Sugar-Sweetened Beverages and Weight Gain in Children and Adults: A Systematic Review from 2013 to 2015 and a Comparison with Previous StudiesLuger M.a, b · Lafontan M.c · Bes-Rastrollo Md,e,f · Winzer E.a, b · Yumuk V.g · Farpour-Lambert N.h
aSpecial Institute for Preventive Cardiology And Nutrition SIPCAN, Salzburg, Austria; bDepartment of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria; cInserm/University Paul Sabatier UMR 1048, Institute of Metabolic and Cardiovascular Diseases, Hôpital Rangueil, Toulouse cedex, France; dDepartment of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain; eCIBERobn, Instituto de Salud Carlos III, Madrid, Spain; fIdiSNA, Navarra's Health Research Institute, Pamplona, Spain; gDivision of Endocrinology, Metabolism and Diabetes, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey; hObesity Prevention and Care Program, Service of Therapeutic Education for Chronic Diseases, Department of Community Health, Primary Care and Emergency, University Hospital of Geneva and University of Geneva, Geneva, Switzerland
Maria Luger, PhD MSc
Special Institute for Preventive Cardiology and Nutrition SIPCAN
5061 Elsbethen/Salzburg, Austria
Do you have an account?
Objective: Partly inconsistent findings from previous reviews have fueled discussions on the impact of sugar-sweetened beverages (SSBs) on obesity development. The aim was to systematically review the recent evidence in children and adults. Methods: Data were retrieved from the databases MEDLINE, EMBASE, and Cochrane library for the period January 2013 to October 2015. A systematic review of prospective cohort studies and randomized controlled trials (RCTs) relating SSBs to weight measures was conducted. Results: 30 publications met the inclusion criteria. Prospective cohort studies (96%; n = 26) showed a positive association between consumption of SSBs and weight/BMI in adults and children (n = 242,352), and only one cohort study in children showed no association. Findings from three RCTs in children demonstrated that SSB consumption had an effect on BMI/BMI z-score. The one RCT in adults showed no significant effect of the intervention. 63% of the studies were of good, 30% of medium quality, and none was funded by industry. Conclusion: Recent evidence suggests that SSB consumption is positively associated with or has an effect on obesity indices in children and adults. By combining the already published evidence with the new one, we conclude that public health policies should aim to reduce the consumption of SSBs and encourage healthy alternatives such as water.
© 2017 The Author(s) Published by S. Karger GmbH, Freiburg
World Health Organization: Global Health Observatory. Overweight and Obesity. www.who.int/gho/ncd/risk_factors/overweight/en/ (last accessed December 4, 2017).
- Basu S, McKee M, Galea G, Stuckler D: Relationship of soft drink consumption to global overweight, obesity, and diabetes: a cross-national analysis of 75 countries. AmericanJ Public Health 2013;103:2071-2077.
- Ma Y, He FJ, Yin Y, Hashem KM, MacGregor GA: Gradual reduction of sugar in soft drinks without substitution as a strategy to reduce overweight, obesity, and type 2 diabetes: a modelling study. Lancet Diabetes Endocrinol 2016;4:105-114.
US Department of Agriculture and US Department of Health and Human Services: Dietary Guidelines for Americans, 2010, 7th ed., Washington, DC: U.S. Government Printing Office, 2010. https://health.gov/dietaryguidelines/dga2010/dietaryguidelines2010.pdf (last accessed December 4, 2017).
- Welsh JA, Sharma AJ, Grellinger L, Vos MB: Consumption of added sugars is decreasing in the United States. Am J Clin Nutr 2011;94:726-734.
World Health Organization: Reducing Consumption of Sugar-Sweetened Beverages to Reduce the Risk of Unhealthy Weight Gain in Adults. 2014. www.who.int/elena/bbc/ssbs_adult_weight/en/ (last accessed December 4, 2017).
- Singh GM, Micha R, Khatibzadeh S, Shi P, Lim S, Andrews KG, Engell RE, Ezzati M, Mozaffarian D; Global Burden of Diseases Nutrition and Chronic Diseases Expert Group (NutriCoDE): Global, regional, and national consumption of sugar-sweetened beverages, fruit juices, and milk: A systematic assessment of beverage intake in 187 countries. PLoS One 2015;10:e0124845.
- Malik VS, Pan A, Willett WC, Hu FB: Sugar-sweetened beverages and weight gain in children and adults: a systematic review and meta-analysis. Am J Clin Nutr 2013;98:1084-1102.
