Burdens of type 2 diabetes and cardiovascular disease attributable to sugar-sweetened beverages in 184 countries
Laura Lara-Castor, Meghan O’Hearn, Frederick Cudhea, Victoria Miller, Peilin Shi, Jianyi Zhang, Julia Reedy Sharib, Sean B. Cash, Sı́món Barquera, Renata Micha, Dariush Mozaffarian, Global Dietary Database, Antonia Trichopoulou, Murat Baş, Jemal Haidar, Tatyana El-Kour, Anand Krishnan, Puneet Misra, Nahla Hwalla, Chandrashekar Janakiram, Nur Indrawaty Lipoeto, Abdulrahman O. Musaiger, Farhad Pourfarzi, Iftikhar Alam, Céline Termote, Anjum Memon, Marieke Vossenaar, Paramita Mazumdar, Ingrid Rached, Alicia Rovirosa, María Elisa Zapata, Mahnaz Rezaei Kelishadi, Tamene Taye Asayehu, Francis Odhiambo Oduor, Julia Boedecker, Lilian Aluso, Emanuele Marconi, Laura D’Addezio, Raffaela Piccinelli, Stefania Sette, Johana Ortíz‐Ulloa, J.V. Meenakshi, Giuseppe Grosso, Anna Waśkiewicz, Umber Khan, Kenneth H. Brown, Lene Frost Andersen, Anastasia Thanopoulou, Reza Malekzadeh, Neville Calleja, Anca Ioana Nicolau, Cornelia Tudorie, Marga C. Ocké, Zohreh Etemad, Mohannad Al Nsour, Lydiah M. Waswa, Maryam Hashemian, Eha Nurk, Joanne E Arsenault, Patricio López‐Jaramillo, Abla Mehio Sibai, Albertino Damasceno, Pulani Lanerolle, Carukshi Arambepola, Carla Lopes, Mílton Severo, Nuno Lunet, Duarte Torres, Heli Tapanainen, Jaana Lindström, Suvi Μ. Virtanen, Cristina Palacios, Noël C. Barengo, Eva Roos, Irmgard Jordan, Charmaine Duante, Corazon Cerdeña, Imelda Angeles‐Agdeppa, Josie Desnacido, Mario V. Capanzana, Anoop Misra, Ilse Khouw, Swee Ai Ng, Edna Gamboa Delgado, Mauricio T. Caballero, Johanna Otero, Hae‐Jeung Lee, Eda Köksal, Idris Guessous, Carl Lachat, Stefaan De Henauw, Ali Reza Rahbar, Alison Tedstone, Annie Ling, Beth Hopping, Catherine Leclercq, Christian Haerpfer, Christine Hotz, Christos Pitsavos, Coline van Oosterhout
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.