Sweetened beverages and atrial fibrillation in people with prediabetes or diabetes

Abstract Aim To assess the association of intake of sugar‐sweetened beverages (SSBs), artificially sweetened beverages (ASBs) and natural juices (NJs) with new‐onset atrial fibrillation (AF) in people with prediabetes or diabetes. Methods A total of 31 433 participants with prediabetes and diabetes from the UK Biobank were included. Information on the intake of SSBs, ASBs and NJs was accessed by 24‐hour dietary recalls from 2009 to 2012. The study outcome was new‐onset AF. Results During a median follow‐up of 12.0 years, 2470 (7.9%) AF cases were documented. Both the intake of SSBs (per 1 unit/day increment; adjusted hazard ratio [HR] = 1.11; 95% confidence interval [CI]: 1.04‐1.18) and ASBs (per 1 unit/day increment; adjusted HR = 1.08; 95% CI: 1.02‐1.14) were linearly and positively associated with new‐onset AF, while NJ intake was not significantly associated with new‐onset AF (per 1 unit/day increment; adjusted HR = 1.00; 95% CI: 0.93‐1.08). Accordingly, compared with non‐consumers, participants who consumed more than one unit per day of SSBs (adjusted HR = 1.30; 95% CI: 1.11‐1.53) or ASBs (adjusted HR = 1.21; 95% CI:1.05‐1.40) had an increased risk of AF. Substituting 1 unit/day of NJs for SSBs was associated with a 9% (adjusted HR = 0.91; 95% CI: 0.83‐0.99) lower risk of new‐onset AF, while replacing SSBs with ASBs was not significantly associated with new‐onset AF (adjusted HR = 0.97; 95% CI: 0.89‐1.06). Conclusions Both the intake of SSBs and ASBs were linearly and positively associated with new‐onset AF, while NJ intake did not show a significant association with AF in people with prediabetes or diabetes. Replacing an equivalent amount of SSB intake with NJs, but not ASBs, was associated with a lower risk of AF.