Burdens of type 2 diabetes and cardiovascular disease attributable to sugar-sweetened beverages in 184 countries
Laura Lara-Castor(Tufts University), Meghan O’Hearn(Tufts University), Frederick Cudhea(Tufts University), Victoria Miller(Tufts University), Peilin Shi(Tufts University), Jianyi Zhang(Brigham and Women's Hospital), Julia Reedy Sharib(Tufts University), Sean B. Cash(Tufts University), Sı́món Barquera(Instituto Nacional de Salud Pública), Renata Micha(Tufts University), Dariush Mozaffarian(Tufts University), Global Dietary Database(Academy of Athens), Antonia Trichopoulou(Academy of Athens), Murat Baş(Acıbadem University), Jemal Haidar(Statistics Canada), Tatyana El-Kour(Aga Khan Foundation), Anand Krishnan(All India Institute of Medical Sciences), Puneet Misra(All India Institute of Medical Sciences), Nahla Hwalla(Amrita Vishwa Vidyapeetham), Chandrashekar Janakiram(Andalas University), Nur Indrawaty Lipoeto(Bahrain Center for Strategic International and Energy Studies), Abdulrahman O. Musaiger(Ardabil University of Medical Sciences), Farhad Pourfarzi(Bacha Khan University), Iftikhar Alam(Bacha Khan University), Céline Termote(Brighton and Sussex Medical School), Anjum Memon(Brighton and Sussex Medical School), Marieke Vossenaar, Paramita Mazumdar, Ingrid Rached(Fundación Centro de Estudios Infectológicos), Alicia Rovirosa(Fundación Centro de Estudios Infectológicos), María Elisa Zapata(Isfahan University of Medical Sciences), Mahnaz Rezaei Kelishadi(Isfahan University of Medical Sciences), Tamene Taye Asayehu(CGIAR), Francis Odhiambo Oduor(CGIAR), Julia Boedecker(CGIAR), Lilian Aluso(CGIAR), Emanuele Marconi(Cereal Research Centre), Laura D’Addezio(Cereal Research Centre), Raffaela Piccinelli(Cereal Research Centre), Stefania Sette(University of Cuenca), Johana Ortíz‐Ulloa(University of Delhi), J.V. Meenakshi(University of Delhi), Giuseppe Grosso(University of Catania), Anna Waśkiewicz(Aga Khan University), Umber Khan(Aga Khan University), Kenneth H. Brown(University of Oslo), Lene Frost Andersen(University of Oslo), Anastasia Thanopoulou(Tehran University of Medical Sciences), Reza Malekzadeh(Ministry for Health), Neville Calleja("Dunarea de Jos" University of Galati), Anca Ioana Nicolau("Dunarea de Jos" University of Galati), Cornelia Tudorie("Dunarea de Jos" University of Galati), Marga C. Ocké(National Institute for Public Health and the Environment), Zohreh Etemad(Eastern Mediterranean Public Health Network), Mohannad Al Nsour(Egerton University), Lydiah M. Waswa(National Institutes of Health), Maryam Hashemian(National Institutes of Health), Eha Nurk(Family Health International 360), Joanne E Arsenault(Family Health International 360), Patricio López‐Jaramillo(Universidad De Santander), Abla Mehio Sibai(Eduardo Mondlane University), Albertino Damasceno(Eduardo Mondlane University), Pulani Lanerolle(University of Colombo), Carukshi Arambepola(Universidade do Porto), Carla Lopes(Universidade do Porto), Mílton Severo(Universidade do Porto), Nuno Lunet(Universidade do Porto), Duarte Torres(Universidade do Porto), Heli Tapanainen(Finnish Institute for Health and Welfare), Jaana Lindström(Finnish Institute for Health and Welfare), Suvi Μ. Virtanen(Florida International University), Cristina Palacios(Florida International University), Noël C. Barengo(Florida International University), Eva Roos(International Center for Tropical Agriculture), Irmgard Jordan(Nutrition Center of the Philippines), Charmaine Duante(Nutrition Center of the Philippines), Corazon Cerdeña(Nutrition Center of the Philippines), Imelda Angeles‐Agdeppa(Nutrition Center of the Philippines), Josie Desnacido(Nutrition Center of the Philippines), Mario V. Capanzana(Nutrition Center of the Philippines), Anoop Misra(FrieslandCampina (Netherlands)), Ilse Khouw(FrieslandCampina (Netherlands)), Swee Ai Ng(University of North Carolina at Chapel Hill), Edna Gamboa Delgado(Consejo Nacional de Investigaciones Científicas y Técnicas), Mauricio T. Caballero(Consejo Nacional de Investigaciones Científicas y Técnicas), Johanna Otero(Gachon University), Hae‐Jeung Lee(Gachon