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Sugary beverages increase mortality risk in older adults
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Middle-aged and older adults who consumed high quantities of sugary beverages had an increased risk for all-cause and CHD-related mortality compared with those who consumed fewer sugary beverages, according to a poster presented at the American Heart Association’s Epidemiology and Prevention | Lifestyle and Cardiometabolic Health Scientific Sessions.
“While our results suggest greater risk of early heart disease death among the highest adult consumers of sugary beverages, high levels of consumption begin for many during childhood,” Jean A. Welsh, PhD, MPH, assistant professor at Emory University and research director for Children’s Healthcare of Atlanta, told Cardiology Today. “Parents of young children are advised to delay the introduction of sugary beverages among their very young children, and to encourage limits on consumption among older children.”
Researchers analyzed data from 13,440 patients from the REGARDS study aged at least 45 years. Those with a history of CVD or diabetes at the beginning of the study were excluded.
Food frequency questionnaires were used to collect information on the consumption of sugary beverages and sweets. Sugary beverages included soft drinks, fruit-flavored drinks and fruit juices. Sweets included candy, desserts and sweetened breakfast foods/pastries and soft drinks.
After adjusting for behavioral, sociodemographic and weight status risk factors (age, BMI, sex, income, region, smoking, alcohol consumption and physical activity), HRs at follow-up (mean 6.9 years) increased for CHD, CVD and all-cause mortality with increasing consumption of sugary beverages. Patients in the highest quartile vs. lowest quartile had increased risk for CHD-related mortality (HR = 2; 95% CI, 1.1-3.58) and all-cause mortality (HR = 1.2; 95% CI, 0.99-1.5). Results for those in the second and third quartiles suggest a dose response with increasing intake. The risk for mortality did not increase with increased consumption of sweets.
“More research [is needed] to identify the strategies that work best to ensure that the intake of sugary beverages remains within recommended limits, and to determine what individual, behavioral and environmental factors [that] may modify the association between high consumption and heart disease risk,” Welsh said in an interview. – by Darlene Dobkowski
Reference:
Collin L, et al. Abstract P235. Presented at: American Heart Association’s Epidemiology and Prevention | Lifestyle and Cardiometabolic Health Scientific Sessions; March 20-23, 2018; New Orleans.
Disclosures: The authors report no relevant financial disclosures.
Editor’s Note: This article was updated on March 28, 2018 to reflect newer data.
Perspective
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Jo Ann S. Carson, PhD, RN
These findings add to a small number of studies that link sugar intake to CVD (in this case, sugar-sweetened beverages in particular). This study is a beneficial addition to our current knowledge because it represents some of the ethnic diversity of the U.S.
Since this was a poster session presented at the AHA Epidemiology and Lifestyle Sessions in New Orleans, it is important to note this is not yet a published study where all the details have undergone rigorous peer review. However, it does support the current recommendations from the AHA that in order to consume a dietary pattern of heart-healthy foods, we should limit our intake of added sugar. Those limits are nine teaspoons of added sugar for adult men and six teaspoons of added sugar for adult women and children above the age of 2 years.
In the perfect world, we could do a randomized controlled trial in which one group was told to limit sugar-sweetened beverage intake and the other group allowed to continue its use, then evidence of CHD could be measured. However, that would be a very expensive study.
In this study, dietary intake was assessed in older individuals. We do not know how sugar-sweetened beverage intake varied over their lifetime. It would be valuable to analyze data in which intake of added sugar from various sources was carefully assessed multiple times across time in an ethnically diverse group of Americans, beginning at an earlier age.
This is an observational study, so it is not feasible to be certain that it is the sugar-sweetened beverages alone, or a general pattern of dietary intake common among those who drink lots of sugar-sweetened beverages that may contribute to a decline in heart health.
Although this study reported that sugar-sweetened beverages, but not sugar added to foods, was associated with CV deaths, one should not assume that abundant intake of sweet foods would not increase CVD risk. In a population study like this one, it is easier to observe the effect of soda or sweet tea that some consume very consistently as contrasted with any relationship with a wide variety of cakes, candies, and other sweets. About half of our added sugar intake in the U.S. comes from beverages.
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