Sugar-Sweetened Beverages and Adverse Human Health Outcomes: An Umbrella Review of Meta-Analyses of Observational Studies

Annu Rev Nutr. 2024 Aug;44(1):383-404. doi: 10.1146/annurev-nutr-062322-020650.

Abstract

Our aim was to conduct an umbrella review of evidence from meta-analyses of observational studies investigating the link between sugar-sweetened beverage consumption and human health outcomes. Using predefined evidence classification criteria, we evaluated evidence from 47 meta-analyses encompassing 22,055,269 individuals. Overall, 79% of these analyses indicated direct associations between greater sugar-sweetened beverage consumption and higher risks of adverse health outcomes. Convincing evidence (class I) supported direct associations between sugar-sweetened beverage consumption and risks of depression, cardiovascular disease, nephrolithiasis, type 2 diabetes mellitus, and higher uric acid concentrations. Highly suggestive evidence (class II) supported associations with risks of nonalcoholic fatty liver disease and dental caries. Out of the remaining 40 meta-analyses, 29 were graded as suggestive or weak in the strength of evidence (classes III and IV), and 11 showed no evidence (class V). These findings inform and provide support for population-based and public health strategies aimed at reducing sugary drink consumption for improved health.

Keywords: Nova food classification system; meta-analysis; noncommunicable disease; sugar-sweetened beverages; ultraprocessed food; umbrella review.

Publication types

  • Systematic Review

MeSH terms

  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / prevention & control
  • Dental Caries / epidemiology
  • Dental Caries / etiology
  • Dental Caries / prevention & control
  • Depression / epidemiology
  • Depression / etiology
  • Depression / prevention & control
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / etiology
  • Diabetes Mellitus, Type 2 / prevention & control
  • Humans
  • Meta-Analysis as Topic
  • Non-alcoholic Fatty Liver Disease / epidemiology
  • Non-alcoholic Fatty Liver Disease / etiology
  • Non-alcoholic Fatty Liver Disease / prevention & control
  • Observational Studies as Topic
  • Sugar-Sweetened Beverages* / adverse effects
  • Sugar-Sweetened Beverages* / statistics & numerical data