Higher soft drink intake can put people at death risk, says study of over 400,000 men and women
Drinking a lot of soft drinks, those with sugar and the artificially sweetened ones, has now been associated with increased risk of overall death in a population-based study of nearly 452,000 men and women from 10 European countries.
According to the research team - drinking two or more glasses per day as compared with less than one glass per month of total soft drinks, sugar-sweetened soft drinks, and artificially sweetened soft drinks - was associated with “higher risk of death from all causes during an average follow-up of 16 years,” in which 41,693 people died. The researchers say that the results of this study are supportive of ongoing public health campaigns that are aimed at reducing the consumption of soft drinks.
“In this large multinational European study, a higher level of consumption of total, sugar-sweetened, and artificially sweetened soft drinks was associated with increased risk of death from all causes. The positive association between soft drink consumption and mortality was evident for both men and women,” says the study published in Jama Internal Medicine.
Previous studies have linked the high level of consumption of sugar-sweetened and artificially sweetened soft drinks to greater risks of obesity, type 2 diabetes, and cardiovascular disease. In 2010, the global burden of cardiovascular diseases (associated with obesity or being severely overweight), cancers, and type 2 diabetes linked with the consumption of sugar-sweetened soft drinks was estimated to be 184,000 deaths.
The current population-based study involved participants in the European Prospective Investigation into Cancer and Nutrition (EPIC), an ongoing, large multinational cohort of people from 10 European countries. The participants were from the UK, France, Germany, Greece, Italy, the Netherlands, Norway, Spain, Sweden, and Denmark. Information on soft drink consumption was collected via self-administered food questionnaires or during personal interviews at baseline from 1992 to 2000. Overall, 521,330 individuals were enrolled, of which 451,743 were included in the study. The researchers excluded participants who at baseline reported cancer, heart disease, stroke, and or diabetes, as well as those with missing soft drink consumption or follow-up information.
Soft drink consumption (grams per day), which is roughly equivalent to the amount in milliliters (where one glass was equal to approximately 250 ml) was calculated using typical glass sizes in each center.
The analysis shows that there were 41,693 deaths, which includes 18,302 men and 23,391 women. Of these deaths, says the study, 18,003 (43.2%) were from cancers, 9,106 (21.8%) from circulatory diseases, and 1,213 (2.9%) from digestive diseases.
According to the research team, greater consumption of total soft drinks and sugar-sweetened soft drinks (more than one glass daily as compared to less than one glass every month), but not artificially sweetened soft drinks, was associated with deaths from digestive disease. Similar associations were found for men and women, adds the team.
“A higher level of soft drink consumption was associated with a greater risk of death from digestive diseases, with a positive association only found for sugar-sweetened soft drinks. Hyperglycemia resulting from consumption of sugar-sweetened soft drinks may alter the gut-barrier function and increase the risk of enteric infection. Further, fructose, a sugar commonly used in soft drinks, promotes liver lipogenesis, which can lead to non-alcoholic fatty liver disease and lower insulin sensitivity,” the findings state.
As far as neurodegenerative diseases are concerned, the team observed that a higher level of total soft drink consumption was associated with a higher risk of Parkinson’s Disease deaths. “Total soft drink consumption was positively associated with risk of Parkinson’s disease mortality (more than one glass daily), with similar magnitude non-significant associations found for artificially sweetened and sugar-sweetened soft drinks. Soft drinks were not associated with Alzheimer's disease mortality. To our knowledge, this study is the first to link soft drink consumption with Parkinson's disease, and additional studies are required to examine this association,” the findings state.
The researchers also found a higher risk of death from circulatory diseases associated with drinking two or more glasses per day of total soft drinks, and artificially sweetened soft drinks.
The researchers did not find a link between total, sugar-sweetened, and artificially sweetened soft drink consumption with risk of deaths from overall cancer, breast cancer, or prostate cancer. However, the study found a positive association between higher level of consumption (more than one glass daily) of total soft drink with colorectal cancer deaths.
“To our knowledge, this study is the largest to date to investigate the association between soft drink consumption and mortality. Further studies are needed to investigate the possible adverse health effects of artificial sweeteners,” says the study.