Sugary Drinks Linked to High Death Tolls Worldwide

“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,” said Dariush Mozaffarian, M.D., Dr.P.H., senior author of the study and dean of the Friedman School of Nutrition Science & Policy at Tufts University in Boston.

In the first detailed global report on the impact of sugar-sweetened beverages, researchers estimated deaths and disabilities from diabetes, heart disease, and cancers in 2010. In this analysis, sugar sweetened beverages were defined as any 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 8oz serving. 100 percent fruit juice was excluded.

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 sugar-sweetened beverages in different populations. Based on meta-analyses of other published evidence on health harms of sugar-sweetened beverages, the investigators calculated the direct impact on diabetes and the obesity-related effects on cardiovascular disease, diabetes and cancer.

In 2010, the researchers estimate that sugar-sweetened beverages consumption may have been responsible for approximately:• 133,000 deaths from diabetes• 45,000 deaths from cardiovascular disease• 6,450 deaths from cancer

“Some population dietary changes, such as increasing fruits and vegetables, can be challenging due to agriculture, costs, storage, and other complexities. This is not complicated. 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.

The impact of sugar-sweetened beverages varied greatly between populations. At the extremes, the estimated percentage of deaths was less than 1 percent in Japanese over 65 years old, but 30 percent in Mexican adults younger than 45. Of the 20 most populous countries, Mexico had the highest death rate attributable to sugar-sweetened beverages with an estimated 405 deaths per million adults (24,000 total deaths) and the U.S. ranked second with an estimated 125 deaths per million adults (25,000 total deaths).

About 76 percent of the estimated sugar-sweetened beverage-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 sugar-sweetened beverage-related deaths, at least 8 were in Latin America and the Caribbean, reflecting the high intakes in that region of the world,” said Gitanjali Singh, Ph.D., lead author of the study and a research assistant professor at the Friedman School.

Overall, in younger adults, the percent of chronic disease attributed to sugar-sweetened beverages was higher than the percent in older adults. “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. It also raises concerns 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,” Singh said.

Other co-authors are Renata Micha, Ph.D.; Shahab Khatibzadeh, M.D.; Stephen Lim, Ph.D.; and Majid Ezzati, Ph.D. Author disclosures are on the manuscript.Singh was supported by a training grant from the National Institute of Diabetes and Digestive and Kidney Diseases (DK007703) and a K00/R00 Pathway to Independence Award from the National Heart, Lung and Blood Institute (1K99HL124321). Initial data collection for this work was supported by a grant from The Bill & Melinda Gates Foundation to the 2010 Global Burden of Diseases study.

Singh GM, Micha R, Khatibzadek S, Lim S, Ezzati M, and Mozaffarian, D. “Estimated global, regional, and national disease burdens related to sugar-sweetened beverage consumption in 2010.” Circulation. Published online ahead of print 06-29-15. Doi:10.1161/CIRCULATIONAHA.114.010636.

About the Friedman School of Nutrition Science & Policy

For three decades, the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University has studied the relationship between good nutrition and good health in aging populations. Tufts research scientists work with federal agencies to establish the USDA Dietary Guidelines, the Dietary Reference Intakes, and other significant public policies. The Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy at Tufts University is the only independent school of nutrition in the United States. The school's eight degree programs – which focus on questions relating to nutrition and chronic diseases, molecular nutrition, agriculture and sustainability, food security, humanitarian assistance, public health nutrition, and food policy and economics – are renowned for the application of scientific research to national and international policy.