Long-Term Consumption of 6 Different Beverages and Cardiovascular Disease–Related Mortality: A Systematic Review and Meta-Analysis of Prospective Cohort Studies
Buna Bhandari, Ling Zeng, Sara Grafenauer, Aletta E. Schutte, Xiaoyue Xu
Abstract
The relationship between beverage consumption and the risk of cardiovascular disease has been extensively examined in cross-sectional studies. However, limited studies have investigated beverage consumption as a longer-term habitual behavior, which is important due to potential cumulative harmful or beneficial cardiovascular effects. We examined the association between the long-term consumption of six types of beverages (sugar-sweetened or artificially sweetened beverages, tea, coffee, fruit juice, energy drinks and alcohol) and cardiovascular mortality, by considering sex differences. We conducted a systematic search of MEDLINE, EMBASE, CINAHL, Web of Science and Scopus databases from 2010 to December 2023. Of 8,049 studies identified, 20 studies were included for meta-analysis. Summary Hazard Ratios (HR) and 95% CIs were estimated with the use of a random effects model. We found that long-term coffee consumption was related to reduced cardiovascular mortality in males (Pooled HR: 0.63; 95% CI: 0.46, 0.87; P=0.005) but not in females (HR: 0.78; 95% CI: 0.60, 1.02; P=0.07). Long-term higher intake of tea was associated with lower risk of cardiovascular mortality in all adults (Pooled HR: 0.81; 95% CI: 0.72, 0.92; P=<0.001). Higher alcohol intake was linked to higher stroke in both males (Pooled HR: 1.44; 95% CI: 1.06, 1.94; P=0.02) and females (Pooled HR: 2.26; 95% CI: 1.34, 3.81; P= 0.002). Higher sugar-sweetened beverage intake was in relation to higher cardiovascular mortality (Pooled HR: 1.31; 95% CI: 1.16, 1.46; P=<0.0001). We concluded that long-term habitual coffee consumption is beneficial for males, and tea consumption is beneficial for all adults. Long-term high alcohol and sugar-sweetened beverage consumption increased the risk of cardiovascular mortality for both males and females. However, we were unable to draw conclusions on the potential benefit or harm of the long-term consumption of fruit juice and energy drinks on cardiovascular mortality due to the limited number of studies available.This review was registered in PROSPERO (CRD42020214679).