Sugar sweetened beverages consumption and risk of coronary heart disease: a meta-analysis of prospective studies

Abstract

Objective: To summarize the evidence with respect to sugar sweetened beverages (SSBs) consumption and risk of coronary heart disease (CHD) and to recommend field standards for future analysis on this topic.

Methods: We searched for articles published up to February 2013 through PubMed, EMbase, and Cochrane Library Database and reviewed reference list of the retrieved articles. Prospective studies with reported relative risks (RRs) with 95% confidence intervals (CIs) of CHD for different categories of SSBs consumption were included. Random-effects models were used to evaluate the associations by comparing the highest and lowest categories of SSBs consumption in relation to risk of CHD.

Results: Four prospective studies with 7396 CHD cases among 173,753 participants were included in the meta-analysis. The pooled RR (95% CI) for CHD in the highest category of SSBs consumption in comparison with the lowest category of SSBs was 1.17 (1.07-1.28). Stratified analyses indicated a significant association for men but not for women, with pooled RRs (95%CI) of 1.17 (1.05-1.29) and 1.19 (0.94-1.50), respectively. For studies carried out in America, the pooled RR for CHD was 1.18 (1.07-1.30). Additionally, a one-severing per day increase in SSBs consumption was associated with a 16% increased risk of CHD (RR: 1.16, 95%CI: 1.10-1.23).

Conclusion: Our meta-analysis of four studies suggests that consumption of SSBs may increase risk of CHD, especially among men and American populations. However, this finding was based on limited studies; further studies are warranted to critically evaluate the relationship.

Keywords: Coronary heart disease; Meta-analysis; Sugar sweetened beverages.