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 In a study that followed more than 400,000 European adults for more
than 16 years, the risk of premature death was heightened in those
who consumed 2 or more glasses per day of soft drinks, according to
the report published in JAMA Internal Medicine.
"Our results for sugar-sweetened soft drinks provide further support
to limit consumption and to replace them with other healthier
beverages, preferably water," said study coauthor Neil Murphy a
scientist at the International Agency for Research on Cancer. "For
artificially sweetened soft drinks, we now need a better
understanding of the mechanisms that may underlie this association
and research such as ours will hopefully stimulate these efforts."
The soft drinks themselves might not be at the root of the
association, Murphy said. The new findings don't mean that soft
drinks cause early death, because "in these types of studies
(observational epidemiology) there are other factors which may be
behind the association we observed," Murphy added in an email. "For
instance, high soft drink consumption may be a marker of overall
unhealthy diet."
To take a closer look at a possible link between soft drinks and
premature mortality, Murphy and his colleagues turned to the data
from the European Prospective Investigation into Cancer and
Nutrition, a multinational study that recruited participants from
1992 through 2000.
The study assessed diet at the start, including soft drink
consumption. Participants also filled out lifestyle questionnaires
that asked about factors such as educational level, smoking habits,
alcohol intake and physical activity.
After excluding participants who already had conditions such as
cancer, heart disease and diabetes at the study's start as well as
those without data on soft drink consumption, the researchers were
left with 451,743 participants, who stayed in the study for an
average of 16.4 years. The average age at the start was about 51
years. During the study, 41,693 participants died.
When the researchers analyzed their data, accounting for factors
that could increase the risk of death, such as body mass index and
smoking, they found that participants who consumed two or more
glasses of soft drinks per day were 17% more likely to die early
compared to those who drank less than a single serving of soft
drinks per month.
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Those who consumed two or more glasses of sugar sweetened soft
drinks per day were 8% more likely to die early compared to those
who drank less than a glass a month and those who consumed two or
more glasses of artificially sweetened soft drinks a day were 26%
more likely to die prematurely compared to those who drank less than
a glass per month.
The researchers allow that there were differences between the two
groups of study participants that went beyond soft drink
consumption.
"High soft drink consumers had higher BMI and were also more likely
to be current tobacco smokers," Murphy said. "We made statistical
adjustments in our analyses for BMI, smoking habits and other
mortality risk factors which may have biased our results and the
positive associations remained. However, we cannot rule out the
possibility that these factors were influencing our findings, hence
we cannot say the associations we observe are causal."
Studies like Murphy's can indeed be biased by other lifestyle
factors, said Dr. Bruce Y. Lee. an associate professor at Johns
Hopkins University.
"There are only so many things you can account for when it comes to
different types of factors," Lee said. "These are very complex
systems."
It's possible that soft drink consumption could be a marker for some
other lifestyle factor or behavior, Lee explained.
Studies like the new one "are helpful but if you really want to go
after a better understanding on how eating and drinking affect
health you have to dive deeper," Lee said.
In the meantime, the best course "is to stick to natural foods with
minimal processing," Lee said.
SOURCE: http://bit.ly/2MSCpCg JAMA Internal Medicine, online
September 3, 2019.
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