Sugar-sweetened beverages linked with about three hundred and forty thousand deaths from type 2 diabetes and cardiovascular disease globally – Study

A study published in Nature Medicine evaluated the burden of type 2 diabetes and cardiovascular disease attributable to sugar sweetened beverages in 184 countries [1]. The study incorporated data from Global Dietary Database and was stratified by age, sex, educational attainment and urbanicity. In 2020, 2.2 million cases of new type 2 diabetes was attributable to sugar sweetened beverages worldwide, which was 9.8% of incident cases. In case of cardiovascular disease, the corresponding figure was 1.2 million, contributing to 3.1% of incident cases. Attributable cases were higher among men, younger adults and in those with higher education levels and in those in urban areas. A previous study published in 2010 had estimated that intake of sugar sweetened beverages were responsible for 184,000 deaths globally, of which 133,000 were from diabetes mellitus and 45,000 from cardiovascular disease.

It is well known that satiety levels are lower with sugar sweetened beverages as they are rapidly consumed and digested, leading to higher caloric intake and weight gain. High doses of glucose activates insulin and other regulatory pathways leading to visceral fat production, as well as hepatic and skeletal muscle insulin resistance. High doses of fructose can directly activate hepatic fat synthesis causing ectopic fat deposition and metabolic dysfunction in liver and muscle. Less quantities of healthier food may be consumed in the diet by those with higher intake of sugar sweetened beverages. Adiposity activates inflammatory cytokines, enhances risk of hypertension, dyslipidemia and diabetes mellitus. Inflammatory cytokines causing unstable plaques lead on to cardiovascular events [1].

Authors of the study under discussion [1] estimated that about 340,000 people died in 2020 from sugar sweetened beverages related type 2 diabetes and cardiovascular disease.

References

1. Lara-Castor L, O’Hearn M, Cudhea F, Miller V, Shi P, Zhang J, Sharib JR, Cash SB, Barquera S, Micha R, Mozaffarian D; Global Dietary Database. Burdens of type 2 diabetes and cardiovascular disease attributable to sugar-sweetened beverages in 184 countries. Nat Med. 2025 Jan 6. doi: 10.1038/s41591-024-03345-4. Epub ahead of print. PMID: 39762424.
2. Singh GM, Micha R, Khatibzadeh S, Lim S, Ezzati M, Mozaffarian D; Global Burden of Diseases Nutrition and Chronic Diseases Expert Group (NutriCoDE). Estimated Global, Regional, and National Disease Burdens Related to Sugar-Sweetened Beverage Consumption in 2010. Circulation. 2015 Aug 25;132(8):639-66. doi: 10.1161/CIRCULATIONAHA.114.010636. Epub 2015 Jun 29. PMID: 26124185; PMCID: PMC4550496.