In recent years, many studies have focused on the adverse effects of sugar sweetened beverages on human health,
given the substantial contribution of these drinks to total added sugar or free sugar intake and the rapidly increasing rate of their consumption.24 25 26
Generally, sugar sweetened beverages are the largest source of added sugars, including carbonated and non carbonated soft drinks, fruit drinks, and sports and energy drinks.27
Previous surveys have shown that consumption of sugar sweetened beverages is declining in many developed countries, although consumption levels remain high.27 28
However, the consumption of sugar sweetened beverages is still increasing in many developing countries, which may be attributed to their increased availability accompanied by economic development.29
The 2007 annual report of the Coca-Cola company revealed that the consumption of sugar sweetened beverages in India and China increased by 14% and 18%, respectively, in one year.30
In 2018 a cross sectional survey conducted among Chinese primary and junior high school students showed that sugar sweetened beverages provide 10-15% of the total calorie consumption of school students.31
Data from the National Health and Nutrition Examination Survey (NHANES) showed that, in 2009-10, sugar sweetened beverage consumption contributed 8% and 6.9% of daily energy intake among children/adolescents and adults, respectively, in the US.32
Additionally, a global survey conducted in 2010 reported that a total of 180 000 adiposity associated deaths could be attributed to the consumption of sugar sweetened beverages around the world.33 All of these findings promote the development of policies worldwide to limit sugar consumption, including sugars taxes, food labelling laws, and restrictions on advertising and marketing.34 35 36 37 Meanwhile, national and international organisations such as WHO, the
US Department of Agriculture, and the US Department of Health and Human Services have recommended reducing the consumption of free sugars or added sugars to less than 10% of total daily energy intake.23 38
Although many meta-analyses of observational studies and randomised controlled trials focused on the associations between sugar consumption and a range of health outcomes have been published in recent decades, deficiencies in the study design, varying measurements of dietary sugar consumption, inconsistent findings, and different definitions of exposure make drawing definitive conclusions difficult.
Therefore, before developing detailed policies for sugar restriction, the quality of existing evidence on the associations of dietary sugar consumption with all health outcomes needs to be comprehensively evaluated. To evaluate the quality of evidence, potential biases, and validity of all studies available on dietary sugar intake and any health outcomes, we did an umbrella review of meta-analyses on this topic.
Ref
fBMJ
. 2023 Apr 5;381:e071609. doi: 10.1136/bmj-2022-071609
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