- O'Connor L, Imamura F, Lentjes MA, Khaw KT, Wareham NJ, Forouhi NG: Prospective associations and population impact of sweet beverage intake and type 2 diabetes, and effects of substitutions with alternative beverages. Diabetologia 2015;58:1474-1483.
- Greenwood DC, Threapleton DE, Evans CE, Cleghorn CL, Nykjaer C, Woodhead C, Burley VJ: Association between sugar-sweetened and artificially sweetened soft drinks and type 2 diabetes: systematic review and dose-response meta-analysis of prospective studies. Br J Nutr 2014;112:725-734.
- Singh GM, Micha R, Khatibzadeh S, Lim S, Ezzati M, Mozaffarian D; Global Burden of Diseases Nutrition and Chronic Diseases Expert Group (NutriCoDE): Estimated global, regional, and national disease burdens related to sugar-sweetened beverage consumption in 2010. Circulation 2015;132:639-666.
- Hu FB: Resolved: there is sufficient scientific evidence that decreasing sugar-sweetened beverage consumption will reduce the prevalence of obesity and obesity-related diseases. Obesi Rev 2013;14:606-619.
- Bes-Rastrollo M, Schulze MB, Ruiz-Canela M, Martinez-Gonzalez MA: Financial conflicts of interest and reporting bias regarding the association between sugar-sweetened beverages and weight gain: A systematic review of systematic reviews. PLoS Med 2013;10:e1001578;discussion e1001578.
- Lesser LI, Ebbeling CB, Goozner M, Wypij D, Ludwig DS: Relationship between funding source and conclusion among nutrition-related scientific articles. PLoS Med 2007;4:e5.
- Keller A, Bucher Della Torre S: Sugar-sweetened beverages and obesity among children and adolescents: a review of systematic literature reviews. Child Obes 2015;11:338-346.
- Bucher Della Torre S, Keller A, Laure Depeyre J, Kruseman M: Sugar-sweetened beverages and obesity risk in children and adolescents: a systematic analysis on how methodological quality may influence conclusions. J Acad Nutr Diet 2016;116:638-659.
- Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group: Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 2009;151:264-269, W264.
Wells GA, Shea B, O'Connell D, Peterson J, Welch V, Losos M, Tugwell P: The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta-Analyses. http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp (last accessed December 4, 2017).
Stephen H, Halpern M, Douglas J: Appendix: Jadad Scale for Reporting Randomized Controlled Trials; Evidence-Based Obstetric Anesthesia. Oxford, Blackwell, 2007. http://onlinelibrary.wiley.com/doi/10.1002/ 9780470988343.fmatter/pdf (last accessed December 4, 2017).
- Ambrosini GL, Oddy WH, Huang RC, Mori TA, Beilin LJ, Jebb SA: Prospective associations between sugar-sweetened beverage intakes and cardiometabolic risk factors in adolescents. Am J Clin Nutr 2013;98:327-334.
- Cantoral A, Tellez-Rojo MM, Ettinger AS, Hu H, Hernandez-Avila M, Peterson K: Early introduction and cumulative consumption of sugar-sweetened beverages during the pre-school period and risk of obesity at 8-14 years of age. Pediatr Obes 2016;11:68.-74.
- Field AE, Sonneville KR, Falbe J, Flint A, Haines J, Rosner B, Camargo CA Jr: Association of sports drinks with weight gain among adolescents and young adults. Obesity (Silver Spring) 2014;22:2238-2243.
- Olafsdottir S, Berg C, Eiben G, Lanfer A, Reisch L, Ahrens W, Kourides Y, Molnar D, Moreno LA, Siani A, Veidebaum T, Lissner L: Young children's screen activities, sweet drink consumption and anthropometry: results from a prospective European study. Eur J Clin Nutr 2014;68:223-228.
- Shroff MR, Perng W, Baylin A, Mora-Plazas M, Marin C, Villamor E: Adherence to a snacking dietary pattern and soda intake are related to the development of adiposity: a prospective study in school-age children. Public Health Nutr 2014;17:1507-1513.
- DeBoer MD, Scharf RJ, Demmer RT: Sugar-sweetened beverages and weight gain in 2- to 5-year-old children. Pediatrics 2013;132:413-420.
- Feeley AB, Musenge E, Pettifor JM, Norris SA: Investigation into longitudinal dietary behaviours and household socio-economic indicators and their association with BMI z-score and fat mass in South African adolescents: the Birth to Twenty (BT20) cohort. Public Health Nutr 2013;16:693-703.
