Online Data Supplement

SUGAR-SWEETENED BEVERAGE, SUGAR INTAKE AND BLOOD PRESSURE:

INTERMAP STUDY

Ian J. Brown, Jeremiah Stamler, Linda Van Horn, Claire E. Robertson, Queenie Chan, Alan R. Dyer,

Chiang-Ching Huang, Beatriz L. Rodriguez, Liancheng Zhao, Martha L. Daviglus,

Hirotsugu Ueshima, and Paul Elliott, for the INTERMAP Research Group
Table S1. Mean and Standard Deviation (SD) or Frequency (N) and Percent (%), Study Variables by Country and Gender

USA UK Men Women

(N=2,195) (N=501) (N=1,369) (N=1,327)
Variable, units Mean (SD) Mean (SD) Mean (SD) Mean (SD)
Age, years 49.1 (5.4) 49.1 (5.6) 49.2 (5.4) 49.1 (5.4)
Systolic blood pressure, mm Hg 118.6 (13.9) 120.4 (14.6) 121.0 (13.1) 116.8 (14.6)
Diastolic blood pressure, mm Hg 73.4 (9.7) 77.3 (9.9) 76.7 (9.7) 71.5 (9.3)
Height, m 1.68 (0.10) 1.69 (0.09) 1.75 (0.07) 1.62 (0.07)
Weight, kg 82.3 (19.6) 78.2 (15.3) 88.5 (17.1) 74.3 (17.9)
Body mass index, kg/m2 28.9 (5.9) 27.5 (4.6) 28.8 (4.9) 28.4 (6.4)
Moderate and heavy physical activity, hours/24-h 3.2 (3.1) 2.2 (2.4) 3.3 (3.2) 2.8 (2.9)
Education, years completed 15.0 (3.0) 12.7 (3.1) 14.9 (3.3) 14.1 (3.0)
Energy, kcal/24-h 2244 (699) 2168 (632) 2582 (685) 1867 (465)
Sugar-sweetened beverages, ml/24-h 306.3 (373.7) 66.4 (117.5) 324.7 (412.7) 196.8 (264.5)
ml/1,000 kcal 130.5 (147.3) 30.8 (55.9) 121.1 (146.0) 102.5 (134.1)
Diet beverages, ml/24-h 181.8 (376.8) 104.5 (263.9) 178.8 (393.8) 155.7 (320.6)
ml/1,000 kcal 89.6 (192.0) 49.5 (105.5) 75.1 (167.2) 89.4 (191.8)
Fructose, g/24-h 28.0 (18.9) 17.4 (10.3) 30.2 (20.8) 21.8 (13.5)
% kcal 5.1 (3.0) 3.4 (1.9) 4.7 (3.0) 4.8 (2.7)
Glucose, g/24-h 30.0 (18.1) 17.9 (9.5) 32.0 (20.2) 23.3 (12.7)
% kcal 5.4 (2.7) 3.4 (1.6) 5.0 (2.8) 5.1 (2.5)
Sucrose, g/24-h 60.8 (35.9) 51.1 (27.7) 65.6 (39.1) 52.2 (28.0)
% kcal 10.7 (5.1) 9.5 (4.2) 9.9 (5.0) 11.0 (4.8)
continued on next page
Table S1. continued, page 2

