Sugar-Sweetened Beverages Linked to Increased Cardiovascular Disease Risk and Stroke

by | Jun 8, 2020 | 2020, Cardiovascular Health, Stroke, Sweeteners

Written by Joyce Smith, BS. Intake of equal to or greater than one serving per day of sugar-sweetened beverages was positively associated with CVD, revascularization and stroke.

sugarConsumption of sugar-sweetened beverages (SSBs) has been associated with a plethora of health problems. Included are weight gain, visceral adiposity and obesity 1,2, cardiometabolic risk factors and/or metabolic syndrome and type 2 diabetes, hypertension and cardiovascular disease (CVD) 3. SSBs account for almost half of the American daily sugar intake and provide 308 kcal /day or 17% of total energy (3). Many Americans do not heed the advice of the World Health Organization 4 or the American Heart Association 5 and almost 50% still drink at least one SSB daily.

Prospective studies have found associations between SSB intake and CVD, thus Pacheco and colleagues strove to examine the association between SSB consumption and CVD risk by examining incidence of CVD events including myocardial infarction (MI), revascularization, and stroke in an ongoing prospective cohort study (California Teachers Study 6. They analyzed data from 106,178 active and retired female teachers and administrators (mean age, 52 years) who were free from CVD and diabetes at baseline (1995-1996). Several questions in the self-administered food frequency questionnaires focused on sugar-sweetened beverage intake. Thus the participants were categorized into groups based on their SSB intake: rare or never (n = 43,425; mean age, 56 years), more than rare/never to less than one serving per week (n = 35,422; mean age, 50 years), one or more servings per week to less than one serving per day (n = 22,825; mean age, 49 years) and one or more servings per day (n = 4,506; mean age, 49 years). The incidence of CVD was defined as the first occurrence of revascularization procedure, fatal or nonfatal MI, or fatal or nonfatal stroke. Follow-up was conducted until participants were diagnosed with a CVD event, relocated or died.

During 1,807,182 person-years of follow-up, there were 8,848 incident cases of CVD, of which 2,889 were revascularization, 2,677 were MI and 5,258 were stroke.

Intake of equal to or greater than one serving per day of sugar-sweetened beverages was positively associated with CVD, revascularization and stroke. Compared with women who rarely or never consumed sugar-sweetened beverages, those who consumed one or more servings per day had a 19% increased risk for CVD (HR = 1.19; 95% CI, 1.06-1.34; P for trend = .016), 26% increased risk for first revascularization event (HR = 1.26; 95% CI, 1.04-1.54; P for trend = .037) and a 21% increased risk for stroke (HR = 1.21; 95% CI, 1.04-1.41; P for trend = .056) after adjusting for potential confounders. When considering increased risk by beverage type, a higher risk for CVD was also observed in women who consumed one or more servings of fruit drinks per day (HR = 1.42; 95% CI, 1-2.01; P for trend = .021) and caloric soft drinks (HR = 1.23; 95% CI, 1.05-1.44; P for trend = .0002) compared with those who rarely or never consumed these beverages.

Mechanisms of action whereby  SSB’s may affect  CVD risk include increased glycemic load due to increased bloodstream levels of glucose and insulin 7, and impaired glucose tolerance and insulin resistance due to increased appetite and weight gain 8, all of which promote triglyceride synthesis and increase CVD risk 9.

This study measured only SSB consumption, and ignored others sources including artificially sweetened beverages, diet soft drinks and sweetened hot beverages. As a prospective study, it could not measure SSB intake over time; however, it does highlight the importance of reducing SSB intake to achieve greater CVD risk reduction.

Source: Pacheco LS, Lacey JV Jr, Martinez ME, Lemus H, Araneta MRG, Sears DD, Talavera GA, Anderson CAM. Sugar-Sweetened Beverage Intake and Cardiovascular Disease Risk in the California Teachers Study. J Am Heart Assoc. 2020 May 18;9(10):e014883. doi: 10.1161/JAHA.119.014883

© 2020 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-No Derivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Click here to read the full text study.

Posted June 8, 2020.

Joyce Smith, BS, is a degreed laboratory technologist. She received her bachelor of arts with a major in Chemistry and a minor in Biology from  the University of Saskatchewan and her internship through the University of Saskatchewan College of Medicine and the Royal University Hospital in Saskatoon, Saskatchewan. She currently resides in Bloomingdale, IL.

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