Sugar-Sweetened Beverages Significantly Linked to Type 2 Diabetes, Heart Disease

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A recent study revealed the global burden of sugar-sweetened beverages (SSBs) on health is significant. In 2020 alone, they were responsible for 2.2 million new type 2 diabetes cases (accounting for 9.8% of all cases) and 1.2 million new cardiovascular disease (CVD) cases (3.1% of all cases) globally. Men, younger adults, people with higher education levels and urban populations were disproportionately affected.

Investigators noted Latin America, the Caribbean and sub-Saharan Africa reported the highest proportional burdens. Between 1990 to 2020, sub-Saharan Africa saw the largest increases in SSB-attributable type 2 diabetes and CVD cases (8.8% and 4.4%, respectively).

“SSBs contribute to excess weight gain and cardiometabolic diseases such as type 2 diabetes and CVD, both directly and mediated by weight gain,” wrote a team of investigators including Laura Lara-Castor, Ph.D., a postdoctoral scholar at the Institute for Health Metrics and Evaluation and associated with the Food Is Medicine Institute at the Friedman School of Nutrition Science and Policy, Tufts University. “Despite progress in elucidating the role of SSBs in health, an updated and comprehensive assessment of the global disease burden attributed to SSBs remains scarce.”

SSBs are consumed and digested quickly due to their liquid form, which leads to lower satiety, a higher caloric intake and ultimately weight gain. Ingesting high doses of this type of glucose can also impact insulin and regulatory pathways, which can lead to insulin resistance, visceral fat production and weight gain. High doses of rapidly digested fructose can increase ectopic fat deposition and affect metabolic function in the muscle and liver.

Given the clear risks of overconsuming SSBs, investigators sought to estimate the burdens of cardiometabolic diseases from SSBs and the global changes over time. They also examined key sociodemographic factors because SBB intake and cardiometabolic risk can significantly vary by these influences within an individual nation. To accomplish this, SSB intakes from the Global Dietary Database were collected, including 450 surveys and encompassing data from 2.9 million people from 118 countries.

SSBs were defined as any beverage with added sugars and at least 50 calories per 8-ounce serving, such as soft drinks, energy drinks, punch, lemonade, fruit drinks and aguas frescas. This did not include 100% fruit and vegetable juices, artificially sweetened noncaloric beverages and sweetened milk.

In 2020, adults consumed 2.6 eight-ounce servings of SSBs per week on average. While the average was the lowest in South Asia (0.7), it increased to an average of 7.3 servings in general Latin America and the Caribbean. The average was even higher in Colombia (17.4 servings), South Africa (9.6 servings), Mexico (8.5 servings) and Ethiopia (6.9 servings). The lowest average of SSB consumption was in India, China and Bangladesh, with 0.2 servings per week.

Nations that consumed more SSBs were also more likely to have higher disease burden. For example, among the most populous countries included in the study, Mexico had the highest number of type 2 diabetes cases attributed to SSBs (2,007 per million adults), followed by Colombia (1,971 per million) and South Africa (1,258 per million). Similarly, the greatest number of new CVD cases were seen in Colombia (1,084 per million), South Africa (828 per million) and Mexico (721 per million).

SSBs were determined to cause 80,278 deaths from type 2 diabetes (5.1% of all diabetes-related deaths) and 257,962 deaths from CVD (2.1% of all CVD deaths).

“These findings emphasize the need for targeted interventions, accounting for social inequities and aligned with global health objectives,” investigators concluded. “While some policies to curb SSB intakes are currently in place in some countries, our study suggests that more work is needed.”