Drinking Sweetened Beverages Significantly Increases Cardiovascular Disease Risk, Study Suggests

In a new study published in the journal Frontiers in Public Health, scientists investigated the associations between intake of added sugar and various sugar-sweetened foods and beverages and risk of 7 cardiovascular diseases in 69,705 participants aged 45-83 years (47.2% female) from the Swedish Mammography Cohort and the Cohort of Swedish Men. They found that eating too much added sugar increases your risk of stroke or aneurysm, but eating a few treats is associated with a lower risk of cardiovascular diseases; meanwhile, drinking sweetened beverages raises stroke, heart failure, and atrial fibrillation risks.

Cardiovascular disease comprises various diseases of the heart and blood vessels and is currently the leading cause of death and disease burden in Europe, primarily by stroke and ischemic heart disease.

Despite diet being one of the main modifiable risk factors of many CVDs, the evidence regarding added sugar intake and CVD risk is scarce and inconclusive.

Furthermore, most studies have primarily focused on sugar-sweetened beverage consumption rather than overall added sugar intake even though sugar-sweetened beverages make up only 14% of added sugar intake in Sweden and 25% in the United States.

“The most striking finding from our study is the divergent relationship between different sources of added sugar and CVD risk,” said Suzanne Janzi, PhD candidate at Lund University.

“This surprising contrast highlights the importance of considering not just the amount of sugar consumed, but its source and context.”

To understand how sugar consumption affects CVD risk, and whether consuming different kinds of sugar changes those risks, Janzi and her colleagues collected data from two major cohort studies, the Swedish Mammography Cohort and the Cohort of Swedish Men.

These studies had diet questionnaires administered in 1997 and 2009, allowing the scientists to monitor participants’ diets over time.

Once exclusions had been made to ensure the two cohorts shared the same inclusion criteria and to remove independent risk factors for CVDs, the researchers were left with a sample of 69,705 participants.

They looked at three classes of sugar consumption — toppings like honey, treats like a pastry, or sweetened beverages like fizzy drinks — and seven CVDs: two different types of stroke, heart attacks, heart failure, aortic aneurysms, atrial fibrillation, and aortic stenosis.

The participants were monitored until they died, were diagnosed with one of the CVDs, or reached the end of the follow-up period in 2019.

During this period, 25,739 participants were diagnosed with a CVD.

The scientists then used this data to break down how the different types of sugar intake affect the risk of different CVDs.

They found that consuming sweet drinks was worse for your health than any other form of sugar: drinking more sweetened drinks significantly increased the risk of ischemic stroke, heart failure, atrial fibrillation and abdominal aortic aneurysm.

“Liquid sugars, found in sweetened beverages, typically provide less satiety than solid forms — they make you feel less full — potentially leading to overconsumption,” Janzi said.

“Context also matters — treats are often enjoyed in social settings or special occasions, while sweetened beverages might be consumed more regularly.”

Different CVDs were affected differently by increased sugar intake, possibly because consuming additional sugar affected participants’ individual risk profile differently.

Increased sugar in general raised the risk of ischemic stroke and abdominal aortic aneurysm, as well as increasing the risk of heart failure in participants with a normal BMI.

However, the highest risks of a negative health outcome arose in the lowest intake category for treats. Consuming occasional treats was associated with better outcomes than no treats at all.

“This might reflect underlying dietary behaviors — individuals consuming very little sugar might have very restrictive diets or might be limiting sugar due to pre-existing health conditions,” Janzi said.

“While our observational study cannot establish causation, these findings suggest that extremely low sugar intake may not be necessary or beneficial for cardiovascular health.”

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Suzanne Janzi et al. 2024. Added sugar intake and its associations with incidence of seven different cardiovascular diseases in 69,705 Swedish men and women. Frontiers in Public Health 12; doi: 10.3389/fpubh.2024.1452085