Starch, g/24-h 125.1 (44.8) 145.0 (48.8) 148.4 (48.7) 108.6 (33.1)
Fibre, g/24-h 19.1 (7.9) 25.5 (9.2) 23.0 (9.2) 17.5 (6.6)
Animal protein, g/24-h 55.9 (23.6) 51.4 (20.7) 63.8 (24.9) 46.1 (17.1)
Vegetable protein, g/24-h 28.0 (10.8) 32.1 (10.7) 32.8 (11.6) 24.6 (8.2)
Total SFA, g/24-h 28.0 (12.5) 29.9 (13.6) 33.0 (13.6) 23.7 (9.7)
Total MFA, g/24-h 31.9 (13.5) 27.3 (11.0) 36.3 (13.6) 25.6 (10.1)
Total PFA, g/24-h 17.9 (8.1) 15.2 (6.9) 20.1 (8.3) 14.6 (6.5)
Omega-3 PFA, g/24-h 1.9 (0.9) 1.8 (0.8) 2.1 (0.9) 1.6 (0.8)
Omega-6 PFA, g/24-h 16.0 (7.3) 13.5 (6.3) 17.9 (7.6) 13.0 (5.9)
Total TFA, g/24-h 5.0 (2.8) 3.3 (1.9) 5.5 (3.1) 4.0 (2.1)
Cholesterol, mg/24-h 296.3 (159.9) 261.8 (133.4) 338.8 (171.5) 239.5 (118.4)
Keys dietary lipid score* 36.2 (9.7) 40.3 (11.0) 37.2 (10.1) 36.8 (10.1)
Phosphorus, mg/24-h 1295.3 (441.4) 1392.3 (410.4) 1501.2 (451.6) 1119.5 (323.0)
Magnesium, mg/24-h 318.7 (111.9) 319.6 (93.8) 363.0 (112.0) 273.3 (83.8)
Calcium, mg/24-h 791.3 (371.6) 933.0 (319.2) 907.6 (396.4) 724.8 (306.6)
Iron, mg/24-h 16.9 (7.1) 13.1 (4.2) 18.5 (7.5) 13.8 (5.0)
Vitamin C, mg/24-h 110.5 (76.4) 86.3 (54.8) 114.8 (81.2) 97.0 (63.3)
Caffeine, mg/24-h 260.4 (258.3) 258.9 (150.5) 298.2 (272.5) 220.9 (198.1)
14-day alcohol, g/24-h 6.9 (13.7) 14.7 (19.2) 12.4 (18.7) 4.2 (8.4)
Urinary sodium, mmol/24-h 162.6 (59.4) 145.2 (49.1) 178.5 (61.0) 139.6 (47.2)
Urinary potassium, mmol/24-h 57.7 (20.9) 68.2 (20.1) 66.4 (21.9) 52.6 (17.8)
Urinary sodium/potassium ratio 3.1 (1.2) 2.3 (0.8) 2.9 (1.2) 2.9 (1.3)
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Table S1. continued, page 3

N (%) N (%) N (%) N (%)

Obese 775 (35.3) 116 (23.2) 457 (33.4) 434 (32.7)

Hypertensive 595 (27.1) 116 (23.2) 386 (28.2) 325 (24.5)
Current alcohol drinkers 1,533 (69.8) 444 (88.6) 1,083 (79.1) 894 (67.4)
Special diet: weight loss, weight gain, vegetarian,
salt reduced, diabetic, fat modified or any other 401 (18.3) 106 (21.2) 210 (15.3) 297 (22.4)
Taking dietary supplements 1,136 (51.8) 191 (38.1) 594 (43.5) 732 (55.2)
Taking antihypertensive, other cardiovascular
disease or diabetes medication 644 (29.3) 98 (19.6) 377 (27.5) 365 (27.5)
History of heart attack, other heart disease, stroke
or diabetes 343 (15.6) 54 (10.8) 208 (15.2) 189 (14.2)
Family history of hypertension in any first degree
relative Yes 1,491 (67.9) 242 (48.3) 808 (59.0) 925 (69.7)
Unknown 489 (22.3) 188 (37.5) 398 (29.1) 279 (21.0)
DBP, diastolic blood pressure; MFA, monounsaturated fatty acids; PFA, polyunsaturated fatty acids; SFA, saturated fatty acids; SBP, systolic blood pressure;
TFA, trans fatty acids.
* Keys dietary lipid score = 1.35(2SFA [%kcal]PFA [%kcal])+1. 5cholesterol [mg/1,000kcal].

Body mass index 30 kg/m2.

SBP 140 mm Hg, or DBP 90 mm Hg, or taking antihypertensive medication for high blood pressure.

Includes lipid-lowering medication.

Table S2. Adjusted* Mean Nutrient Intakes, Other Variables, by Category of Diet Beverage Intake

