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. 2023 Mar 15:10:1019534.
doi: 10.3389/fnut.2023.1019534. eCollection 2023.

Consumption of sugar sweetened beverages, artificially sweetened beverages and fruit juices and risk of type 2 diabetes, hypertension, cardiovascular disease, and mortality: A meta-analysis

Baoyu Li  1 , Ni Yan  1 , Hong Jiang  1 , Meng Cui  1 , Min Wu  1 , Lina Wang  1 , Baibing Mi  1 , Zhaofang Li  1 , Jia Shi  1 , Yahui Fan  1 , Mougni Mohamed Azalati  1 , Chao Li  1 , Fangyao Chen  1 , Mao Ma  2 , Duolao Wang  3 , Le Ma  1   4
Affiliations

Consumption of sugar sweetened beverages, artificially sweetened beverages and fruit juices and risk of type 2 diabetes, hypertension, cardiovascular disease, and mortality: A meta-analysis

Baoyu Li et al. Front Nutr. .

Abstract

Introduction: Sugar-sweetened beverage (SSB) intake is associated with an increased risk of cardiometabolic diseases. However, evidence regarding associations of artificially sweetened beverages (ASBs) and fruit juices with cardiometabolic diseases is mixed. In this study, we aimed to investigate the association between the SSB, ASB and fruit juice consumption with the incidence of cardiometabolic conditions and mortality.

Methods: Relevant prospective studies were identified by searching PubMed, Web of Science, Embase, and Cochrane Library until December 2022 without language restrictions. The pooled relative risk (RR) and 95% confidence intervals (CIs) were estimated for the association of SSBs, ASBs, and fruit juices with the risk of type 2 diabetes (T2D), cardiovascular disease (CVD), and mortality by using random-effect models.

Results: A total of 72 articles were included in this meta-analysis study. Significantly positive associations were observed between the consumption of individual beverages and T2D risk (RR: 1.27; 95% CI: 1.17, 1.38 for SSBs; RR: 1.32; 95% CI: 1.11, 1.56 for ASBs; and RR:0.98; 95% CI: 0.93, 1.03 for fruit juices). Moreover, our findings showed that intakes of SSBs and ASBs were significantly associated with risk of hypertension, stroke, and all-cause mortality (RR ranging from 1.08 to 1.54; all p < 0.05). A dose-response meta-analysis showed monotonic associations between SSB intake and hypertension, T2D, coronary heart disease (CHD), stroke and mortality, and the linear association was only significant between ASB consumption and hypertension risk. Higher SSB and ASB consumptions were associated with a greater risk of developing cardiometabolic diseases and mortality. Fruit juice intake was associated with a higher risk of T2D.

Conclusion: Therefore, our findings suggest that neither ASBs nor fruit juices could be considered as healthier beverages alternative to SSBs for achieving improved health.Systematic Review Registration: [PROSPERO], identifier [No. CRD42022307003].

Keywords: artificially sweetened beverages; cardiovascular disease; fruit juices; hypertension; mortality; sugar sweetened beverages; type 2 diabetes.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Screening and selection process of studies of SSB, ASB and fruit juice consumption and T2D, hypertension, CHD, stroke, and mortality risk. ASB, artificially sweetened beverage; CHD, coronary heart disease; SSB, sugar-sweetened beverage; T2D, type 2 diabetes.
Figure 2
Figure 2
Pooled relative risks of type 2 diabetes, hypertension, coronary heart disease, stroke and mortality comparing the highest with the lowest categories of sugar-sweetened beverage, artificially sweetened beverage and fruit juice consumption. ASB, artificially sweetened beverage; CHD, coronary heart disease; CVD, cardiovascular disease; SSB, sugar-sweetened beverage; T2D, type 2 diabetes.
Figure 3
Figure 3
Dose–response analysis for curvilinear association of sugar-sweetened beverages, artificially sweetened beverages, and fruit juices with type 2 diabetes (A–C), hypertension (D,E), coronary heart disease (F), stroke (G) and mortality (H,I). Circles represent point estimates plotted over precision measures. The solid line and the dotted lines represent the estimated relative risks and their 95% confidence intervals.
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References

    1. Global Food Research Program . (2022). Sugary drink taxes around the world. Chapel Hill. Available at: https://www.globalfoodresearchprogram.org/wp-content/uploads/2022/11/Sug...
    1. Backholer K, Blake M, Vandevijvere S. Sugar-sweetened beverage taxation: an update on the year that was 2017. Public Health Nutr. (2017) 20:3219–24. doi: 10.1017/S1368980017003329, PMID: - DOI - PMC - PubMed
    1. Guthrie JF, Morton JF. Food sources of added sweeteners in the diets of Americans. J Am Diet Assoc. (2000) 100:43–51. doi: 10.1016/S0002-8223(00)00018-3 - DOI - PubMed
    1. Azaïs-Braesco V, Sluik D, Maillot M, Kok F, Moreno LA. A review of total & added sugar intakes and dietary sources in Europe. Nutr J. (2017) 16:6. doi: 10.1186/s12937-016-0225-2, PMID: - DOI - PMC - PubMed
    1. Louie JC, Moshtaghian H, Rangan AM, Flood VM, Gill TP. Intake and sources of added sugars among Australian children and adolescents. Eur J Nutr. (2016) 55:2347–55. doi: 10.1007/s00394-015-1041-8, PMID: - DOI - PubMed

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