Abstract WE425: Non-Alcoholic Beverage Consumption Is Associated with Mortality Risk and Organ Ages across Cardiovascular-Kidney-Metabolic Health Stages

Abstract

Introduction: Beverage consumption is an essential dietary component providing hydration, nutrients, and energy. Different cardiovascular-kidney-metabolic (CKM) stages represent distinct metabolic and hydration requirements, yet evidence on beverage consumption effects across CKM stages remains limited. Hypothesis: Non-alcoholic beverage consumption impacts on mortality and organ aging vary across CKM disease stages. Methods: We analyzed 180,613 UK Biobank participants with completed 24-hour dietary recalls, classified into CKM stages 0-4 per American Heart Association criteria. Eight beverage types (coffee, tea, sugar-sweetened beverages [SSBs], artificially-sweetened beverages [ASBs], natural juice, plain water, low-fat milk, whole milk) were assessed in servings/day. Hierarchical clustering identified beverage patterns. Cox proportional hazards models were used to assess associations between individual beverages, beverage patterns, and all-cause mortality. Additionally, associations between beverage patterns and plasma proteomics-derived organ ages were examined across CKM stages in a subset of 16,120 participants. Results: ver median 12.3-year follow-up, 14,253 deaths occurred. Whole milk (>1 serving/day) associated with increased mortality across stages: HR 1.13 (95% CI: 1.02-1.26) stages 0-1, 1.20 (1.12-1.28) stage 2, 1.15 (1.02-1.29) stages 3-4. SSBs and ASBs showed stage-progressive mortality associations, strongest in stages 3-4 (established cardiovascular disease): HR 1.05 (1.00-1.11) SSBs, 1.07 (1.01-1.13) ASBs. Tea (>4 servings/day) demonstrated protection in stages 3-4: HR 0.91 (0.86-0.97). Three distinct beverage patterns were identified through hierarchical clustering: SSB/ASB pattern, coffee/tea pattern, and natural juice/plain water pattern. CKM progression associated with multiple accelerated organ aging. SSB/ASB pattern showed substantially greater aging acceleration versus other patterns for adipose, kidney, liver, and lung across all stages. Conclusions: Beverage choices significantly impact outcomes across CKM stages. Minimizing SSBs and ASBs, especially in advanced stages, may lower mortality risk and mitigate organ aging. These findings support CKM stage-specific dietary guidance for cardiovascular-kidney-metabolic disease prevention.