Diet Beverage Intake

Zero serving/day > serving/day
(N=1,589) (N=683) (N=424)
Variable Mean (95% CI) Mean (95% CI) Mean (95% CI) F-score P-value
Diet beverages, ml/1,000 kcal 0.0 (0.0, 0.0) 80.8 (69.8, 91.9) 390.3 (377.2, 403.4) --- ---
Sugar-sweetened beverages, ml/1,000 kcal 105.4 (94.9, 115.9) 52.6 (40.5, 64.8) 2.6 (0.0, 17.0) 122.48 <0.001
Energy, kcal/24-h 2162 (2115, 2210) 2139 (2084, 2195) 2146 (2081, 2212) 0.43 0.65
Fructose, % kcal 4.8 (4.6, 5.1) 3.8 (3.6, 4.1) 2.8 (2.5, 3.1) 103.52 <0.001
Glucose, % kcal 4.9 (4.7, 5.1) 4.1 (3.8, 4.3) 3.2 (2.9, 3.5) 88.08 <0.001
Sucrose, % kcal 10.5 (10.1, 10.9) 9.5 (9.1, 10.0) 8.7 (8.1, 9.2) 27.08 <0.001
Starch, % kcal 23.8 (23.4, 24.3) 24.8 (24.2, 25.3) 25.1 (24.5, 25.7) 12.66 <0.001
Fiber, g/1,000 kcal 10.9 (10.6, 11.1) 11.1 (10.8, 11.4) 11.2 (10.8, 11.5) 2.20 0.11
Animal protein, % kcal 9.9 (9.6, 10.2) 10.5 (10.1, 10.8) 10.8 (10.4, 11.1) 14.66 <0.001
Vegetable protein, % kcal 5.7 (5.6, 5.8) 5.9 (5.7, 6.0) 5.9 (5.7, 6.0) 4.14 0.02
Total SFA, % kcal 11.0 (10.7, 11.2) 11.1 (10.8, 11.4) 11.9 (11.5, 12.2) 15.88 <0.001
Total MFA, % kcal 11.3 (11.1, 11.5) 11.5 (11.2, 11.7) 12.3 (12.0, 12.6) 21.34 <0.001
Total PFA, % kcal 6.5 (6.3, 6.6) 6.7 (6.5, 6.9) 7.1 (6.8, 7.3) 12.67 <0.001
Omega-3 PFA, % kcal 0.73 (0.70, 0.75) 0.75 (0.73, 0.78) 0.75 (0.72, 0.79) 2.75 0.06
Omega-6 PFA, % kcal 5.8 (5.6, 5.9) 6.0 (5.8, 6.2) 6.4 (6.2, 6.6) 15.07 <0.001
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Table S2. continued, page 2

Trans-fatty acids, % kcal 1.5 (1.5, 1.6) 1.6 (1.5, 1.7) 1.8 (1.7, 1.9) 17.77 <0.001
Dietary cholesterol, mg/1,000 kcal 126.5 (121.8, 131.1) 126.7 (121.3, 132.1) 133.5 (127.0, 139.9) 2.62 0.07

Keys dietary lipid score 37.4 (36.5, 38.2) 37.4 (36.5, 38.4) 39.4 (38.3, 40.5) 7.44 <0.001
Phosphorus, mg/1,000 kcal 625.4 (615.6, 635.3) 652.1 (640.6, 663.5) 687.1 (673.5, 700.7) 46.85 <0.001
Magnesium, mg/1,000 kcal 152.8 (149.7, 155.9) 156.9 (153.4, 160.5) 159.2 (154.9, 163.4) 6.19 0.002
Calcium, mg/1,000 kcal 402.4 (391.3, 413.6) 426.2 (413.3, 439.1) 442.0 (426.7, 457.3) 17.38 <0.001
Iron, mg/1,000 kcal 7.0 (6.8, 7.2) 7.4 (7.2, 7.7) 7.7 (7.4, 7.9) 16.13 <0.001
Vitamin C, mg/1,000 kcal 51.6 (48.8, 54.3) 47.5 (44.3, 50.8) 45.9 (42.0, 49.7) 6.40 0.002
Caffeine, mg/1,000 kcal 121.0 (110.7, 131.2) 132.1 (120.2, 144.0) 149.8 (135.7, 163.9) 9.25 <0.001
14-day alcohol, g/24-h 10.3 (9.1, 11.5) 10.5 (9.1, 11.9) 9.4 (7.8, 11.1) 0.71 0.49
Urinary sodium, mmol/24-h 148.7 (144.3, 153.1) 156.8 (151.6, 161.9) 170.5 (164.4, 176.6) 28.13 <0.001
Urinary potassium, mmol/24-h 61.1 (59.5, 62.7) 64.1 (62.3, 66.0) 67.3 (65.1, 69.5) 19.33 <0.001
Urinary sodium/potassium ratio 2.7 (2.6, 2.8) 2.7 (2.6, 2.8) 2.7 (2.6, 2.8) 0.18 0.84
Age, years 49.7 (49.3, 50.1) 50.3 (49.8, 50.8) 49.9 (49.3, 50.5) 2.98 0.05
Education, years completed 13.5 (13.3, 13.8) 13.7 (13.4, 13.9) 13.5 (13.2, 13.9) 0.35 0.70
Moderate and heavy physical activity,
hours/24-h 2.7 (2.4, 2.9) 2.6 (2.3, 2.9) 2.1 (1.8, 2.5) 5.18 0.006
Body mass index, kg/m2 28.2 (27.8, 28.7) 28.8 (28.2, 29.3) 30.2 (29.5, 30.8) 19.28 <0.001
Systolic blood pressure, mm Hg 119.9 (118.7, 121.0) 119.1 (117.8, 120.4) 119.9 (118.3, 121.4) 0.80 0.45
Diastolic blood pressure, mm Hg 74.2 (73.4, 75.0) 73.9 (73.0, 74.8) 73.8 (72.7, 74.9) 0.41 0.66
continued on next page
Table S2. Continued, page 3