University), Eda Köksal(University Hospital of Geneva), Idris Guessous(Ghent University Hospital), Carl Lachat(Ghent University Hospital), Stefaan De Henauw(Ghent University Hospital), Ali Reza Rahbar, Alison Tedstone, Annie Ling, Beth Hopping, Catherine Leclercq, Christian Haerpfer, Christine Hotz, Christos Pitsavos, Coline van Oosterhout, Debbie Bradshaw, Dimitrios Trichopoulos, Dorothy Gauci, Dulitha Fernando, Elżbieta Sygnowska, Erkki Vartiainen, Farshad Farzadfar, G Zajkás, Gillian Swan, Guansheng Ma, Hajah Masni Ibrahim, Harri Sinkko, Isabelle Sioen, Jean‐Michel Gaspoz, Jillian Odenkirk, Kanitta Bundhamcharoen, Keiu Nelis, Khairul Zarina, Lajos Biró, Lars Johansson, Leanne M Riley, Mabel Yap, Manami Inoue, Maria Szabo, Marja‐Leena Ovaskainen, Meei‐Shyuan Lee, Mei Fen Chan, Melanie Cowan, Mirnalini Kandiah, Ola Kally, Olof Jonsdottir, Pam Palmer, Philippos Orfanos, Renzo Asciak, Robert Templeton, Rokiah Don, Roseyati Yaakub, Rusidah Selamat, Safiah Md Yusof, Sameer Al‐Zenki, Shu-Yi Hung, Sigrid Beer‐Borst, Suh Wu, Widjaja Lukito, Wilbur C. Hadden, Xia Cao, Yi Ma, Yuen Lai, Zaiton Hjdaud(Statistics Canada), Jennifer Ali(Statistics Canada), Ron Gravel(Statistics Canada), Tina Tao(Griffith University), Lennert Veerman(Griffith University), Mustafa Arıcı(Harokopio University of Athens), Demosthenes B. Panagiotakos(Harvard University), Yanping Li(Harvard University), Ayla Gülden Pekcan(Instituts Supérieurs des Professions Infirmières et Techniques de Santé), Karim Anzid(Jehangir Hospital), Anuradha Khadilkar(Jehangir Hospital), Veena Ekbote(Jehangir Hospital), Irina Kovalskys(Fundación Pro Salud y Medio Ambiente), Nimmathota Arlappa(National Institute of Nutrition), Avula Laxmaiah(National Institute of Nutrition), Nagalla Balakrishna(National Institute of Nutrition), Brahmam Ginnela(National Institute of Nutrition), Hemalatha Rajkumar(National Institute of Nutrition), Indrapal I Meshram(National Institute of Nutrition), Kalpagam Polasa(Libera Università Maria SS. Assunta), Licia Iacoviello(Libera Università Maria SS. Assunta), Marialaura Bonaccio(Istituto Neurologico Mediterraneo), Simona Costanzo(Istituto Neurologico Mediterraneo), Yves Martin‐Prével(Institut de Recherche pour le Développement), Nattinee Jitnarin(Institute of Biomedical Sciences, Academia Sinica), Wen-Harn Pan(Institute of Biomedical Sciences, Academia Sinica), Yao-Te Hsieh(Institute of Biomedical Sciences, Academia Sinica), Sonia Olivares(Institute of Nutrition of Central America and Panama), Gabriela Tejeda(Institute of Nutrition of Central America and Panama), Aida Hadziomeragic(Duy Tan University), Ngoan Tran Le(Universidade Federal do Rio de Janeiro), Amanda de Moura Souza(Universidade Federal do Rio de Janeiro), Daniel Illescas-Zárate(Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán), Inge Huybrechts(International Food Policy Research Institute), Alan de Brauw(International Food Policy Research Institute), Mourad Moursi(International Food Policy Research Institute), Augustin Nawidimbasba Zeba(Isfahan University of Medical Sciences), Maryam Maghroun(Isfahan University of Medical Sciences), Nizal Sarrafzadegan(Isfahan University of Medical Sciences), Noushin Mohammadifard(Isfahan University of Medical Sciences), Lital Keinan-Boker, Rebecca Goldsmith, Tal Shimony(Justus-Liebig-Universität Gießen), Gudrun B. Keding(Justus-Liebig-Universität Gießen), Shivanand C. Mastiholi(Kenya Medical Research Institute), Moses Mwangi(Kenya Medical Research Institute), Yeri Kombe(Kenya Medical Research Institute), Zipporah Bukania(King Abdulaziz University), Eman M. Alissa(King Abdulaziz University), Nasser Al-Daghri(King Saud University), Shaun Sabico(King Saud University), Rajesh Jeewon(King's College London), Martin Gulliford(Ministry of Public Health), Tshilenge S. Diba(Ministry of Public Health), Kyungwon Oh(Korea Disease Control and Prevention Agency), Sihyun Park(Korea Disease Control and Prevention Agency), Sungha Yun(Korea University), Yoonsu Cho(Korea University), Suad Al-Hooti(Kuwait Institute for Scientific Research), Chanthaly Luangphaxay(Public Health