- Sonneville KR, Long MW, Rifas-Shiman SL, Kleinman K, Gillman MW, Taveras EM: Juice and water intake in infancy and later beverage intake and adiposity: could juice be a gateway drink? Obesity (Silver Spring) 2015;23:170-176.
- Zheng M, Allman-Farinelli M, Heitmann BL, Toelle B, Marks G, Cowell C, Rangan A: Liquid versus solid energy intake in relation to body composition among Australian children. J Hum Nutr Diet 2015;28:70-79.
- Zheng M, Rangan A, Olsen NJ, Andersen LB, Wedderkopp N, Kristensen P, Grontved A, Ried-Larsen M, Lempert SM, Allman-Farinelli M, Heitmann BL: Substituting sugar-sweetened beverages with water or milk is inversely associated with body fatness development from childhood to adolescence. Nutrition 2015;31:38-44.
- Gopinath B, Flood VM, Rochtchina E, Baur LA, Louie JC, Smith W, Mitchell P: Carbohydrate nutrition and development of adiposity during adolescence. Obesity (Silver Spring) 2013;21:1884-1890.
- Hasnain SR, Singer MR, Bradlee ML, Moore LL: Beverage intake in early childhood and change in body fat from preschool to adolescence. Child Obes 2014;10:42-49.
- Laverty AA, Magee L, Monteiro CA, Saxena S, Millett C: Sugar and artificially sweetened beverage consumption and adiposity changes: national longitudinal study. Int J Behav Nutr Phys Act 2015;12:137.
- Bigornia SJ, LaValley MP, Noel SE, Moore LL, Ness AR, Newby PK: Sugar-sweetened beverage consumption and central and total adiposity in older children: a prospective study accounting for dietary reporting errors. Public Health Nutr 2015;18:1155-1163.
- Mirmiran P, Yuzbashian E, Asghari G, Hosseinpour-Niazi S, Azizi F: Consumption of sugar sweetened beverage is associated with incidence of metabolic syndrome in Tehranian children and adolescents. Nutr Metab (Lond) 2015;12:25.
- Zheng M, Rangan A, Olsen NJ, Bo Andersen L, Wedderkopp N, Kristensen P, Grontved A, Ried-Larsen M, Lempert SM, Allman-Farinelli M, Heitmann BL: Sugar-sweetened beverages consumption in relation to changes in body fatness over 6 and 12 years among 9-year-old children: the European Youth Heart Study. Eur J Clin Nutr 2014;68:77-83.
- Chaidez V, McNiven S, Vosti SA, Kaiser LL: Sweetened food purchases and indulgent feeding are associated with increased toddler anthropometry. J Nutr Educ Behav 2014;46:293-298.
- Fagherazzi G, Vilier A, Saes Sartorelli D, Lajous M, Balkau B, Clavel-Chapelon F: Consumption of artificially and sugar-sweetened beverages and incident type 2 diabetes in the Etude Epidemiologique aupres des femmes de la Mutuelle Generale de lʼEducation Nationale-European Prospective Investigation into Cancer and Nutrition cohort. Am J Clin Nutr 2013;97:517-523.
- InterAct C, Romaguera D, Norat T, Wark PA, Vergnaud AC, Schulze MB, van Woudenbergh GJ, Drogan D, Amiano P, Molina-Montes E, Sanchez MJ, Balkau B, Barricarte A, Beulens JW, Clavel-Chapelon F, Crispim SP, Fagherazzi G, Franks PW, Grote VA, Huybrechts I, Kaaks R, Key TJ, Khaw KT, Nilsson P, Overvad K, Palli D, Panico S, Quiros JR, Rolandsson O, Sacerdote C, Sieri S, Slimani N, Spijkerman AM, Tjonneland A, Tormo MJ, Tumino R, van den Berg SW, Wermeling PR, Zamara-Ros R, Feskens EJ, Langenberg C, Sharp SJ, Forouhi NG, Riboli E, Wareham NJ: Consumption of sweet beverages and type 2 diabetes incidence in European adults: results from EPIC-InterAct. Diabetologia 2013;56:1520-1530.
- Sakurai M, Nakamura K, Miura K, Takamura T, Yoshita K, Nagasawa SY, Morikawa Y, Ishizaki M, Kido T, Naruse Y, Suwazono Y, Sasaki S, Nakagawa H: Sugar-sweetened beverage and diet soda consumption and the 7-year risk for type 2 diabetes mellitus in middle-aged Japanese men. Eur J Nutr 2014;53:251-258.
