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Sweetened beverage consumption and risk of cardiovascular mortality: A systematic review and meta-analysis
Akshaya Srikanth Bhagavathula1, Jamal Rahmani2, Kota Vidyasagar3
1Department of Social and Clinical Pharmacy, Faculty of Pharmacy at Hradec Kralove, Charles University, Hradec Kralove, Czech Republic.
Insights
High consumption of sweetened beverages (SB), including sugar-sweetened beverages (SSB) and artificial-sweetened beverages (ASB), significantly increases the risk of cardiovascular mortality. Reducing SB intake is crucial for public health.
Area of Science:
- Cardiovascular Health
- Nutritional Epidemiology
- Public Health
Background:
- Sweetened beverages (SB) are frequently consumed globally.
- Existing research suggests an association between SB and cardiovascular disease.
- The specific link between SB consumption and cardiovascular mortality requires further clarification.
Purpose of the Study:
- To systematically review and meta-analyze prospective cohort studies.
- To investigate the association between sweetened beverage consumption and cardiovascular mortality.
- To quantify the risk associated with different levels of SB intake.
Main Methods:
- Systematic literature search of PubMed/MEDLINE, Web of Science, and Embase up to July 31, 2021.
- Inclusion of prospective cohort studies in adults examining SB consumption and cardiovascular mortality.
- Pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated.
Main Results:
- Eight cohort studies with 1.2 million participants were analyzed.
- Consuming ≥2 glasses (250 ml/glass) of SB daily was associated with a 24% increased risk of cardiovascular mortality (RR: 1.24).
- Both sugar-sweetened beverages (SSB) and artificial-sweetened beverages (ASB) at ≥2 glasses/day significantly elevated cardiovascular mortality risk by 21% and 33%, respectively.
Conclusions:
- High intake of both SSB and ASB is linked to increased cardiovascular mortality.
- Public health strategies are needed to reduce sweetened beverage consumption worldwide.
- Interventions should target all population groups to mitigate cardiovascular risks.
Background And Aims:
Several studies have reported the association of sweetened beverages (SB) with cardiovascular disease. However, the relationship between SB and cardiovascular mortality has not been clearly established. This systematic review and meta-analysis investigated the association between SB consumption and cardiovascular mortality.
Methods:
PubMed/MEDLINE, Web of Science, and Embase were systematically searched up to July 31, 2021, for prospective cohort studies investigating this association in adults. Pooled relative risks (RRs) and 95% confidence intervals (CIs) were used to assess the strength of association between SB: sugar-sweetened beverages (SSB)/artificial-sweetened beverages (ASB) exposure and cardiovascular mortality.
Results:
A total of eight cohort studies comprising 1.2 million participants exposed to SB, reported 15,831 (1.2%) cases of cardiovascular mortality with a median follow-up of 12.2 years. Consuming at least one glass (250 ml) of SB per day (RR: 1.06; 95% CI: 1.00-1.12, P < 0.001) or ≥2 glasses per day (RR: 1.24; 95% CI: 1.16-1.31, P < 0.001) was significantly associated with increased risk of cardiovascular mortality. SSB and ASB intake of ≥2 glasses per day increased the risk of cardiovascular mortality by 21% (RR:1.21, 95% CI: 1.09-1.33, P < 0.001) and 33% (RR: 1.33, 95% CI: 1.12-1.55, P < 0.001), respectively.
Conclusions:
Our findings reveal that high SSB and ASB consumption are associated with an increased risk of cardiovascular mortality. Policymakers and public health practitioners should work on multisectoral strategies to reduce the consumption of sweetened beverages around the world and among all population groups.
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