SSBs are the single largest source of added sugar in the US diet. It includes both carbonated and non-carbonated soft drinks, sports drinks, and fruit drinks that contain added caloric sweeteners such as fruit juice concentrates, sucrose, and high fructose corn syrup. Previous studies have shown SSBs intake to be associated with multiple adverse effects on health including weight gain, higher risk of type 2 diabetes, stroke, and coronary heart disease. However, only a few studies have examined the association between SSB intake and mortality.
Vasanti S. Malik, Chan School of Public Health, Boston, MA, and colleagues examined associations between SSBs and ASBs consumption with risk of total and cause-specific mortality. The study recruited 37 716 men from the Health Professional's Follow-up study (from 1986 to 2014) and 80 647 women from the Nurses' Health study (from 1980 to 2014) who were free from chronic diseases at baseline.
Key findings of the study include:
- The researchers documented 36 436 deaths (7896 cardiovascular disease [CVD] and 12 380 cancer deaths) during 3 415 564 person-years of follow-up.
- After adjusting for major diet and lifestyle factors, consumption of SSBs was associated with a higher risk of total mortality; pooled hazard ratios (95% confidence intervals) across categories (<1/mo, 1–4/mo, 2–6/week, 1-<2/d, and ≥2/d) were 1.00 (reference), 1.01 (0.98, 1.04), 1.06 (1.03, 1.09), 1.14 (1.09, 1.19), and 1.21.
- The association was observed for CVD mortality (hazard ratio comparing extreme categories was 1.31 and cancer mortality (1.16).
- ASBs were associated with total and CVD mortality in the highest intake category only; pooled hazard ratio across categories were 1.00 (reference), 0.96, 0.97, 0.98, and 1.04 for total mortality and 1.00 (reference), 0.93, 0.95, 1.02, and 1.13 for CVD mortality.
- In cohort-specific analysis, ASBs were associated with mortality in NHS (Nurses' Health Study) but not in HPFS (Health Professionals Follow-up Study).
- ASBs were not associated with cancer mortality in either cohort.
"Consumption of SSBs was positively associated with mortality primarily through CVD mortality and showed a graded association with dose. The positive association between high intake levels of ASBs and total and CVD mortality observed among women requires further confirmation," concluded the authors.
Lichtenstein AH. Circulation. 2019;doi:10.1161/CIRCULATIONAHA.119.040245.
Malik VS, et al. Circulation. 2019;doi:10.1161/CIRCULATIONAHA.118.037401.
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