- Barrio-Lopez MT, Martinez-Gonzalez MA, Fernandez-Montero A, Beunza JJ, Zazpe I, Bes-Rastrollo M: Prospective study of changes in sugar-sweetened beverage consumption and the incidence of the metabolic syndrome and its components: the SUN cohort. Br J Nutr 2013;110:1722-1731.
Boggs DA, Rosenberg L, Coogan PF, Makambi KH, Adams-Campbell LL, Palmer JR: Restaurant foods, sugar-sweetened soft drinks, and obesity risk among young African American women. Ethn Dis 2013;23:445-451.
- Lim L, Banwell C, Bain C, Banks E, Seubsman SA, Kelly M, Yiengprugsawan V, Sleigh A: Sugar sweetened beverages and weight gain over 4 years in a Thai national cohort - a prospective analysis. PLoS One 2014;9:e95309.
- Fowler SP, Williams K, Hazuda HP: Diet soda intake is associated with long-term increases in waist circumference in a biethnic cohort of older adults: the San Antonio Longitudinal Study of Aging. J Am Geriatr Soc 2015;63:708-715.
- Funtikova AN, Subirana I, Gomez SF, Fito M, Elosua R, Benitez-Arciniega AA, Schroder H: Soft drink consumption is positively associated with increased waist circumference and 10-year incidence of abdominal obesity in Spanish adults. J Nutr 2015;145:328-334.
- Vorster HH, Kruger A, Wentzel-Viljoen E, Kruger HS, Margetts BM: Added sugar intake in South Africa: findings from the adult prospective urban and rural epidemiology cohort study. Am J Clin Nutr 2014;99:1479-1486.
- Sichieri R, Yokoo EM, Pereira RA, Veiga GV: Water and sugar-sweetened beverage consumption and changes in BMI among Brazilian fourth graders after 1-year follow-up. Public Health Nutr 2013;16:73-77.
- Cunha DB, de Souza Bda S, Pereira RA, Sichieri R: Effectiveness of a randomized school-based intervention involving families and teachers to prevent excessive weight gain among adolescents in Brazil. PLoS One 2013;8:e57498.
- Zheng M, Rangan A, Allman-Farinelli M, Rohde JF, Olsen NJ, Heitmann BL: Replacing sugary drinks with milk is inversely associated with weight gain among young obesity-predisposed children. Br J Nutr 2015;114:1448-1455.
- Hernandez-Cordero S, Barquera S, Rodriguez-Ramirez S, Villanueva-Borbolla MA, Gonzalez de Cossio T, Dommarco JR, Popkin B: Substituting water for sugar-sweetened beverages reduces circulating triglycerides and the prevalence of metabolic syndrome in obese but not in overweight Mexican women in a randomized controlled trial. J Nutr 2014;144:1742-1752.
- Mozaffarian D, Hao T, Rimm EB, Willett WC, Hu FB: Changes in diet and lifestyle and long-term weight gain in women and men. N Engl J Med 2011;364:2392-2404.
- Duffey KJ, Poti J: Modeling the effect of replacing sugar-sweetened beverage consumption with water on energy intake, HBI score, and obesity prevalence. Nutrients 2016;8: pii: E395.
- Fresan U, Gea A, Bes-Rastrollo M, Ruiz-Canela M, Martinez-Gonzalez MA: Substitution models of water for other beverages, and the incidence of obesity and weight gain in the sun cohort. Nutrients 2016;8: pii: E688.
- Popkin BM, Hawkes C: Sweetening of the global diet, particularly beverages: patterns, trends, and policy responses. Lancet Diabetes Endocrinol 2016;4:174-186.
- Colchero MA, Popkin BM, Rivera JA, Ng SW: Beverage purchases from stores in Mexico under the excise tax on sugar sweetened beverages: observational study. BMJ 2016;352:h6704.
Euromonitor International: Sin tax in Food and Beverages - Strategies, Outcomes and Learnings. London 2016. www.euromonitor.com/sin-tax-in-food-and-beverages-strategies-outcomes-and-learnings/report (last accessed December 4, 2017).
European Commission: EU Action Plan on Childhood Obesity 2014-2020. 2014. https://ec.europa.eu/health/sites/health/files/nutrition_physical_activity/docs/childhoodobesity_actionplan_2014_2020_en.pdf (last accessed December 4, 2017).
- He FJ, Brinsden HC, MacGregor GA: Salt reduction in the United Kingdom: a successful experiment in public health. J Human Hypertens 2014;28:345-352.
- He FJ, Pombo-Rodrigues S, MacGregor GA: Salt reduction in England from 2003 to 2011: its relationship to blood pressure, stroke and ischaemic heart disease mortality. BMJ Open 2014;4:e004549.