Sugar-Sweetened and Artificially Sweetened Beverages Consumption and Risk of Cardiovascular Health

Am J Med. 2023 Feb;136(2):163-171. doi: 10.1016/j.amjmed.2022.10.003. Epub 2022 Oct 14.

Abstract

Introduction: Sugar-sweetened and artificially sweetened beverages are routinely consumed worldwide. Given their popularity, there has been much debate about the effect that these beverages have on cardiovascular health. We sought to determine the exact relationship between sugar-sweetened and artificially sweetened beverages consumption on cardiovascular health.

Methods: All studies that reported an association between sugar-sweetened/artificially sweetened beverages consumption and cardiovascular health were extracted from database inception to September 2022 using keywords from several databases. We used the DerSimonian & Laird random-effects method for the analysis.

Results: Of the total 16 prospective studies, 1,405,375 individuals were followed for a median follow-up of 14.8 years. Compared with low sugar-sweetened and artificially sweetened beverage consumption, a higher consumption of sugar-sweetened and artificially sweetened beverages was associated with greater cardiovascular outcomes (hazard ratio [HR] of 1.27, 95% confidence interval [CI] of 1.16-1.40 and risk ratios of 1.16, 95% CI of 1.02-1.33). Similarly, compared with low artificially sweetened beverages consumption, a higher consumption of artificially sweetened beverages was associated with greater cardiovascular outcomes (HR of 1.32, 95% CI of 1.12-1.57). Likewise, compared with low sugar-sweetened beverages consumption, a higher consumption of sugar-sweetened beverages was associated with greater cardiovascular outcomes (HR of 1.21, 95% CI of 1.07-1.37 and risk ratios of 1.22, 95% CI of 1.09-1.35).

Conclusions: Increasing consumption of sugar-sweetened and artificially sweetened beverages may be correlated with an increased risk of developing cardiovascular/vascular complications and mortality, albeit without causality of cardiovascular/vascular morbidity.

Keywords: Artificially sweetened beverages; Sugar-sweetened beverages.

MeSH terms

  • Artificially Sweetened Beverages / adverse effects
  • Beverages / adverse effects
  • Humans
  • Prospective Studies
  • Risk Factors
  • Sugars* / adverse effects
  • Sweetening Agents* / adverse effects

Substances

  • Sugars
  • Sweetening Agents