* Estimated by analysis of variance and least squares means. Adjusted for country, sex, (age), special diet, supplement use, CVD or diabetes diagnosis,
(physical activity), family history of high BP.

1 serving = 355 ml/24-h.

Keys dietary lipid score = 1.35(2SFA [%kcal]PFA [%kcal])+1. 5cholesterol [mg/1,000kcal].

SFA=saturated fatty acids; MFA=monounsaturated fatty acids; PFA=polyunsaturated fatty acids.
Table S3. Ratio of Within to Between person Variance* and its Effect on Univariate Regression
Coefficients for Sugar-Sweetened and Diet Beverages, Main Dietary Sugars, and Blood Pressure

Mean of First and

Repeat visits: observed
Ratio of within to regression coefficient as
between person % of theoretical
Variable, units Country variance* coefficient
Sugar-sweetened USA (N=2,195) 0.49 80.4
beverages, UK (N=501) 1.43 58.3
ml/24-h Overall (N=2,696) 0.66 75.1

Diet beverages, USA (N=2,195) 0.20 90.7

ml/24-h UK (N=501) 0.36 84.8
Overall (N=2,696) 0.23 89.6

Fructose, USA (N=2,195) 0.79 71.7

% kcal UK (N=501) 0.65 75.5
Overall (N=2,696) 0.76 72.4

Glucose, USA (N=2,195) 0.83 70.7

% kcal UK (N=501) 0.83 70.7
Overall (N=2,696) 0.83 70.7

Sucrose, USA (N=2,195) 0.94 67.9

% kcal UK (N=501) 0.46 81.1
Overall (N=2,696) 0.86 70.0

Systolic blood USA (N=2,195) 0.19 91.2

pressure, mm Hg UK (N=501) 0.17 92.1
Overall (N=2,696) 0.19 91.4

Diastolic blood USA (N=2,195) 0.22 90.1

pressure, mm Hg UK (N=501) 0.22 90.1
Overall (N=2,696) 0.22 90.1
* Ratio calculated from mean of visits 1 and 2 and mean of visits 3 and 4, estimated separately for 4
country-gender subgroups and pooled by N-1.
Reliability = 1/[1+(ratio/2)]100
Table S4. Partial Correlations* with Selected Nutrient Variables of Sugar-Sweetened and Diet
Beverages, Main Dietary Sugars, Expressed as Amount/24-h

Sugar-
sweetened Diet
Variable, units beverages beverages Fructose Glucose Sucrose
Sugar-sweetened beverages,
ml/24-h - -0.21 0.72 0.72 0.29
Diet beverages, ml/24-h -0.21 - -0.18 -0.15 -0.08
Fructose, g/24-h 0.72 -0.18 - 0.94 0.26
Glucose, g/24-h 0.72 -0.15 0.94 - 0.32
Sucrose, g/24-h 0.29 -0.08 0.26 0.32 -
Energy, kcal/24-h 0.29 0.00 0.38 0.45 0.53
Starch, g/24-h -0.01 0.08 0.13 0.17 0.22
Fiber, g/24-h -0.11 0.04 0.24 0.21 0.14
Animal protein, g/24-h 0.09 0.04 0.06 0.09 0.13
Vegetable protein, g/24-h -0.05 0.06 0.21 0.22 0.17
Total SFA, g/24-h 0.13 0.06 0.09 0.15 0.36
Total MFA, g/24-h 0.14 0.05 0.11 0.17 0.30
Total PFA, g/24-h 0.11 0.05 0.11 0.15 0.22
Omega-3 PFA, g/24-h 0.07 0.02 0.11 0.13 0.15
Omega-6 PFA, g/24-h 0.11 0.05 0.11 0.14 0.22
Total TFA, g/24-h 0.10 0.04 0.05 0.10 0.33
Cholesterol, mg/24-h 0.11 0.03 0.04 0.08 0.14

