Sugar-Sweetened Beverages and Cardiometabolic Health: How Strong is the Link?

Abstract

Sugary drinks, also categorized as sugar-sweetened beverages or soft drinks refer to any beverage with added sugar or other sweeteners (high fructose corn syrup, sucrose, fruit juice concentrates, and more). This include soda, pop, cola, tonic, fruit punch, lemonade (and other “ades”), sweetened powdered drinks, as well as sports and energy drinks. Sugar-sweetened beverages (SSBs) are a major source of added sugar in the diet. A robust body of evidence has linked habitual intake of SSBs with weight gain and a higher risk (compared with infrequent SSB consumption) of type 2 diabetes mellitus, cardiovascular diseases and some cancers, which makes these beverages a clear target for policy and regulatory actions. This review provides an update on the evidence linking SSBs to obesity, cardiometabolic outcomes and related cancers, as well as global trends in intake, alternative beverages and policy strategies targeting SSBs that have been implemented in different settings. Potential biological mechanism by which constituent sugars can contribute to these outcomes was also discussed. Strong evidence from cohort studies on clinical outcomes and clinical trials assessing cardiometabolic risk factors supports an aetiological role of SSBs in relation to weight gain and cardiometabolic diseases. Many populations show high levels of SSBs consumption and in low-income and middle income countries, increased consumption patterns are associated with urbanization and economic growth. More intensified policy efforts are required to limit intake of SSBs and the global burden of obesity and other chronic diseases.