We estimated the adjusted HRs by comparing the middle values of each quintile (Q) with the lowest quintile as reference (Q5, Q4, Q3, and Q2
vs Q1).35, 38 To examine the association between added sugar intake and CVD mortality by different cut points, ie, less than 10 % by the World Health Organization (in line with the American Heart Association's recommendation) 4,5 and less than 25 % by the Institute of Medicine, 3 we estimated the adjusted HRs by comparing participants who
consumed 25 % or more, more than 10 %, and less than 25 % of their
calories from added sugar with those who
consumed less than 10 % of their
calories from added sugar.