Keys dietary lipid score -0.03 0.04 -0.20 -0.17 0.00
Phosphorus, mg/24-h 0.02 0.11 0.18 0.22 0.24
Magnesium, mg/24-h -0.09 0.05 0.21 0.22 0.19
Calcium, mg/24-h -0.03 0.06 0.12 0.14 0.21
Iron, mg/24-h -0.06 0.08 0.16 0.18 0.19
Vitamin C, mg/24-h 0.08 -0.03 0.43 0.45 0.15
Caffeine, mg/24-h -0.09 0.05 -0.13 -0.10 0.10
14-day alcohol, g/24-h -0.07 -0.05 -0.09 -0.05 -0.16
Urinary sodium, mmol/24-h -0.03 0.13 -0.04 -0.01 0.02
Urinary potassium, mmol/24-h -0.20 0.08 0.06 0.05 0.00
Urinary sodium/potassium ratio 0.16 0.03 -0.05 -0.02 0.03
MFA, monounsaturated fatty acids; PFA, polyunsaturated fatty acids; SFA, saturated fatty acids;
TFA, trans fatty acids.
* Adjusted for age, sex, sample
Keys dietary lipid score = 1.35(2SFA [%kcal]PFA [%kcal])+1. 5cholesterol [mg/1,000kcal].
Table S5. Partial Correlations* with Selected Nutrient Variables of Sugar-Sweetened and Diet
Beverages, Main Dietary Sugars, Expressed as ml/1,000 kcal

Sugar-
sweetened Diet
Variable, units beverages beverages Fructose Glucose Sucrose
Sugar-sweetened beverages,
ml/1,000 kcal - -0.21 0.66 0.67 0.19
Diet beverages, ml/1,000 kcal -0.21 - -0.18 -0.16 -0.12
Fructose, % kcal 0.66 -0.18 - 0.93 0.10
Glucose, % kcal 0.67 -0.16 0.93 - 0.14
Sucrose, % kcal 0.19 -0.12 0.10 0.14 -
Energy, kcal/24-h 0.07 -0.12 -0.04 -0.02 0.08
Starch, % kcal -0.31 0.13 -0.22 -0.24 -0.23
Fiber, g/1,000 kcal -0.29 0.07 0.11 0.03 -0.13
Animal protein, % kcal -0.12 0.09 -0.19 -0.22 -0.26
Vegetable protein, % kcal -0.31 0.09 -0.03 -0.08 -0.22
Total SFA, % kcal -0.10 0.03 -0.37 -0.36 -0.12
Total MFA, % kcal -0.11 0.03 -0.37 -0.37 -0.23
Total PFA, % kcal -0.08 0.05 -0.21 -0.22 -0.23
Omega-3 PFA, % kcal -0.10 0.01 -0.12 -0.14 -0.21
Omega-6 PFA, % kcal -0.09 0.06 -0.22 -0.22 -0.23
Total TFA, % kcal -0.08 0.03 -0.27 -0.26 0.00
Cholesterol, mg/1,000 kcal -0.03 0.02 -0.20 -0.19 -0.22

Keys dietary lipid score -0.06 0.01 -0.30 -0.29 -0.11
Phosphorus, mg/1,000 kcal -0.33 0.20 -0.15 -0.19 -0.29
Magnesium, mg/1,000 kcal -0.37 0.11 -0.01 -0.06 -0.20
Calcium, mg/1,000 kcal -0.26 0.09 -0.11 -0.14 -0.12
Iron, mg/1,000 kcal -0.27 0.12 -0.05 -0.08 -0.14
Vitamin C, mg/1,000 kcal -0.01 -0.01 0.40 0.43 0.04
Caffeine, mg/1,000 kcal -0.13 0.10 -0.17 -0.17 0.01
14-day alcohol, g/24-h -0.09 -0.05 -0.13 -0.10 -0.22
Urinary sodium, mmol/24-h -0.09 0.09 -0.15 -0.14 -0.12
Urinary potassium, mmol/24-h -0.25 0.06 0.00 -0.02 -0.09
Urinary sodium/potassium ratio 0.15 0.02 -0.09 -0.08 -0.02
MFA, monounsaturated fatty acids; PFA, polyunsaturated fatty acids; SFA, saturated fatty acids;
TFA, trans fatty acids.
* Adjusted for age, sex, sample

Keys dietary lipid score = 1.35(2SFA [%kcal]PFA [%kcal])+1. 5cholesterol [mg/1,000kcal].

