A study published in Nature Medicine found sugar-sweetened beverages were associated with 2.2 million new type 2 diabetes cases and 1.2 million new cardiovascular disease cases worldwide in 2020, accounting for 9.8% and 3.1% of all incident cases, respectively.

The analysis of data from 184 countries between 1990 and 2020 revealed the highest attributable burdens occurred in Latin America and the Caribbean (type 2 diabetes (T2D): 24.4%; cardiovascular disease (CVD): 11.3%), with sub-Saharan Africa showing the largest increases over time (T2D: +8.8%; CVD: +4.4%). In contrast, Southeast and East Asia reported the lowest proportional burdens (T2D: 3.1%; CVD: 0.6%). Among the 30 most populous nations, Mexico led with 2007 new diabetes cases per million adults attributable to sugar-sweetened beverages (SSBs), followed by Colombia (1971 cases) and South Africa (1258 cases).

Globally, SSB-associated disease burdens were higher among men than women, younger adults compared to older adults, individuals with higher education versus lower education, and urban residents compared to rural residents. Proportional risks were particularly pronounced among adults aged 20 to 29, with 15.6% of T2D cases and 12.0% of CVD cases attributable to SSBs in this group.

The study defined SSBs as beverages with added sugars and ≥50 kcal per 8 oz serving, excluding 100% fruit juice, artificially sweetened drinks, and sweetened milk. Researchers utilized data from 450 dietary surveys encompassing 2.9 million individuals across 118 countries, alongside Bayesian hierarchical modeling, to estimate global SSB intake and associated health outcomes.

Although the findings highlight significant disease burdens, the study’s authors noted limitations. Exclusions of sugar-sweetened tea and coffee, as well as potential underreporting in dietary surveys, may have underestimated the true impact of SSBs. Additionally, the modeling approach estimates burdens attributable to SSBs but does not establish direct causation.

The study was conducted by researchers from the Institute of Health Metrics and Evaluation at the University of Washington and international collaborators. Conflict of interest disclosures can be found in the study.