Consumption of sugar sweetened beverages, artificially sweetened beverages and fruit juices and risk of type 2 diabetes, hypertension, cardiovascular disease, and mortality: A meta-analysis

Abstract

IntroductionSugar-sweetened beverage (SSB) intake is associated with an increased risk of cardiometabolic diseases. However, evidence regarding associations of artificially sweetened beverages (ASBs) and fruit juices with cardiometabolic diseases is mixed. In this study, we aimed to investigate the association between the SSB, ASB and fruit juice consumption with the incidence of cardiometabolic conditions and mortality.MethodsRelevant prospective studies were identified by searching PubMed, Web of Science, Embase, and Cochrane Library until December 2022 without language restrictions. The pooled relative risk (RR) and 95% confidence intervals (CIs) were estimated for the association of SSBs, ASBs, and fruit juices with the risk of type 2 diabetes (T2D), cardiovascular disease (CVD), and mortality by using random-effect models.ResultsA total of 72 articles were included in this meta-analysis study. Significantly positive associations were observed between the consumption of individual beverages and T2D risk (RR: 1.27; 95% CI: 1.17, 1.38 for SSBs; RR: 1.32; 95% CI: 1.11, 1.56 for ASBs; and RR:0.98; 95% CI: 0.93, 1.03 for fruit juices). Moreover, our findings showed that intakes of SSBs and ASBs were significantly associated with risk of hypertension, stroke, and all-cause mortality (RR ranging from 1.08 to 1.54; all p < 0.05). A dose-response meta-analysis showed monotonic associations between SSB intake and hypertension, T2D, coronary heart disease (CHD), stroke and mortality, and the linear association was only significant between ASB consumption and hypertension risk. Higher SSB and ASB consumptions were associated with a greater risk of developing cardiometabolic diseases and mortality. Fruit juice intake was associated with a higher risk of T2D.ConclusionTherefore, our findings suggest that neither ASBs nor fruit juices could be considered as healthier beverages alternative to SSBs for achieving improved health.Systematic Review Registration: [PROSPERO], identifier [No. CRD42022307003].

Diet strategies for promoting healthy aging and longevity: An epidemiological perspective

“…Overall evidence suggests that carbohydrate quality plays a more important role in chronic disease outcomes than carbohydrate amount. A series of systematic reviews and meta-analyses of data from large cohort studies have shown that high glycemic index or glycemic load diets (often containing higher amounts of refined grains, such as white rice and white bread, starchy foods such as potatoes, and sugar-sweetened beverages [SSBs]), are consistently associated with increased risk of weight gain, obesity, diabetes, CVD, some cancers, and mortality [60][61][62][63][64], whereas minimally processed grains, legumes, whole fruits, and non-starchy vegetables are protective against these conditions [65][66][67][68]. In a recent longitudinal analysis of changes in carbohydrate intake and long-term weight gain in the NHS and HPFS, increasing dietary glycemic index, glycemic load, and amounts of starch, added sugars, refined grains, and starchy vegetables was associated with greater midlife weight gain.…”

Consumption of sugar-sweetened and artificially sweetened beverages and prevalence of hypertension in adults: a population- based study

“…In a meta-analysis of prospective studies, the consumption of sugar-sweetened beverages and artificially sweetened beverages was associated with a 12% and 14% increased risk of hypertension, respectively, indicating a positive and linear dose-response relationship between the consumption of these beverages and the risk of hypertension 12 .…”

Comparative network pharmacology of artificial sweeteners to understand Its health consequences

“…Despite safety evaluations, several studies suggest potential health risks associated with chronic consumption of ASwt. A WHO systematic review 3 revealed that replacement of ASwt with sugar does not provide a means for weight management in the long-term, and several studies have discovered a positive correlation between long term ASwt consumption and risk of developing cardiovascular disease [5][6][7][8] , type 2 diabetes mellitus 6,[8][9][10][11] , and mortality in adults 6,8,9,12 . Current literature also reveals other concerning associations between ASwt consumption and various routinely observed clinical conditions, including heightened risks of developing cancer [13][14][15] , chronic kidney disease 16,17 , adiposity related diseases 8,9,18,19 , as well as non-alcoholic fatty liver disease 20 .…”

“…While regulatory bodies generally consider ASwt safe at recommended intake levels, some observational studies suggest an association between high ASwt consumption and an increased risk of CVD. [5][6][7][8] This study did reveal potential interactions between ASwt, particularly As and Su, with cellular targets (CAPN1, LTA4H, MKNK2, ITGA2, and HDAC1) involved in various physiological processes. Notably, some of these targets are linked to functions relevant to CVD development.…”