Table S6. Sensitivity Analyses: Estimated Mean Difference in Blood Pressure (mm Hg), Sugar-Sweetened Beverage Intake Higher by 1 Serving/day
(355 ml/24-h*), Regression Model 3

Systolic Blood Pressure Diastolic Blood Pressure

Not adjusted for Adjusted for Not adjusted for Adjusted for
Height, Weight Height, Weight Height, Weight Height, Weight
Difference (Z-score) Difference (Z-score) Difference (Z-score) Difference (Z-score)
Model mm Hg mm Hg mm Hg mm Hg
(a) ml/1000 kcal, not adjusted for energy
intake (N=2,696) 1.65 (4.99) 0.99 (3.09) 0.78 (3.42) 0.38 (1.71)
(b) ml/1000 kcal, adjusted for energy
intake (N=2,696) 1.59 (4.72) 0.94 (2.90) 0.78 (3.37) 0.39 (1.74)
(c) ml/24-h, censored normal regression,
adjusting for anti-hypertensive treatment
(N=2,696) 2.08 (5.45) 1.30 (3.62) 1.03 (3.98) 0.53 (2.13)
(d) ml/24-h, non-intervened participants
(N=852) 1.52 (2.90) 0.87 (1.69) 1.08 (2.89) 0.65 (1.76)
(e) ml/24-h, nonhypertensive participants
(N=1,985) 1.26 (4.12) 0.77 (2.63) 0.41 (1.78) 0.10 (0.43)
(f) ml/24-h, with exclusion of people with
high day-to-day variability of SBP, DBP,
and/or nutrient intakes (N=2,077) 1.74 (4.55) 1.18 (3.20) 0.87 (3.37) 0.54 (2.15)
(g) ml/24-h, adjusted for education (years)
(N=2,696) 1.51 (4.68) 0.99 (3.19) 0.71 (3.20) 0.40 (1.84)
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Table S6. continued, page 2

Model 3: Adjusted for sample, age, gender, special diet, supplement use, physical activity, CVD/diabetes, family history of high BP, urinary Na,
urinary K, dietary alcohol, cholesterol, PFA, SFA, energy.
Z-score = regression coefficient/standard error; Z 1.96, uncorrected P 0.05; Z 2.58, uncorrected P 0.01; Z 3.29, P 0.001.
Non-intervened: individuals not on a special diet, not consuming nutritional supplements, not with diagnosed CVD/diabetes, not taking medication
for high BP/CVD/diabetes.
Nonhypertensive: SBP <140 and DBP <90 mm Hg and not taking antihypertensive medication.
* intake higher by 160 ml/1,000 kcal for rows (a) and (b).
Regressions not adjusted for special diet, supplement use, or CVD/diabetes.
USA-UK difference significant, P <0.05.
Table S7. Estimated Mean Difference in Blood Pressure (mm Hg), Sugar-Sweetened or Diet Beverage
Intake Higher by 1 Serving/day (355 ml/24-h), Regression Models 3 and 4c, INTERMAP USA and UK
Participants, Dichotomized by Median Body Mass Index*

Systolic Blood Pressure Diastolic Blood Pressure

Not adjusted for Adjusted for Not adjusted for Adjusted for
Beverage Weight, Height Weight, Height Weight, Height Weight, Height
Subcohort Difference (Z-Score) Difference (Z-Score) Difference (Z-Score) Difference (Z-Score)
Model mm Hg mm Hg mm Hg mm Hg
Sugar-sweetened beverages
Lower body mass index (N=1,348)
3 1.63 (3.40) 1.28 (2.75) 0.78 (2.36) 0.55 (1.72)
4c (Mg) 1.38 (2.72) 1.21 (2.45) 0.69 (1.99) 0.58 (1.71)
Higher body mass index (N=1,348)
3 0.95 (2.24) 0.76 (1.83) 0.29 (1.01) 0.21 (0.29)
4c (Mg) 0.80 (1.70) 0.74 (1.61) 0.28 (0.86) 0.26 (0.32)
Diet beverages
Lower body mass index (N=1,348)
3 -0.02 (-0.05) -0.30 (-0.80) -0.13 (-0.50) -0.32 (-1.25)
4c (Mg) -0.01 (-0.04) -0.29 (-0.76) -0.13 (-0.49) -0.32 (-1.23)
Higher body mass index (N=1,348)
3 -0.73 (-2.13) -0.81 (-2.42) -0.52 (-2.18) -0.55 (-2.32)
4c (Mg) -0.67 (-1.93) -0.79 (-2.33) -0.51 (-2.15) -0.56 (-2.36)

