Association between soft drink consumption and cardiovascular disease risk among Brazilian adults: a cross-sectional study

Abstract

Background: Inadequate diet is considered a major risk factor for chronic noncommunicable diseases and mortality. Among the ultra-processed foods, sweetened soft drinks are significant contributors to high-calorie diets and are associated with adverse health outcomes.

Objective: To estimate the association between soft drink consumption and the risk of cardiovascular events.

Design and setting: A cross-sectional study was conducted using data of adults aged ≥ 18 years from the 2013 National Health Survey.

Methods: The explanatory variable was the daily consumption of sugar-sweetened soft drinks. Cardiovascular risk (CVR) was calculated using the Framingham score. Multinomial logistic regression was used for the analyses. Two models were used: one adjusted for age and body mass index and the other for age and waist circumference. Both models were applied to the general population and stratified by race and educational attainment.

Results: The study sample consisted of 8,391 participants. Individuals with sugary soda consumption ≥ 0.4 cups/day were associated with a higher CVR, which escalated with increasing consumption of soft drinks.

Conclusions: CVR was observed across all consumption categories and difference in risk was based on the intake quantity.

Figure 1. Odds ratio and 95% confidence interval for medium/high cardiovascular risk according to the consumption of daily servings of sweetened soft drinks in the Brazilian population. National Health Survey, 2013.

Figure 2. Conditional probability of low, medium, and high cardiovascular risk scores according to soft drink consumption levels, adjusted for body mass index and age. National Health Survey, 2013.