Sugary soft drinks (sodas) are associated with an increase in mortality according to a new study. Doctors must absolutely look for this consumption and do everything to reduce it ... with the help of public authorities.
It has long been known that the consumption of high-sugar beverages, primarily sodas, is associated with an increased risk of obesity, diabetes and cardiovascular disease. But this is the first time that consumption of sugar-rich sodas has been shown to increase the risk of all-cause mortality and coronary heart disease mortality.
This is shown in a study of 30,183 adults over 45 in the US REGARDS cohort (Reasons for Geographic and Racial Differences in Stroke). The results were presented by Lindsay Collin (P235) at the American Heart Association's Conference on Epidemiology and Prevention
A cohort of Americans of all races
The study excluded all individuals with a history of stroke, cardiovascular disease and type 2 diabetes leaving a population of 17,930.
Their intake of added sugar, in grams, was calculated from beverages and foods separately using self-administered questionnaires from the Block 98 food frequency questionnaires.
By dividing participants into 4 groups ("quartiles"), from the lowest consumers of sugary drinks to the strongest consumers, including soft drinks, fruit and fruit drinks, the authors found that the risk coronary heart disease is significantly higher in the quartile where soda consumption is highest: risk ratio (HR: 2.0, 95% CI 1.12 - 3.54) than in the lowest category of the consumption. The risk of death from all causes is also higher in the upper quartile (HR: 1.2, 95% CI 0.99 - 1.52).
Net influence of income and weight
The risk of cardiovascular disease and all-cause mortality remains the highest even taking into account disruptive factors such as age, body mass index, sex, income, region, smoking, alcohol consumption and physical activity.
No significant differences were observed in terms of sex or race. But, the increase in mortality is significantly higher for low-income people than for high-income people for all-cause mortality.
People who were overweight (body mass index of 25.0 - 29.9) also had all-cause mortality associated with higher consumption of sugary drinks.
A real "shot" of sugar
Various hypotheses can explain the increase in mortality rates with the consumption of sugary drinks compared to sugary foods. Taking sugar with a drink makes it pass very quickly into the bloodstream, which explains why the body reacts by over-storing. The digestion of sugary foods occurs more slowly than that of sugary drinks because of the presence of other components such as fiber, fat and protein. When sugary drinks are eaten, people eat so much food and end up overeating sugar and calories.
The tax on sodas helps reduce consumption
Doctors must act on this consumption of soft drinks to reduce it, but it is necessary that the public authorities help them and that is the stakes of taxes on sodas. Taxes sodas are developing around the world. In France, the tax rate is 7.53 euros per hectolitre. The version voted in 2013 was revised last October: today drinks are taxed as soon as they contain one gram of sugar per 100 ml, against 5 grams previously.
In the United Kingdom, a tax was also introduced in early April. The goal is always the same: reduce the consumption of sugary drinks, and therefore fight against obesity. In the United States, this type of tax was launched in January 2017 in the city of Philadelphia. Researchers at Drexel University have studied the effectiveness of this tax in a study published in American Journal of Preventive Medicine. Daily consumption of sodas decreased by 40%.
Physicians must therefore look for soda consumption in the same way as other cardiovascular risk factors such as cholesterol, smoking and high blood pressure.
Lindsay Collin et al. Sugar-Sweetened Beverage and Food Intake and Mortality Risk Among U.S. Adults AHA EPI / Lifestyle 2018, Abstract P235