(1) Background: The increasing occurrence of the metabolic syndrome (MetS) is largely related to harmful food habits. Among them, the consumption of sugar-sweetened beverages (SSBs) is noteworthy. However, to our knowledge, there are not enough high-quality methodological studies summarizing the association between the intake of SSBs and the MetS. Therefore, the aim of this study is to examine the existing published results on this association among adults by synthesizing the existing evidence. (2) Methods: Systematic review and meta-analysis of observational studies following the PRISMA guidelines. Relevant information was extracted and presented following the PRISMA recommendations. PubMed and SCOPUS databases were searched for studies published until June 2022 that assessed the association between SSB consumption (including soft drinks, bottled fruit juices, energy drinks, and milkshakes) and the occurrence of MetS. Random effect models were used to estimate pooled odds ratios (ORs) with their 95% coefficient interval, and I² was used to assess heterogeneity. (3) Results: A total of 14 publications from 6 different countries were included in this meta-analysis (9 cross-sectional and 5 cohort studies). For the cross-sectional studies, which included 62,693 adults, the pooled OR for the risk of MetS was 1.35 (95% CI 1.15, 1.58; I² 57%) when the highest versus the lowest categories of SSB consumption were compared. For the cohort studies, which included 28,932 adults, the pooled OR was 1.18 (95% CI 1.06, 1.32; I² 70%). (4) Conclusions: The consumption of SSBs was positively associated with an increased risk of MetS. The published literature supports public health strategies and the need to reduce the consumption of SSBs to prevent MetS.

(1) Background: Working night shifts has been associated with altered circadian rhythms, lifestyle habits, and cardiometabolic risks. No information on the potential association of working shift and the presence of atherosclerosis is available. The aim of this study was to quantify the association between different work shifts and the presence of subclinical atherosclerosis objectively measured by imaging. (2) Methods: Analyses were conducted on the baseline data of the Aragon Workers Health Study (AWHS) cohort, including information on 2459 middle-aged men. Categories of shift work included central day shift, rotating morning-evening or morning-evening-night shift, and night shift. The presence of atherosclerotic plaques was assessed by 2D ultrasound in the carotid and femoral vascular territories. Multivariable logistic models and mediation analysis were conducted to characterize and quantify the association between study variables. (3) Results: Participants working night or rotating shifts presented an overall worse cardiometabolic risk profile, as well as more detrimental lifestyle habits. Workers in the most intense (morning-evening-night) rotating shift presented higher odds of subclinical atherosclerosis (odds ratio: 1.6; 95% confidence interval: 1.12 to 2.27) compared to workers in the central shift, independently of the presence of lifestyle and metabolic risk factors. A considerable (21%) proportion of this association was found to be mediated by smoking, indicating that altered sleep-wake cycles have a direct relationship with the early presence of atherosclerotic lesions. (4) Conclusions: Work shifts should be factored in during workers health examinations, and when developing effective workplace wellness programs.

(1) Background: Cardiovascular diseases (CVDs) are the leading cause of mortality worldwide. The aim of the study was to examine the existing published results of the association between elevated serum phosphate concentrations and cardiovascular mortality, along with the CVD incidence and subclinical coronary atherosclerosis, in primary prevention among non-selected samples of the general population. (2) Methods: A systematic review and meta-analysis were carried out using literature obtained from PubMed, SCOPUS, and the Web Of Science until March 2024 and following the PRISMA guidelines. Relevant information was extracted and presented. Random and fixed effects models were used to estimate the pooled odds ratio (OR) and hazard ratio (HR) with their 95% coefficient interval (CI), and I² was used to assess heterogeneity. (3) Results: Twenty-five studies met our inclusion criteria and were included in the meta-analysis (11 cross-sectional and 14 cohort studies). For cardiovascular mortality, which included 7 cohort studies and 41,764 adults, the pooled HR was 1.44 (95% CIs 1.28, 1.61; I² 0%) when the highest versus the reference level of serum phosphate concentrations were compared. For CVDs, which included 8 cohort studies and 61,723 adults, the pooled HR was 1.12 (95% CIs 0.99, 1.27; I² 51%). For subclinical coronary atherosclerosis, which included 11 cross-sectional studies and 24,820 adults, the pooled OR was 1.44 (95% CIs 1.15, 1.79; I² 88%). (4) Conclusions: The highest serum phosphate concentrations were positively associated with a 44% increased risk of cardiovascular mortality and subclinical coronary atherosclerosis.

