The most comprehensive review of the evidence on the health effects of sugar-sweetened beverages to date has reported that there is ‘compelling evidence’ that drinking too many sugar-sweetened beverages – which generally contain added-sugars in the form of high fructose corn syrup or sucrose – can lead to excess weight gain and a greater risk of developing type 2 diabetes and cardiovascular disease (CVD).
The paper, which reviewed data from recent epidemiological studies and meta-analyses of these studies, concludes that consuming one or two servings a day has been linked to: up to a 26% greater risk of developing type 2 diabetes, a 35% greater risk of heart attack or fatal heart disease, and a 16% increased risk of stroke.
Writing in the Journal of the American College of Cardiology, the team behind the review also call for more aggressive efforts to reduce consumption of products containing added sugar.
"Our findings underscore the urgent need for public health strategies that reduce the consumption of these drinks,” commented Professor Frank Hu of Harvard T.H. Chan School of Public Health – who led the review.
"Although reducing the consumption of sugar-sweetened beverages or added sugar alone is unlikely to solve the obesity epidemic entirely, limiting intake is one simple change that will have a measurable impact on weight control and prevention of cardio-metabolic diseases," Hu and his team concluded.
The review is part of a comprehensive Population Health Promotion issue of the Journal of the American College of Cardiology focusing on issues that broadly impact public health and the prevention of cardiovascular disease and related conditions.
In the new review Hu and his team summarise the epidemiological and clinical evidence for added sugars – and especially sugar sweetened beverages – for the risk of obesity, diabetes and CVD, and looks at the relevant biological mechanisms including investigating the unique role fructose may play in the development of these conditions.
The team noted that while the consumption of sugar-sweetened beverages has decreased moderately in the past decade, they are still the single greatest source of added sugar intake in the diet. Indeed, US data has shown that half of the population consumes these types of drinks every day, with one in four getting at least 200 calories per day from them and 5% consuming more than 500 calories per day – which is the equivalent of four cans of soda.
"This is particularly concerning as the research shows that consuming one or more sugar-sweetened beverages a day has been linked to greater weight gain and obesity in numerous published studies," said Hu. "Regular consumption of sugar-sweetened beverages can lead to weight gain because the liquid calories are not filling, and so people don't reduce their food intake at subsequent meals."
The researchers point out that since fructose and glucose typically travel together in sugar-sweetened beverages and foods, it is important to reduce total amounts of added sugars, especially in the form of sugar-sweetened beverages. They outline a number of alternatives to sugar-sweetened beverages that include water, coffee, and tea.
Hu added that while artificially sweetened drinks may be preferable to sugary drinks in the short-term, further studies are needed to evaluate their long-term health effects.
He commented that additional research is also needed to explore the health effects of different types of sugars and how liquid vs. solid forms of sugar affect the body.
However, Hu warned that there is already sufficient evidence to support the need for more aggressive public policy interventions to help reduce consumption of sugar-sweetened beverages.
Source: Journal of the American College of Cardiology
Volume 66, Issue 14, Pages 1615-1624, doi: 10.1016/j.jacc.2015.08.025
“Fructose and Cardiometabolic Health: What the Evidence From Sugar-Sweetened Beverages Tells Us”
Authors: Vasanti S. Malik; Frank B. Hu