Tuesday June 30 2015
Some brands can contain a surprisingly high amount of sugar
“Sugary drinks are killing 184,000 adults around the world every year, says study,” The Independent reports. This is the alarming claim of researchers who created a model of sugary drink-related deaths based on global consumption rates.
They defined sugary drinks as any sugar-sweetened fizzy drinks, fruit drinks (not pure fruit juice), sweetened iced teas, sports or energy drinks, or homemade sugary drinks. The model used a large amount of data on the consumption of sugary drinks from national surveys, and on the effect of sugary drink consumption on body mass index (BMI) and risk of diabetes, and the knock-on effect of BMI on heart disease, cancer and diabetes.
It estimated that sugary drinks caused around 133,000 deaths in adults per year globally from diabetes, with 45,000 from heart disease and 6,450 from cancer. In the UK, it estimated that 1,316 deaths per year were caused by sugary drinks – equivalent to about 30 people per one million adults.
As with any modelling study, results are based on the data available and some assumptions, which may or may not be correct. Therefore, these figures should be viewed as estimates, rather than exact numbers.
Most of us eat far too much sugar so cutting down can reduce your risk of a range of chronic diseases such as type 2 diabetes and obesity. Read more about how to cut down on sugar in your diet
Where did the story come from?
The study was carried out by an international group of researchers called the Global Burden of Diseases Nutrition and Chronic Diseases Expert Group (NutriCoDE). The work was part of the Global Burden of Diseases, Injuries, and Risk Factors Study, which was supported by the Bill & Melinda Gates Foundation. The first author received funding from the National Institute of Diabetes and Digestive and Kidney Diseases, and the National Heart, Lung, and Blood Institute, National Institutes of Health.
The study was published in the peer-reviewed medical journal Circulation.
The study was widely reported in the UK media and the reports were largely an accurate summary of the study’s findings. Most headlines focused on the overall figure that sugary drinks are estimated to be responsible for 184,000 deaths per year worldwide. A few of the headlines placed the focus on fizzy drinks, coke and lemonade, but the study covered the wider effect of any sugar-sweetened drinks. For example, the researchers also included data on fresca – a type of homemade sugary drink popular in Latin America.
What kind of research was this?
This was a modelling study that aimed to estimate how many deaths a year might be attributable to sugary drinks.
Drinking sugar-sweetened beverages (sugary drinks) has been linked to increased body fat and weight gain. Some studies have also suggested that they are linked to increased risk of diabetes, and not just as a result of their association with weight gain. The researchers say there have not been comprehensive estimates of the impact of sugary drinks on disease worldwide, and that their study aimed to provide these.
This type of study helps policymakers to get an idea of what the potential impact of changing or reducing a particular habit or behaviour might be.
What did the research involve?
The researchers obtained data on how many sugary drinks people consume, the link between sugary drink consumption and deaths from different causes, and deaths from these causes around the world. They then used this data to calculate how many deaths from specific causes in individual countries could be attributed to sugary drink consumption.
The researchers did a systematic review of data on sugary drink consumption in countries around the world. They defined sugar-sweetened beverages as:
- sugar-sweetened fizzy drinks (sodas)
- fruit drinks
- sports or energy drinks
- sweetened iced tea
- homemade sugar-sweetened drinks
The drinks also had to have at least 50 calories per eight ounce serving to be included. Pure (100%) fruit juice was not included as a sugar-sweetened beverage. They identified 62 surveys carried out from 1980 to 2010 assessing sugary drink consumption in 51 countries, in almost 612,000 people. They also included data for 187 countries from the United Nations Food and Agriculture Organization (FAO). The researchers used various methods to try to make the data comparable and representative of sugary drink consumption in 2010.
They used data on the association between sugary drink consumption and increased BMI from the statistical pooling of three large US cohort studies. They say these results were generally consistent with results from pooling other cohort studies, short-term trials of adding sugary drinks to the diet, and trials in children where sugary drink intake was reduced. They similarly obtained data on the association between sugary drink consumption and diabetes risk (eight cohort studies pooled with almost 311,000 participants), and between BMI and heart and blood system (cardiovascular) disease, diabetes and cancer (163 international cohorts, with 2.43 million people).
They also assessed whether their approach might overestimate the effects of sugary drinks, due to the estimates coming from cohort studies, which might be affected by confounding.
Finally, the researchers used data on causes of death for 187 countries from 1980 to 2010. They used all of this information in their model to estimate how many deaths of each type in the individual countries in 2010 could be attributed to sugary drink consumption.
What were the basic results?
In 2010, adults worldwide drank an average of about half a serving of sugary drink per day. The amount consumed varied by gender, age and region.
The study estimated that internationally, 184,000 deaths per year were attributable to sugary drink consumption. This included:
- 133,000 from diabetes
- 45,000 from cardiovascular disease
- 6,450 from cancers
Overall, this was about 1.2% of the diabetes, cardiovascular and cancer deaths worldwide. When looking at individual countries and age groups, this proportion varied. It was lowest in Japanese adults aged over 65 (less than 1% of deaths), and highest in Mexicans aged under 45 (30% of deaths).
The majority of the deaths (70.9%) occurred in middle-income countries, with 24.1% in high-income countries and 5% in low-income countries.
How did the researchers interpret the results?
The researchers concluded that sugary drinks are a part of the diet that can be changed, and this could reduce preventable deaths. They say that this “indicat[es] an urgent need for strong global prevention programs”.
This study estimated that 184,000 deaths per year worldwide in adults are caused by the consumption of sugary drinks. These results do not mean that individual people can be identified whose deaths are specifically attributable to sugary drinks alone. Instead, they estimate how many deaths in the population could be prevented if sugary drinks were not consumed at all.
The study used a large amount of data from individual countries on sugary drink consumption. It also used pooled estimates from large cohort studies of the impact of these drinks on people’s BMI and risk of diabetes, and impact of BMI on other diseases. In cohort studies, other factors may be contributing to the links seen. However, long-term randomised controlled trials looking at the effects of sugary drinks on risk of disease or death are unlikely to be feasible, or ethical. Therefore, cohort studies are likely to be the best evidence available.
As many different factors contribute to a person’s health and risk of death, it can be difficult to separate out the impact of a single factor. Therefore, it is possible that the effects of sugary drinks used are overestimates. The researchers did carry out some analyses to test this, and their findings suggested that their results were not overestimating the effects of these drinks compared to other dietary components.
This type of study is a standard way that public health professionals and policymakers estimate the impact of individual factors on deaths overall. They use this information to identify how they could reduce the burden of disease in the population they are responsible for. As such, this study is likely to be of interest to policymakers globally.
Sugary drinks contain calories. If we consume more calories than we burn off, we will gain weight. Being overweight or obese is linked to increased risk of a range of diseases, including heart disease and cancer. If you are overweight or obese and consume sugary drinks, reducing the amount you drink or cutting them out completely is one way of cutting down your calorie intake.