Institute), Daovieng Douangvichit(Public Health Institute), Latsamy Siengsounthone(Public Health Institute), Pedro Marques‐Vidal(University of Lausanne), Péter Vollenweider(Leibniz Centre for Agricultural Landscape Research), Constance Rybak(Loyola University Chicago), Amy Luke(Loyola University Chicago), Nipa Rojroongwasinkul(Mahidol University), Noppawan Piaseu(Malaysian Palm Oil Board), Kalyana Sundram(Malaysian Palm Oil Board), Jeremy Koster(Max Planck Institute for Evolutionary Anthropology), Donka Baykova(Ahvaz Jundishapur University of Medical Sciences), Parvin Abedi(Ahvaz Jundishapur University of Medical Sciences), Sandjaja Sandjaja(Ministry of Health), Fariza Fadzil(Ministry of Health), Noriklil Bukhary Ismail Bukhary(Ministry of Health), Pascal Bovet(Centre universitaire de médecine générale et santé publique, Lausanne), Yu Chen(New York University), Norie Sawada, Shoichiro Tsugane(National Center of Public Health and Analyses), Lalka Rangelova(National Center of Public Health and Analyses), Stefka Petrova(National Center of Public Health and Analyses), Vesselka Duleva(National Center of Public Health and Analyses), Ward Siamusantu(Instytut Zywnosci Zywienia), L Szponar(National Health Research Institutes), Hsing‐Yi Chang(National Health Research Institutes), Makiko Sekiyama(National Institute for Environmental Studies), Khanh Le Nguyen Bao(National Institute of Nutrition), Sesikeran Boindala(Institut National de Nutrition et de Technologie Alimentaire), Jalila El Ati(Institut National de Nutrition et de Technologie Alimentaire), Ivonne Ramirez Silva(Instituto Nacional de Salud Pública), Juan Rivera Dommarco(Instituto Nacional de Salud Pública), Luz María Sánchez‐Romero(Instituto Nacional de Salud Pública), Sı́món Barquera(Instituto Nacional de Salud Pública), Sonia Rodríguez‐Ramírez(National Institute of Biomedical Innovation, Health and Nutrition), Nayu Ikeda(National Institute of Biomedical Innovation, Health and Nutrition), Sahar Zaghloul(National Nutrition and Food Technology Research Institute), Anahita Houshiarrad(National Nutrition and Food Technology Research Institute), Fatemeh Mohammadi‐Nasrabadi(National Nutrition and Food Technology Research Institute), Morteza Abdollahi(National Nutrition and Food Technology Research Institute), Khun-Aik Chuah(National University of Malaysia), Zaleha Abdullah Mahdy(Nestlé (Switzerland)), Alison L. Eldridge(Nestlé (Switzerland)), Eric L. Ding(North-West University), Herculina Kruger(OsloMet – Oslo Metropolitan University), Sigrun Henjum(OsloMet – Oslo Metropolitan University), Milton Fabian Suárez‐Ortegón(Pontificia Universidad Javeriana), Nawal Al‐Hamad(Public Health Authority of the Slovak Republic), Veronika Janská(University of Jordan), Reema Tayyem(University of Jordan), Bemnet Tedla(Queensland University of Technology), Parvin Mirmiran(Robert Koch Institute), Almut Richter(Robert Koch Institute), Gert Mensink(Robert Koch Institute), Lothar H. Wieler(Rutgers, The State University of New Jersey), Daniël J. Hoffman(Rutgers, The State University of New Jersey), Benoı̂t Salanave(Santé Publique France), Shashi Chiplonkar(Deakin University), Anne C. Fernandez(Deakin University), Androniki Naska(National and Kapodistrian University of Athens), Karin De Ridder(Seoul National University), Cho‐il Kim(Seoul National University), Rebecca Kuriyan, Sumathi Swaminathan(Statistics Canada), Didier Garriguet(National Food Administration), Anna Karin Lindroos(National Food Administration), Eva Warensjö Lemming(National Food Administration), Jessica Petrelius Sipinen(National Food Administration), Lotta Moraeus(National Food Administration), Saeed Dastgiri(Tabriz University of Medical Sciences), Sirje Vaask(Tallinn University), Tilakavati Karupaiah(Taylor's University), Fatemeh Vida Zohoori(Tehran University of Medical Sciences), Alireza Esteghamati(Tehran University of Medical Sciences), Sina Noshad(Hashemite University), Suhad Abumweis(Technical University of Kenya), Elizabeth Mwaniki(Technical University of Kenya), Simon Anderson(University of the West Indies), Justin Chileshe(Tropical Diseases Research