Sugary drinks linked to high death toll for diabetes

Consumption of sugary drinks may lead to an estimated 184,000 adult deaths each year worldwide, according to research published in the journal Circulation.

Sugar-sweetened beverages (SSB) are a single, modifiable component of diet that can impact preventable death/disability in adults in high, middle, and low-income countries, according to the study authors, indicating an urgent need for strong global prevention programs. SSB are defined as sugar-sweetened sodas, fruit drinks, sports/energy drinks, sweetened iced teas, or homemade sugary drinks, such as frescas, that contained at least 50 kcal per 8-oz serving; 100% fruit juice was excluded.

In the first detailed global report on the impact of SSB, Tufts University researchers modeled global, regional, and national burdens of disease associated with SSB consumption by age and sex in 2010.

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“Many countries in the world have a significant number of deaths occurring from a single dietary factor, sugar-sweetened beverages. It should be a global priority to substantially reduce or eliminate sugar-sweetened beverages from the diet,” Dariush Mozaffarian, MD, DrPH, senior author of the study and dean of the Friedman School of Nutrition Science & Policy at Tufts University in Boston, said in a press release.

In 2010, the researchers estimate that SSB consumption may have been responsible for approximately:

• 133,000 deaths from diabetes

• 45,000 deaths from cardiovascular disease (CVD)

• 6,450 deaths from cancer

In the study, estimates of consumption were made from 62 dietary surveys including 611,971 individuals, conducted between 1980 and 2010 across 51 countries, along with data on national availability of sugar in 187 countries and other information. This allowed capture of geographical, gender and age variation in consumption levels of SSBs in different populations. Based on meta-analyses of other published evidence on health harms of SSBs, the investigators calculated the direct impact on diabetes and the obesity-related effects on CVD, diabetes and cancer.

“There are no health benefits from sugar-sweetened beverages, and the potential impact of reducing consumption is saving tens of thousands of deaths each year,” Mozaffarian said in the release.

Impact of SSBs varied greatly between populations. At the extremes, the estimated percentage of deaths was less than 1% in Japanese adults aged 65 years and older, but 30% in Mexican adults younger than 45 years of age.

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Of the 20 most populous countries, Mexico had the highest death rate attributable to SSBs with an estimated 405 deaths per million adults (24,000 total deaths) and the United States ranked second with an estimated 125 deaths per million adults (25,000 total deaths). About 76% of the estimated SSB-related deaths occurred in low- or middle-income countries.

In nations of the Caribbean and Latin America, such as Mexico, homemade sugary drinks (e.g. frescas) are popular and consumed in addition to commercially prepared sugar-sweetened beverages. Among the 20 countries with the highest estimated SSB-related deaths, at least eight were in Latin America and the Caribbean, reflecting the high intake in that region of the world.

Overall, in younger adults, the percent of chronic disease attributed to SSBs was higher than the percent in older adults.

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“The health impact of sugar-sweetened beverage intake on the young is important because younger adults form a large sector of the workforce in many countries, so the economic impact of sugar-sweetened beverage-related deaths and disability in this age group can be significant,” said Gitanjali Singh, PhD, lead author of the study and a research assistant professor at the Friedman School, in the press release.

Dr. Singh is concerned about the future. “If these young people continue to consume high levels as they age, the effects of high consumption will be compounded by the effects of aging, leading to even higher death and disability rates from heart disease and diabetes than we are seeing now,” he said.

The study was previously presented as an abstract at the American Heart Association Council on Epidemiology and Prevention in 2013.