By Robert Dillard -September 4, 2019
Consumption of total, sugar-sweetened, and artificially sweetened soft drinks is linked to all-cause mortality, according to the findings of a recent study published in JAMA Internal Medicine.
In this population-based cohort study, researchers assessed 451,743 (mean age, 51, 71% women) participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) – an ongoing, multinational cohort of individuals residing in 10 European counties (Denmark, France, Germany, Greece, Italy, the Netherlands, Norway, Spain, Sweden, and the United Kingdom), which recruited participants between January, 1992, and Decembe, 2000. Exclusion criteria was specified as any participants who reported cancer, heart disease, stroke, or diabetes at study baseline, and participants with with implausible dietary intake data, as well as those with missing soft drink consumption or follow-up information.
The study exposure was consumption of total, sugar-sweetened, and artificially sweetened soft drinks, and the key endpoints were total mortality and cause-specific mortality. Hazard ratios (HRs) and 95% CIs were estimated using multivariable Cox proportional hazards regression models adjusted for other mortality risk factors. The researchers performed data analyses from February 2018, to October 2018.
A Public Health Issue
The results showed that during a mean (range) follow-up of 16.4 (11.1 in Greece to 19.2 in France) years, 41, 693 deaths occurred. The researchers observed higher all-cause mortality among participants who consumed two or more soft drink glasses per day (vs consumers of <1 glass per month) of total soft drinks (hazard ratio [HR=1.17; 95% CI, 1.11 to 1.22; P < .001), sugar-sweetened soft drinks (HR=1.08; 95% CI, 1.01 to 1.16; P = .004), and artificially sweetened soft drinks (HR=1.26; 95% CI, 1.16to 1.35; P < .001). Moreover, the study found positive associations between artificially sweetened soft drinks and mortalities from circulatory diseases (≥2 glasses per day vs <1 glass per month; HR=1.52; 95% CI, 1.30 to 1.78; P < .001) and between sugar-sweetened soft drinks and deaths from digestive diseases (≥1 glass per day vs <1 glass per month; HR=1.59; 95% CI, 1.24to 2.05; P < .001).
“In this study, the high level of consumption of total, sugar-sweetened, and artificially sweetened soft drinks was associated with elevated risks of death from all causes,” the study authors wrote in their conclusion. “Positive associations were observed between sugar-sweetened soft drinks and digestive disease deaths as well as between artificially sweetened soft drinks and circulatory disease deaths.”
The authors added that further studies are necessary “to investigate the possible adverse health effects of artificial sweeteners. The results of this study are supportive of ongoing public health campaigns aimed at reducing the consumption of soft drinks.”