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Articles April 2016 Issue

New Reasons to Skip Sugary Drinks

Sweetened beverages linked to heart failure and dangerous belly fat.

IMAGE © THINKSTOCK

Two new studies add to the evidence that led the latest Dietary Guidelines for Americans to recommend restricting intake of added sugars, nearly half of which in US diets come from sugar-sweetened beverages. (See Sugar Warnings Getting Through.) In one study, sweetened beverage consumption was significantly associated with greater risk of heart failure in more than 42,000 Swedish men. In another, sugary drink intake was associated with greater belly fat - a dangerous fat deposit that builds up around your organs, leading to increased risk of chronic diseases.

"These well-designed studies contribute to the growing evidence that sugar-sweetened beverage consumption may be harmful to our health, and this may be linked to gaining more visceral fat in our belly," says Nicola McKeown, PhD, director of the nutritional epidemiology program at Tufts' Friedman School and a co-author of the second study.

HEART FAILURE: The Swedish study, published in the journal Heart, looked at data on 42,400 men, ages 45 to 79, who were followed for nearly 12 years. During that timespan, 4,113 of the men were diagnosed with heart failure, a condition in which the heart can no longer keep up with the body’s demands. It’s estimated that about 5.1 million Americans suffer from heart failure, with a total of more than 23 million cases worldwide.

Study participants initially completed a questionnaire in which they were asked to report daily or weekly intakes of "soft drinks or sweetened juice drinks," with one serving defined as about seven ounces. The men were then assigned to four different categories of beverage consumption, with a fifth category assigned to those reporting zero intake. Those in the highest-consumption group reported drinking two or more servings of sweetened beverages daily.

Compared with men drinking no sweetened beverages, those in the highest-consumption group were 23% more likely to develop heart failure. Men who averaged a half-serving or one serving daily were at 8% and 9% greater risk of heart failure.

A weakness of the study is that the questionnaire asked about "soft drinks" and did not specifically separate artificially sweetened beverages from those sweetened with sugar or high-fructose corn syrup (HFCS). Given that previous observational studies have associated consumption of non-diet sweetened beverages with greater risk of heart disease and stroke, however, the findings should be one more reason to skip that sugary soda, energy drink or juice drink.

BELLY FAT: The second study, published in Circulation, did look specifically at sugar (or HFCS)-sweetened beverages, using food questionnaires. It grouped together both caffeinated and caffeine-free sodas, other carbonated beverages, and fruit punch, lemonade and other non-carbonated fruit drinks. Diet beverages were analyzed separately. One serving was defined as a single glass, bottle or can, or about 12 ounces.

Caroline Fox, MD, of the National Heart, Lung and Blood Institute, and colleagues looked at data on more than 1,000 middle-aged men and women participating in the Framingham Heart Study. Researchers measured changes in visceral adipose tissue - belly fat that surrounds your organs - over six years.

"What is important to recognize is that visceral adipose tissue is more dangerous than fat elsewhere in the body," says Tufts' McKeown. It has been associated with greater risk of metabolic syndrome, cardiovascular disease and prostate, breast and colorectal cancers.

FREQUENCY LINKED TO FAT: Participants who consumed more sugary beverages gained more belly fat over six years. Those adults who were "frequent consumers" - drinking on average three sugary beverages a week - gained 7.4% more visceral adipose tissue than those consuming less than one a month. For daily sugary beverage drinkers, that figure jumped to a 27% gain in belly fat.

Paul F. Jacques, DSc, director of Tufts' HNRCA Nutritional Epidemiology Program and a co-author on the paper, points out, "This longitudinal design captured the temporal relationship between sugary beverage consumption and gains in visceral fat, the first observational study to do so."

There was no similar association between visceral adipose tissue and consumption of diet beverages.

McKeown, who recently led a study linking sugary beverage consumption to risk of liver disease (see the August 2015 newsletter), advises, "If you drink a sugary beverage daily, whether it's a soft drink, an energy drink, or a coffee drink with extra syrup and sugar, it's time to kick the habit. Making a dietary change is challenging, so if you enjoy the fizz, replace your sugary soda with a diet version or seltzer water."

TO LEARN MORE: Heart, -

http://dx.doi.org/10.1136/heartjnl-2015-307542

TO LEARN MORE: Circulation, -

http://circ.ahajournals.org/content/early/2016/01/06/CIRCULATIONAHA.115.018704.abstract

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