A high intake of sugar-sweetened beverages is independently associated with greater BMI or BMI z score, according to findings from a meta-analysis of more than 240,000 children and adults.
The review, which includes 30 studies published between 2013 and 2015, also suggested that the evidence concerning education interventions to reduce sugar-sweetened beverage consumption is limited, and it is difficult to draw a causal relationship.
“By combining the already published evidence with this new research, we conclude something that in many ways should already be obvious: Public health policies should aim to reduce the consumption of [sugar-sweetened beverages] and encourage healthy alternatives, such as water,” Nathalie Farpour-Lambert, MD, PhD, of University Hospitals of Geneva, said in a press release. “Yet, to date, actions to reduce [sugar-sweetened beverage] consumption in many countries are limited or non-existent.”
Farpour-Lambert and colleagues analyzed data from 26 prospective studies and four randomized controlled trials (n = 244,651) conducted worldwide between January 2013 and October 2015 that evaluated the association between sugar-sweetened beverages and body weight measures in children (n = 56,340; mean age, 9 years; study durations ranged 6 months to 13 years) and adults (n = 186,012; mean age, 46 years; study durations ranged 5 to 14 years).
Among prospective studies and randomized controlled trials of children, 94% showed a positive relationship between sugar-sweetened beverage intake and body weight measures; one prospective study showed no relationship between sugar-sweetened beverage consumption and body weight.
Among studies of adults, all prospective studies showed a positive relationship between sugar-sweetened beverage consumption and body weight measures. One randomized controlled trial (n = 240), in which adults were randomly assigned to an intervention to replace sugary drinks with water and receive education counseling or to counseling only, showed no benefit from the intervention, according to researchers.
“While those adults receiving the intervention lost more weight, however, the result was just outside statistical significance,” the researchers wrote.
Farpour-Lambert noted that any association between sugar-sweetened beverage consumption and body weight measures might be affected by other diet and lifestyle factors; however, most of the prospective cohort studies adjusted for these possible confounding factors, which suggests an independent effect of sugary drinks, she said.
Farpour-Lambert said future research should focus on how to effectively reduce the consumption of sugar-sweetened beverages in different populations and on the impact of interventions on body weight or obesity in children and adults, as well as the responsibilities of the food and beverages industry, policy makers and other stakeholders.
“The balance between the responsibility of individuals, health advocates and governments and society must be clarified,” Farpour-Lambert said in the statement. “It is important to mobilize multiple stakeholders and to develop operational synergies across different sectors. Professional networks and the food and beverages industry must be encouraged to promote healthy diets in accordance with international standards.” – by Regina Schaffer
Disclosures: The authors report no relevant financial disclosures.