Model 3: adjusted for age, gender, sample, special diet, supplement use, history of CVD/diabetes,
physical activity, family history of high BP, urinary Na, urinary K, 14-day alcohol, dietary cholesterol,
polyunsaturated fatty acids, saturated fatty acids. Model 4c: adjusted for Model 3 variables + magnesium.
Z-score = regression coefficient/standard error; Z 1.96, uncorrected P 0.05; Z 2.58, uncorrected
P 0.01; Z 3.29, P 0.001.
* Body mass index dichotomized by country-gender-specific medians: UK men, 27.1 kg/m2; UK women,
26.3 kg/m2; USA men, 28.6 kg/m2; USA women, 27.2 kg/m2.
Table S8. Estimated Mean Difference in Blood Pressure (mm Hg), Sugar-Sweetened or Diet Beverage
Intake Higher by 1 Serving/day (355 ml/24-h), Regression Models 3 and 4c, INTERMAP USA and UK
Participants, Dichotomized by Median 24-h Urinary Sodium Excretion*

Systolic Blood Pressure Diastolic Blood Pressure

Not adjusted for Adjusted for Not adjusted for Adjusted for
Beverage Weight, Height Weight, Height Weight, Height Weight, Height
Subcohort Difference (Z-Score) Difference (Z-Score) Difference (Z-Score) Difference (Z-Score)
Model mm Hg mm Hg mm Hg mm Hg
Sugar-sweetened beverages
Lower Sodium (N=1,349)
3 1.04 (2.16) 0.60 (1.29) 0.42 (1.27) 0.10 (0.31)
4c (Mg) 0.54 (1.02) 0.34 (0.67) 0.08 (0.21) -0.09 (-0.24)
Higher Sodium (N=1,347)
3 2.03 (4.71) 1.44 (3.49) 1.04 (3.51) 0.71 (2.47)
4c (Mg) 1.78 (3.79) 1.47 (3.30) 1.02 (3.19) 0.85 (2.72)

Diet beverages
Lower Sodium (N=1,349)
3 -0.11 (-0.25) -0.46 (-1.07) -0.14 (-0.44) -0.39 (-1.30)
4c (Mg) -0.02 (-0.04) -0.40 (-0.92) -0.08 (-0.25) -0.36 (-1.19)
Higher Sodium (N=1,347)
3 -0.47 (-1.46) -0.63 (-2.07) -0.34 (-1.56) -0.42 (-1.96)
4c (Mg) -0.42 (-1.29) -0.62 (-2.01) -0.33 (-1.49) -0.43 (-2.00)

Model 3: adjusted for age, gender, sample, special diet, supplement use, history of CVD/diabetes,
physical activity, family history of high BP, urinary Na, urinary K, 14-day alcohol, dietary cholesterol,
polyunsaturated fatty acids, saturated fatty acids. Model 4c: adjusted for Model 3 variables + magnesium.
Z-score = regression coefficient/standard error; Z 1.96, uncorrected P 0.05; Z 2.58, uncorrected
P 0.01; Z 3.29, P 0.001.
* Urinary sodium excretion dichotomized by country-gender-specific medians: UK men, 155 mmol/24-h;
UK women, 125 mmol/24-h; USA men, 174 mmol/24-h; USA women, 137 mmol/24-h.

USA-UK heterogeneity significant, P<0.05

Table S9. Sensitivity Analyses: Estimated Mean Difference in Blood Pressure (mm Hg), Diet Beverage Intake Higher by 1 Serving/day (355
ml/24-h*), Regression Model 3

