Sugar-Sweetened Beverages and Cardiometabolic Health: An Update of the Evidence

Abstract

Sugar-sweetened beverages (SSBs) have little nutritional value and a robust body of evidence has linked the intake of SSBs to weight gain and risk of type 2 diabetes (T2D), cardiovascular disease (CVD), and some cancers. Metabolic Syndrome (MetSyn) is a clustering of risk factors that precedes the development of T2D and CVD; however, evidence linking SSBs to MetSyn is not clear. To make informed recommendations about SSBs, new evidence needs to be considered against existing literature. This review provides an update on the evidence linking SSBs and cardiometabolic outcomes including MetSyn. Findings from prospective cohort studies support a strong positive association between SSBs and weight gain and risk of T2D and coronary heart disease (CHD), independent of adiposity. Associations with MetSyn are less consistent, and there appears to be a sex difference with stroke with greater risk in women. Findings from short-term trials on metabolic risk factors provide mechanistic support for associations with T2D and CHD. Conclusive evidence from cohort studies and trials on risk factors support an etiologic role of SSB in relation to weight gain and risk of T2D and CHD. Continued efforts to reduce intake of SSB should be encouraged to improve the cardiometabolic health of individuals and populations.

Sugar-Sweetened and Diet Beverage Consumption in Philadelphia One Year after the Beverage Tax

“…Sugar-sweetened beverages (SSB) are significant sources of added sugar and calories in the American diet [1,2]. High consumption of SSB is associated with increased risk of obesity, type 2 diabetes, cardiovascular disease and other health problems [3][4][5][6][7][8]. Reasons for high consumption include the low price of SSB relative to healthier beverages, high availability, and aggressive marketing [9][10][11].…”

Time and Age Trends in Free Sugar Intake from Food Groups among Children and Adolescents between 1985 and 2016

“…A high dietary sugar intake is thought to contribute to the development of several diseases such as dental caries [1], overweight and obesity [2][3][4][5], cardiovascular diseases [6][7][8] or metabolic syndrome [9]. With the recent shift towards food-based recommendations, evidence has emerged regarding the relevance of specific food source of sugar for health outcomes [10][11][12][13][14][15][16].…”

Sugar-sweetened beverage and sugar intake during adolescence and risk of colorectal cancer precursors: a large prospective U.S. cohort study

“…61 Fructose in whole fruits is slowly digested due to fiber content and the need to disrupt cell structure, facilitating gradual and complete intestinal clearance. 10 In contrast, rapid flux of liquid fructose from fruit juice may exceed small intestine uptake capacity, resulting in fructose overflow to the liver and colon. 10 61 62 We also found stronger associations among women with unhealthy (low prudent and high western) dietary patterns during adolescence than those with healthy patterns.…”

“…5 6 Sugar-sweetened beverages (SSBs) include carbonated and noncarbonated soft drinks, fruit drinks, and sports drinks, mostly sweetened with high-fructose corn syrup (first marketed in the early 1970s; usually 55% fructose and 45% glucose) or sucrose (table sugar; half fructose and half glucose). [7][8][9] SSB intake is markedly increasing worldwide, particularly in developing countries, 10 with concomitant increase in fructose and added sugar intake. 9 In 53 low-and middle-income countries, 54% of adolescents aged 12-15 years consumed carbonated soft drinks at least once per day.…”