Global health alarm

Sugary drinks are fueling the rise in diabetes and heart disease around the world. What must be done to limit its devastating effects?

study: Burden of type 2 diabetes and cardiovascular disease attributable to sugar-sweetened beverages in 184 countries. Image credit: Stokkete / Shutterstock

In a recent study published in the journal natural medicineAn international research team, including the Global Dietary Database collaboration, aims to reduce the global health burden associated with sugar-sweetened beverage (SSB) consumption, focusing on its contribution to type 2 diabetes (T2D) and cardiovascular disease (CVD). We investigated.

background

Excess consumption of sugar-sweetened beverages is recognized as a major dietary risk factor associated with non-communicable diseases such as T2D and CVD. Previous studies have emphasized that high intake of sugary drinks contributes to obesity, weight gain, impaired glucose metabolism, and an increased risk of these conditions.

Global dietary trends show that sugar-sweetened beverage consumption is increasing, particularly in low- and middle-income countries, but comprehensive assessments of population-level impacts remain limited. . Existing studies have identified an association between sugar-sweetened beverage consumption and cardiometabolic risk. However, detailed quantification of this association across diverse populations is lacking.

Moreover, important sociodemographic disparities related to age, gender, education, and urbanicity often remain unexplored. The study further highlights temporary trends, such as an increase in the burden due to SSBs, particularly in sub-Saharan Africa, from 1990 to 2020. Understanding these variations is important for estimating the disease burden attributable to sugar-sweetened beverage consumption and designing targeted public health strategies to address this growing health challenge.

About research

In this study, we conducted a comparative risk assessment to estimate the global burden of T2D and CVD attributable to sugar-sweetened beverage consumption. The framework integrates a variety of input parameters, including demographics, sugar-sweetened beverage intake distribution, and disease-specific risk factors.

The researchers used data from the Global Dietary Database, which covers 184 countries, and other reliable sources. This approach incorporates over 450 dietary surveys covering 2.9 million people, making it one of the most comprehensive datasets available. Inputs used in the analysis included population-level sugar-sweetened beverage consumption data, optimal intake levels derived from meta-analyses, and direct and body mass index (BMI)-mediated effects of sugar-sweetened beverages on disease risk. Included.

For dietary assessment, this study used individual-level survey data from a nationally representative sample. The researchers also employed a Bayesian hierarchical model to estimate average sugar-sweetened beverage intake across stratified demographic subgroups, accounting for variability and uncertainty. These estimates were expressed in standard serving sizes (8 ounces) and were adjusted for age, gender, education, and urbanicity.

Additionally, estimates of disease burden, including morbidity, mortality, and disability-adjusted life years (DALYs), are estimated using input data on background T2D and CVD rates from the 2019 and 2021 Global Burden of Disease surveys. was derived. Monte Carlo simulations assess uncertainty and provide robust 95% confidence intervals for all estimates. Risk estimates are based on established epidemiological evidence linking sugar-sweetened beverage consumption with T2D, ischemic stroke, and ischemic heart disease.

The researchers adjusted for the effects of potential confounders such as BMI and other sociodemographic factors. Age-specific relative risks were also calculated to reflect the influence of metabolic factors at different life stages.

result

The study found that sugar-sweetened beverage consumption significantly contributes to the global burden of T2D and CVD. In 2020, SSB intake was associated with 2.2 million new T2D cases (9.8% of all cases worldwide) and 1.2 million new CVD cases (3.1% of all cases). This study reveals that the health effects associated with sugar-sweetened beverage consumption vary considerably across regions, with a higher burden observed in countries with higher intakes and sociodemographic disparities. I did.

Globally, sugar-sweetened beverage consumption is associated with a significant proportion of T2D and CVD cases and accounts for significant disease incidence, mortality, and DALYs. Among adults aged 20 years and older, the burden of T2D is primarily driven by both the direct effects of sugar-sweetened beverages and their role in weight gain, the study found.

Additionally, cardiovascular effects were similarly influenced by weight changes associated with sugar-sweetened beverages and the direct etiological effects of sugar intake. For example, SSB contributed 12.5 million cardiometabolic DALYs in 2020, including 6.9% of all T2D-related DALYs and 3.0% of all CVD-related DALYs. This study showed that younger people and urban residents often have a higher relative burden than older people and rural residents, reflecting their sugar-sweetened beverage consumption patterns.

The attributable disease burden was particularly pronounced in countries with high sugar-sweetened beverage consumption, such as Mexico and the United States. Conversely, the impact was reduced in countries with lower consumption of sugar-sweetened beverages, highlighting the role of national dietary patterns in shaping health outcomes.

Notably, from 1990 to 2020, SSB-related T2D burden increased by 8.8 percentage points and CVD burden increased by 4.4 percentage points in sub-Saharan Africa, reflecting the rapid dietary changes occurring in the region. is emphasized.

The findings also revealed disparities based on gender, education, and urbanicity, highlighting the importance of targeted interventions. For example, people with lower educational attainment were more vulnerable to the negative effects of sugar-sweetened beverages, likely due to limited access to health information and resources.

Researchers developed a comprehensive understanding of the health risks associated with sugary drinks by incorporating both direct and BMI-mediated pathways. These findings draw attention to the urgent need for global and regional strategies, including public health campaigns and regulatory policies, to reduce sugar-sweetened beverage consumption and reduce its health impacts. Masu.

conclusion

Overall, the results highlight the significant global health burden of sugar-sweetened beverage consumption, particularly its contribution to T2D and CVD. The study highlights that targeted policies such as SSB taxes, front-of-pack labeling, and educational campaigns can significantly reduce these burdens. By quantifying these effects across diverse populations, the researchers highlighted the need for targeted public health interventions and policy measures to reduce sugar-sweetened beverage intake.

Addressing this preventable dietary risk can significantly reduce the world's growing burden of noncommunicable diseases, improve health outcomes, and reduce regional and demographic disparities. Immediate action is essential given the continuing rise in SSB-related burdens in low- and middle-income countries, particularly in sub-Saharan Africa.