Systolic Blood Pressure Diastolic Blood Pressure

Not adjusted for Adjusted for Not adjusted for Adjusted for
Height, Weight Height, Weight Height, Weight Height, Weight
Difference (Z-score) Difference (Z-score) Difference (Z-score) Difference (Z-score)
Model mm Hg mm Hg mm Hg mm Hg
(a) ml/1000 kcal, not adjusted for energy
intake (N=2,696) -0.52 (-2.23) -0.65 (-2.96) -0.35 (-2.23) -0.43 (-2.82)
(b) ml/1000 kcal, adjusted for energy
intake (N=2,696) -0.46 (-1.96) -0.63 (-2.81) -0.35 (-2.15) -0.45 (-2.85)
(c) ml/24-h, censored normal regression,
adjusting for anti-hypertensive treatment
(N=2,696) -0.41 (-1.31) -0.79 (-2.73) -0.38 (-1.82) -0.61 (-3.07)
(d) ml/24-h, non-intervened participants
(N=852) -0.32 (-0.59) -0.69 (-1.33) -0.11 (-0.29) -0.37 (-1.01)
(e) ml/24-h, nonhypertensive participants
(N=1,985) -0.10 (-0.43) -0.38 (-1.71) -0.19 (-1.07) -0.36 (-2.13)
(f) ml/24-h, with exclusion of people with
high day-to-day variability of SBP, DBP,
and/or nutrient intakes (N=2,077) -0.35 (-1.18) -0.64 (-2.26) -0.26 (-1.28) -0.42 (-2.17)
(g) ml/24-h, adjusted for education (years)
(N=2,696) -0.35 (-1.35) -0.58 (-2.31) -0.30 (-1.70) -0.44 (-2.52)
Model 3: Adjusted for sample, age, gender, special diet, supplement use, physical activity, CVD/diabetes, family history of high BP, urinary Na,
urinary K, dietary alcohol, cholesterol, PFA, SFA, energy.
continued on next page
Table S9. continued

Z-score = regression coefficient/standard error; Z 1.96, uncorrected P 0.05; Z 2.58, uncorrected P 0.01; Z 3.29, P 0.001.
Non-intervened: individuals not on a special diet, not consuming nutritional supplements, not with diagnosed CVD/diabetes, not taking medication
for high BP/CVD/diabetes.
Nonhypertensive: SBP <140 and DBP <90 mm Hg and not taking antihypertensive medication.
No significant USA-UK difference detected, P<0.05.
* 160 ml/1,000 kcal for rows (a) and (b).
Regressions not adjusted for special diet, supplement use, or CVD/diabetes.
Table S10. Estimated Mean Difference in Blood Pressure (mm Hg), Fructose, Glucose, or Sucrose Intake
Higher by 2 SD, Regressed Separately in Sequential Models, INTERMAP USA and UK Participants
(N=2,696)

Systolic Blood Pressure Diastolic Blood Pressure

Not adjusted for Adjusted for Not adjusted for Adjusted for
Weight, Height Weight, Height Weight, Height Weight, Height
Sugar (2 SD) Difference (Z-Score) Difference (Z-Score) Difference (Z-Score) Difference (Z-Score)
Model mm Hg mm Hg mm Hg mm Hg
Fructose (5.6 %kcal)
1 0.12 (0.23) 0.29 (0.60) 0.19 (0.55) 0.29 (0.84)
2 0.92 (1.75) 0.73 (1.45) 0.56 (1.56) 0.44 (1.28)
3 1.69 (2.95) 1.07 (1.94) 1.00 (2.54) 0.62 (1.63)
4c (Mg) 1.10 (1.85) 0.83 (1.46) 0.76 (1.85) 0.59 (1.48)
Glucose (5.1 %kcal)
1 0.37 (0.72) 0.46 (0.93) 0.31 (0.88) 0.35 (1.04)
2 1.03 (1.96) 0.75 (1.51) 0.61 (1.69) 0.44 (1.27)
3 1.80 (3.14) 1.08 (1.98) 1.04 (2.65) 0.60 (1.59)
4 c (Mg) 1.14 (1.90) 0.81 (1.41) 0.78 (1.89) 0.57 (1.43)
Sucrose (9.8 %kcal)
1 -0.74 (-1.40) -0.27 (-0.55) 0.24 (0.66) 0.49 (1.43)
2 -0.02 (-0.04) 0.21 (0.41) 0.60 (1.63) 0.71 (2.02)
3 0.35 (0.61) 0.33 (0.60) 0.77 (1.99) 0.74 (1.97)
4 c (Mg) -0.45 (-0.76) -0.05 (-0.09) 0.52 (1.28) 0.74 (1.87)
Model 1: adjusted for age, gender, sample, special diet, supplement use, history of CVD/diabetes,
physical activity, family history of high BP. Model 2: adjusted for Model 1 variables + urinary Na,
urinary K, 14-day alcohol. Model 3: adjusted for Model 2 variables + dietary cholesterol, polyunsaturated
fatty acids, saturated fatty acids. Model 4c: adjusted for Model 3 variables + magnesium.
Z-score = regression coefficient/standard error; Z 1.96, uncorrected P 0.05; Z 2.58, uncorrected
P 0.01; Z 3.29, P 0.001.
No significant USA-UK difference detected, P <0.05.