![]() 5 In a 2015 meta-analysis of 17 prospective cohort studies, 6 each additional daily serving of SSBs was associated with 13% (95% CI, 6%-21%) greater risk of diabetes, while each additional daily serving of fruit juices was associated with 7% (95% CI, 1%-14%) greater risk. Results from a 2013 prospective cohort study 5 that included 187 382 participants who were observed for up to 24 years (dietary intake information was updated every 4 years) showed that greater whole-fruit consumption was significantly associated with a lower risk of type 2 diabetes, whereas greater consumption of fruit juices was associated with a higher type 2 diabetes risk. The evidence for an association of intake of fruit juices with health outcomes is much less abundant and consistent. ![]() Comparing extreme categories of SSBs intake, the relative risk of cardiovascular mortality was 31% (95% CI, 15%-49%) higher in participants who consumed more than 2 servings of SSBs per day after adjusting for major diet and lifestyle factors. These findings were consistent with a 2019 study 4 that included 36 436 deaths. In a 2014 prospective analysis using data from the National Health and Nutrition Examination Survey, 3 higher intake of added sugar and SSBs was associated with increased risk of cardiovascular mortality among US adults after a median 14.6 years of follow-up. There is compelling evidence that higher intakes of SSBs are associated with a wide range of health consequences, including tooth decay, weight gain, type 2 diabetes, fatty liver disease, and cardiovascular disease. ![]() Although the evidence from the REGARDS study is only suggestive, the study by Collins et al 2 brings attention to potential adverse effects of SSB vs fruit juice consumption on health. This is one of the first studies examining the associations of SSBs and 100% fruit juices with mortality outcomes in a multiethnic cohort, to our knowledge. In addition to the small number of CHD-related deaths, another limitation of this study was that the analyses used self-reported intake only at baseline, which did not reflect long-term dietary intakes. Collin et al 2 concluded that fruit juice consumption contributed to the association of increased risk of all-cause mortality with sugary beverage consumption in the study population and suggested that well-powered and longer-term studies are needed to evaluate the associations of fruit juice consumption with CHD mortality risk. With each additional 12 oz of sugary beverages or of fruit juice alone, risk-adjusted all-cause mortality HRs were 1.11 (95% CI, 1.03-1.19) and 1.24 (95% CI, 1.09-1.42), respectively. Compared with participants who consumed less than 5% of their daily calories as sugary beverages (ie, SSBs and fruit juices), participants who consumed 10% or more of their daily calories as sugary beverages had a hazard ratio (HR) of 1.44 (95% CI, 0.97-2.15) for CHD mortality and 1.14 (95% CI, 0.97-1.33) for all-cause mortality after adjusting the models for cardiovascular risk factors. 2 Among a cohort of 13 440 US adults (4174 black adults and 9266 white adults), 168 died of CHD and 1000 died of any cause after 6 years of follow-up. Using findings from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, Collin et al 2 evaluated the associations of SSBs and 100% fruit juices with coronary heart disease (CHD) mortality and all-cause mortality. It is widely accepted that SSBs are implicated in weight gain and adverse cardiometabolic health, but the evidence regarding fruit juices is less abundant. Although the sugar in 100% fruit juices is naturally occurring rather than added, once metabolized, the biological response is essentially the same. However, they often contain as much sugar and as many calories as SSBs. 1 Substantial efforts have been devoted to discourage the consumption of SSBs, including policies for taxation and restrictions on marketing to children.įruit juices are still widely perceived as a healthier option than SSBs. ![]() Sugar-sweetened beverages typically contain 140 to 150 kcal and 35 to 37.5 g of sugar per 12-oz serving, and they are the largest source of added sugars in the US diet. Sugar-sweetened beverages include any beverage with added sugar or other sweetener, such as carbonated and noncarbonated soft drinks, fruit punch, fruit juice concentrates, powdered drink mixes, and energy drinks. In the past few years, the health effects of sugar-sweetened beverages (SSBs) have been a matter of scientific and public interest.
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