Centre), Sydney Mwanza(Fundación Chile), Lydia Lera Marques(Fundación Chile), Samuel Durán‐Agüero(San Sebastián University), Mariana Oleas(Universidad de Antioquia), Luz Posada(University of Cuenca), Angélica Ochoa‐Avilés(University of Puerto Rico, Medical Sciences Campus), Alan Martin Preston(University of Puerto Rico, Medical Sciences Campus), Khadijah Shamsuddin(Universiti Putra Malaysia), Zalilah Mohd Shariff(Universiti Putra Malaysia), Hamid Jan Bin Jan Mohamed(Hospital Universiti Sains Malaysia), Wan Manan(Hospital Universiti Sains Malaysia), Bee Koon Poh(University of Aberdeen), Pamela Abbott(University of Alberta), Mohammadreza Pakseresht(University of Alberta), Sangita Sharma(University of Alberta), Tor A. Strand(University of Bonn), Ute Alexy(University of Bonn), Ute Nöthlings(University of Bonn), Indu Waidyatilaka(University of Colombo), Ranil Jayawardena(University of Colombo), Julie M. Long(University of Colorado Denver), K. Michael Hambidge(University of Colorado Denver), Nancy F. Krebs(University of Dhaka), Aminul Haque(University of Helsinki), Liisa Korkalo(University of Helsinki), Maijaliisa Erkkola(University of Helsinki), Riitta Freese(University of Hohenheim), Laila Eleraky(University of Hohenheim), Wolfgang Stuetz(University of Hohenheim), Laufey Steingrímsdóttir(University of Iceland), Inga Þórsdóttir(University of Iceland), Ingibjörg Gunnarsdóttir(Universidad de Las Palmas de Gran Canaria), Lluís Serra‐Majem(Universidad de Las Palmas de Gran Canaria), Foong Ming Moy(Carol Davila University of Medicine and Pharmacy), Corina‐Aurelia Zugravu(Carol Davila University of Medicine and Pharmacy), Elizabeth Yakes Jimenez(University of North Carolina at Chapel Hill), Linda S. Adair(University of North Carolina at Chapel Hill), Shu Wen Ng(University of North Carolina at Chapel Hill), Sheila Skeaff(Universidade de São Paulo), Regina Mara Fisberg(Universidade de São Paulo), Carol J. Henry(University of Saskatchewan), Getahun Ersino(University of Saskatchewan), Gordon A. Zello(University of Vienna), Alexa Meyer(University of Vienna), Ibrahim Elmadfa(University of Vienna), Claudette Mitchell(University of the Southern Caribbean), David J.K. Balfour(University of the Southern Caribbean), Johanna M. Geleijnse(Washington University in St. Louis), Mark Manary(Washington University in St. Louis), Laetitia Nikièma(Shahid Sadoughi University of Medical Sciences and Health Services), Masoud Mirzaei(Shahid Sadoughi University of Medical Sciences and Health Services), Rubina Hakeem(Ziauddin University)
Cited by 83Open Access
Abstract
The consumption of sugar-sweetened beverages (SSBs) is associated with type 2 diabetes (T2D) and cardiovascular diseases (CVD). However, an updated and comprehensive assessment of the global burden attributable to SSBs remains scarce. Here we estimated SSB-attributable T2D and CVD burdens across 184 countries in 1990 and 2020 globally, regionally and nationally, incorporating data from the Global Dietary Database, jointly stratified by age, sex, educational attainment and urbanicity. In 2020, 2.2 million (95% uncertainty interval 2.0-2.3) new T2D cases and 1.2 million (95% uncertainty interval 1.1-1.3) new CVD cases were attributable to SSBs worldwide, representing 9.8% and 3.1%, respectively, of all incident cases. Globally, proportional SSB-attributable burdens were higher among men versus women, younger versus older adults, higher- versus lower-educated adults, and adults in urban versus rural areas. By world region, the highest SSB-attributable percentage burdens were in Latin America and the Caribbean (T2D: 24.4%; CVD: 11.3%) and sub-Saharan Africa (T2D: 21.5%; CVD: 10.5%). From 1990 to 2020, the largest proportional increases in SSB-attributable incident T2D and CVD cases were in sub-Saharan Africa (+8.8% and +4.4%, respectively). Our study highlights the countries and subpopulations most affected by cardiometabolic disease associated with SSB consumption, assisting in shaping effective policies and interventions to reduce these burdens globally.
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