Sugar-sweetened beverages and risk of hypertension and CVD: a dose–response meta-analysis

Abstract

A number of prospective cohort studies have investigated the associations between consumption of sugar-sweetened beverages (SSB) and the risk of hypertension, CHD and stroke, but revealed mixed results. In the present study, we aimed to perform a dose -response metaanalysis of these prospective studies to clarify these associations. A systematic literature search was conducted using the PubMed and Embase databases up to 5 May 2014. Random-or fixed-effects models were used to calculate the pooled relative risks (RR) with 95 % CI for the highest compared with the lowest category of SSB consumption, and to conduct a dose -response analysis. A total of six prospective studies (240 726 participants and 80 411 incident cases of hypertension) from four publications on hypertension were identified. A total of four prospective studies (194 664 participants and 7396 incident cases of CHD) from four publications on CHD were identified. A total of four prospective studies (259 176 participants and 10 011 incident cases of stroke) from four publications on stroke were identified. The summary RR for incident hypertension was 1·08 (95 % CI 1·04, 1·12) for every additional one serving/d increase in SSB consumption. The summary RR for incident CHD was 1·17 (95 % CI 1·10, 1·24) for every serving/d increase in SSB consumption. There was no significant association between SSB consumption and total stroke (summary RR 1·06, 95 % CI 0·97, 1·15) for every serving/d increase in SSB consumption. The present meta-analysis suggested that a higher consumption of SSB was associated with a higher risk of hypertension and CHD, but not with a higher risk of stroke.

Recommended Dietary Pattern to Achieve Adherence to the American Heart Association/American College of Cardiology (AHA/ACC) Guidelines: A Scientific Statement From the American Heart Association

“…Healthy beverage options such as water and fat-free or low-fat milk should be encouraged in place of SSBs. There is a robust body of evidence that SSB consumption is detrimental to health and has been associated with increased risk of CVD mortality, 58 hypertension, 59,60 liver lipogenesis, 61 T2DM, [62][63][64] obesity, and kidney disease. 65 Figure 3 illustrates the excessive intake of added sugars across the population.…”

Food Consumption and its Impact on Cardiovascular Disease: Importance of Solutions Focused on the Globalized Food System

“…The epidemiological relationships between SSB consumption, overweight, obesity, hypertension, and T2DM are strong (122). In a meta-analysis of prospective studies of SSB and hypertension, CHD, and stroke, the RR for a 1-serving increase in SSB/d was 1.17 (95 % CI 1.10, 1.24) for CHD and 1.08 (95% CI: 1.04 to 1.12) for incident hypertension, but no clear effect was seen for total stroke (RR 1.06, 95 % CI 0.97, 1.15) (123). A meta-analysis of seven cohort studies and five randomized controlled trials (RCTs) found SSB’s increased weight by 0.12 kg/serving/year (95% confidence interval [CI]: 0.10–0.14) in adults (124).…”

Two weeks of watermelon juice supplementation improves nitric oxide bioavailability but not endurance exercise performance in humans

“…The increase in resting heart rate after watermelon juice and placebo supplementation in this study is consistent with this interpretation. Given the increased stress placed on the cardiovascular system after watermelon juice consumption in this study, and the increase in coronary heart disease and hypertension morbidity associated with the consumption of sugar-sweetened beverages [59], longer term supplementation with a watermelon juice concentrate, at least in the form administered in this study, cannot be recommended.…”