Association of added sugar intake and its forms and sources with handgrip strength decline among middle-aged and older adults: A prospective cohort study

The consumption of added sugar has increased rapidly in recent years. Limited knowledge exists regarding the association between added sugar intake and muscle strength, although the latter is a predictor of physical disability in older adults. This study aimed to investigate the association between added sugar intake and longitudinal changes in handgrip strength among middle-aged and elderly Chinese adults. This prospective cohort study included 5298 adults aged 40 years and older (62.6% men) from the TCLSIH (Tianjin Chronic Low-grade Systemic Inflammation and Health) cohort study. Added sugar intake was obtained through a frequency questionnaire containing 100 items of food. Handgrip strength is measured annually using a handheld digital dynamometer. Multivariate linear regression models were used to examine the association between added sugars intake and the annual changes in handgrip strength and weight-adjusted handgrip strength. In the fully adjusted model, the annual change in handgrip strength for one unit increase in total added sugar, solid added sugar, and liquid added sugar intake was −0.0353 kg, (95% confidence intervals (CI) −0.000148, −0.0000164; P = 0.01), −0.0348 kg (95% CI: −0.000227, −0.0000269; P = 0.01) and −0.0189 kg (95% CI -0.000187, 0.0000338; P = 0.17), respectively. Added sugar from bread and biscuits sources were remarkably associated with a decline in handgrip strength (β = −0.0498; 95%CI -0.00281, −0.000787) and (β = −0.0459; 95%CI 0.00158, 0.00733) (P