According to a new study, sugary drinks may leave a sour taste, given their possible impact on mortality. “This is a public health crisis requiring urgent action,” said the study’s senior author, Dr. Dariush Mozaffarian, a cardiologist and director of the Food, Medicine Institute at Tufts University.
The study, published Monday in the journal Nature Medicine, analysed global data on sugar-sweetened beverages consumed worldwide, observational and randomized studies, and diabetes and cardiovascular disease prevalence.
With the evidence, researchers created a comparative risk model and estimated that sugary drinks “cause more than 330,000 annual deaths from diabetes and cardiovascular disease,” Mozaffarian said.
The problem is particularly serious in Latin America and the Caribbean, which had the largest number of cardiovascular disease cases related to beverages, and sub-Saharan Africa, which also had the most cases of type 2 diabetes from sugary drinks, he added, based on the researchers’ model.
Toby Smithson, a registered dietitian nutritionist, a fellow of the Academy of Nutrition and Dietetics, and senior manager of nutrition and wellness at the American Diabetes Association, said the study also examined the demographics of those most affected by sweetened drinks—namely, younger male adults with higher education in urban areas. She was not involved in the study.
“It’s time to pay attention to and take priority actions to deal with this tragic, preventable suffering,” Mozaffarian said in an email.
Why liquid sugar is so fast-acting
Because the study did not test a behaviour or intervention against a control group, the new study’s researchers can’t say that sugar-sweetened beverages are causing diabetes and cardiovascular disease; they can only estimate the impact.
The researchers collected valuable data across 184 countries. Still, the study did not factor in all income levels and the increased risk of diabetes and cardiovascular disease among high-risk ethnic groups, Smithson said.
However, Mozaffarian said the finding that sugary beverages are harmful makes sense, as many studies have shown a link between such drinks and poor health.
Smithson said that sugar-sweetened beverages have “empty calories”—or calories without any nutritional benefits. She added that they are also a source of fast-acting carbohydrates, which enter the bloodstream and raise blood sugar quickly.
Suzanne Janzi, a doctoral student in nutritional epidemiology at Lund University in Sweden, said in an earlier CNN article that these empty sugars in liquid form are even more harmful than those in desserts or sweet foods. Although she was not involved in the most recent research, she believes this is true.
“Liquid sugars are absorbed more rapidly in the digestive system since they do not require the same breakdown processes as solid foods,” Janzi said in an email. “Solid sugars are often part of foods that contain other nutrients like fibre, proteins, and fats.”
She said those nutrients slow digestion, meaning there is a more gradual release of sugar into the bloodstream.
While fats, fibre and proteins in solid food leave you feeling fuller longer, she added that liquid sugars often don’t fill you up, leading to appetite dysregulation and consuming too many calories.
“Different sources of added sugars also vary in their consumption patterns, which could further explain why they associate differently with cardiovascular disease risk,” Janzi said.
Are alternative sweeteners the answer?
What about drinks that are sweetened with something other than sugar? They might be better, but they aren’t the answer, Mozaffarian said.
“Growing research shows that natural and artificial low-calorie sweeteners are not innocuous and may cause health harms, so these should be considered a short-term, less harmful alternative, not a long-term solution,” he said.
For example, artificial sweeteners might be a good substitute in moderation for people with diabetes, who may be accustomed to sugary drinks, Smithson said.
“By providing a diabetes-friendly way to prepare foods people are used to eating, we can meet people where they are in offering support to manage their diabetes effectively,” she said.
But instead of relying on artificial sweeteners, Mozaffarian advises switching to unsweetened drinks, such as seltzer, unsweetened tea or coffee, or just plain water.
Hydration is important for managing blood pressure, blood sugar, internal temperature and digestion, Smithson said.
“The best hydrating beverage is water,” she said in an email. “If a person doesn’t like plain water, they can jazz up their beverage by drinking infused water with slices of lemon, lime, or fresh herbs, or using sparkling waters that contain no added sugar.”