Context: The relationship between carbohydrate quality intake and metabolic syndrome (MetS) is of growing interest. Objective: We aimed to assess the association between the adherence to a dietary carbohydrate quality index (CQI) with the occurrence of MetS in a Spanish cohort of working adults. Methods: A cross-sectional study was conducted of 2316 middle-aged men, aged 50.9 (SD 3.9) years, with no previous cardiovascular disease, and pertaining to the Aragon Workers’ Health Study (AWHS) cohort. Diet was collected with a 136-item semiquantitative food-frequency questionnaire. The CQI (range 4-15) was based on: dietary fiber intake, a low glycemic index, the ratio of whole grains/total grains, and the ratio of solid carbohydrates/total carbohydrates. The higher the CQI, the healthier the diet. MetS was defined by using the harmonized National Cholesterol Education Programme–Adult Treatment Panel III (NCEP-ATP III) definition. The associations across 3-point categories of the CQI and the presence of MetS were examined using logistic regression. Results: An inverse and significant association between the CQI and MetS was found. Fully adjusted odds ratios (ORs) for MetS risk among participants in the 10- to 12-point category (second highest CQI category) was 0.64 (95% CI, 0.45-0.94), and in the 13- to 15-point category (highest category) was 0.52 (95% CI, 0.30-0.88), when compared with the 4- to 6-point category (lowest category). Participants with 10 to 12 and 13 to 15 points on the CQI showed a lower risk of hypertriglyceridemia: OR 0.61 (95% CI, 0.46-0.81), and 0.48 (95% CI, 0.32-0.71) respectively. Conclusion: Among middle-aged men, a higher adherence to a high-quality carbohydrate diet is associated with a lower prevalence of MetS. Triglyceridemia is the MetS component that contributed the most to this reduced risk.

Context: The recommendation of a low-sugar diet to prevent cardiovascular disease (CVD) has led to the popularity of artificial sweeteners (AS). Although their consumption is considered mostly safe, their potential associations with cardiovascular health remain controversial. Objectives: The aim of this study was to review the existing published evidence on the association between AS and CVD, specifically excluding artificially sweetened beverages, which have been studied more recently. Data Sources: Articles were retrieved from the PubMed, Web of Science, and Scopus databases from inception to February 2025. Data Extraction: Study characteristics related to AS and CVD meeting the inclusion criteria were extracted by 2 independent reviewers. Relevant information was extracted and presented according to PRISMA guidelines. A random-effects model was used to estimate the pooled hazard ratio with its 95% CI, and I2 was used to assess heterogeneity. Funnel plots and Egger’s tests were used to evaluate publication bias. Data Analysis: A total of 11 articles were identified (6 for serum/plasma measurements of AS and 5 for dietary consumption). The meta-analysis showed a positive association for serum/plasma polyols, with a 26% higher risk of cardiovascular events when comparing extreme categories. However, there was high heterogeneity and suspicion of publication bias. Second, the systematic review of AS consumption found mixed results for CVD mortality, although most estimates for cardiovascular events were positive. However, the number of included articles was relatively small and based on specific foods, making it difficult to draw conclusions. Conclusion: Elevated serum/plasma polyols are positively associated with a higher presence of cardiovascular events. However, total AS consumption was not clearly associated with CVD mortality or cardiovascular events. Future research is needed to better establish the association between AS and CVD. Systematic Review Registration: PROSPERO registration no. CRD42025644601.

Background/Objectives: Emerging approaches aim to protect both human and environmental health. Therefore, we hypothesise that adherence to the Healthy and Sustainable Dietary Recommendations for the Spanish Population Index (HS-DRSI) is inversely associated with the occurrence of Metabolic Syndrome (MetS) and promotes environmental sustainability. Methods: A cross-sectional analysis was performed with 2286 middle-aged men, with no previous cardiovascular disease and belonging to the Aragon Workers’ Health Study (AWHS). Diet was collected with a 136-item food-frequency questionnaire. Adherence to the recommendation was assessed with the HS-DRSI, which assigns one point for each of 19 food categories. The National Cholesterol Education Programme-Adult Treatment Panel III (NCEP-ATP III) definition was used to define MetS. Logistic regressions were used to estimate the association between adherence to the HS-DRSI and presence of MetS. Environmental assessment was calculated based on the 2016 European database. Results: Higher adherence to the HS-DRSI was inversely associated with MetS and elevated waist circumference. The odds ratio (OR) of having MetS for participants in the highest (8–13 points) vs. lowest (1–5 points) quartile of adherence to the diet score was 0.72 (95% CI, 0.52–0.99) and the OR of elevated waist circumference was 0.69 (95% CI, 0.48–0.99), with consistent results per 1 SD increase (2 points). In addition, greenhouse gas emissions (GHGE) decreased progressively across adherence quartiles (from 6.10 to 5.70 kg CO₂-eq/day). Conclusions: Adherence to the HS-DRSI was associated with a lower risk of MetS and may contribute to lower GHGE production.