Association of Sugar-Sweetened Beverages and Cardiovascular Diseases Mortality in a Large Young Cohort of Nearly 300,000 Adults (Age 20–39)

Abstract

(1) Background: The association of sugar-sweetened beverages (SSBs) with cardiovascular disease (CVD) mortality in younger adults (age 20–39) is rarely mentioned in the literature. Younger adults are less vulnerable to CVDs, but they tend to consume more SSBs. This prospective study aimed to assess the association between CVD mortality and SSBs in younger adults between 1994 and 2017. (2) Methods: The cohort enrolled 288,747 participants consisting of 139,413 men and 148,355 women, with a mean age 30.6 ± 4.8 years, from a health surveillance program. SSBs referred to any drink with real sugar added, such as fructose corn syrup or sucrose. One serving of SSB contains about 150 Kcal of sugar in 12 oz of drink. Cox models were used to estimate the mortality risk. (3) Results: There were 391 deaths from CVDs in the younger adults, and the positive association with CVD mortality started when SSB intake was ≥2 servings/day (HR: 1.59, 95% CI: 1.16–2.17). With mortalities from diabetes and kidney disease added to CVDs, the so-called expanded CVD mortality risk was 1.49 (95% CI: 1.11–2.01). By excluding CVD risk factors (hypertension, diabetes, and smoking), the CVD mortality risk increased to 2.48 (95% CI: 1.33–4.62). The dose–response relationship persisted (p < 0.05 for trend) in every model above. (4) Conclusions: Higher intake of SSBs (≥2 servings/day) was associated with increased CVD mortality in younger adults. The younger adults (age 20–39) with SSB intake ≥2 servings/day had a 50% increase in CVD mortality in our study, and the mortality risk increased up to 2.5 times for those without CVD risk factors. The dose–response relationship between the quantity of SSB intake and the mortality risk of CVD in younger adults discourages SSB intake for the prevention of CVD mortality.

Plant-based diets, mediating biomarkers, and mortality risk among adults with diabetes or prediabetes

“…While higher seafood intake was associated with a lower mortality risk (regardless of diabetes status); in the present study, we did not find a significant relationship between sugar-sweetened beverages and morality risk, which is inconsistent with some previous studies. 23–25 On the other hand, we found several healthy plant foods ( e.g. , fruits, vegetables, legumes, nuts and tea) associated with a lower risk of all-cause mortality both in diabetes and in prediabetes, and these are in line with findings from previous large cohort studies conducted in the general populations.…”

A Review of Healthy Dietary Choices for Cardiovascular Disease: From Individual Nutrients and Foods to Dietary Patterns

“…Of note, the intake of SSBs is rising in low-and middle-income countries due to urbanization and beverage marketing [69]. Although no significant association between CVD mortality and SSB intake is found in a Chinese adult cohort in Singapore [70], a positive association of SSB intake (≥2 servings/day) with CVD mortality is observed in a Chinese younger adult cohort [71]. Thus, reducing intake of SSBs is important to improve overall diet quality and cardiometabolic health.…”

Gender-Specific Clustering of Lifestyle Behaviors and Its Impacts on Cardiovascular Health

“…Five unhealthy lifestyle behaviors were selected based on strong empirical evidence of cardiovascular behavioral risk factors and the population health context as described in the Introduction section: current smoking, 33 binge drinking, 34 physical inactivity, 35 insufficient fruit intake, 36 and SSB drinking. 37,38 Current smoking was defined as currently smoking every day or often, concomitantly with the criteria of having smoked at least 100 cigarettes over a lifetime, excluding those who E116 The Journal of Cardiovascular Nursing x July/August 2024 had never smoked and those who had quit smoking. 39 Binge drinking was defined as the consumption of 7 or more drinks for men and 5 or more drinks for women in 1 session once or more per week according to the criteria of the Korean Ministry of Health and Welfare.…”

“…Five unhealthy lifestyle behaviors were selected based on strong empirical evidence of cardiovascular behavioral risk factors and the population health context as described in the Introduction section: current smoking, 33 binge drinking, 34 physical inactivity, 35 insufficient fruit intake, 36 and SSB drinking 37,38 . Current smoking was defined as currently smoking every day or often, concomitantly with the criteria of having smoked at least 100 cigarettes over a lifetime, excluding those who had never smoked and those who had quit smoking 39 .…”