n               \u003Cem\u003EThe editors would like to thank the many members of the 2\u003Csup\u003End\u003C\/sup\u003E International Congress on Abdominal Obesity presenting faculty who generously gave their time to ensure the accuracy and quality of the articles in this publication.\u003C\/em\u003E\n            \u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n      \u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2011 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/11\/2\/13.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzn3v1\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzn3v1\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}