In the search to live a longer and healthier life, people not only look to what to include in their diet, but also what to leave out. There’s a growing body of evidence that sugar should be on everyone’s list of things to avoid, and that sweetened beverages — both using sugar and artificial sweeteners — have no place in a healthy diet.
Now, a new study suggests those sweet-tasting drinks are associated with an increased risk of earlier death from all causes. Researchers with the International Agency for Research on Cancer used data from nearly 452,000 people from 10 European countries involved in the European Prospective Investigation into Cancer and Nutrition (EPIC).
They concluded that death from all causes was higher among people who drank two or more soft drinks a day, no matter how they were sweetened.
The study, published in JAMA Internal Medicine, also found that people who drank more than two sugar-sweetened soft drinks a day had higher rates of death from digestive diseases.
All sugary drinks, regardless of the source, in excess of four drinks [per] day is associated with an increased risk of both cardiovascular disease and cancer
“This study found that consumption of total, sugar-sweetened, and artificially sweetened soft drinks was positively associated with all-cause deaths in this large European cohort,” the researchers concluded. “The results are supportive of public health campaigns aimed at limiting the consumption of soft drinks.”
Targeting Sugar
The study’s findings are akin to others that have shown that diets high in sugar pose serious health risks, including heart disease, stroke, and some cancers.
The research raises concerns, especially with America’s obesity epidemic being propelled by the high sugar content in many processed foods. That includes sugary beverages such as sodas, juices, sports, and energy drinks.
Dr. Robert Lustig is a pediatric endocrinologist and professor emeritus of pediatrics in the division of endocrinology at the University of California, San Francisco and outspoken critic of the sugar industry.
He says in the 10 years since his viral speech on the “bitter truth” of sugar, he’s noticed a trend: Research funded by the sugar industry finds no adverse health effects to consuming sugar, while research without funding from that industry always finds diets high in sugar lead to more disease and shorter life spans.
The most recent study didn’t receive funding from the sugar industry.
Lustig notes the findings are “going in the same direction as everything else,” which shows poor diets turn into health problems in the future.
Read more: Can eating this type of sugar prevent weight gain?
“It’s garbage in and garbage out, and sugary beverages — and artificially sweetened beverages for that matter — are the epitome of garbage,” according to Lustig.
While Lustig says the study was done reasonably well, he says its greatest weakness is that it shows correlation, not causation. That means it illustrates that sweetened beverages are linked to these diseases, but it doesn’t show it causes them.
One reason is because studying people’s diets is complicated, as they often change from day to day and over a person’s lifetime. “Ultimately, there’s no clinical trial in the history of mankind that can control for everything,” Lustig said.
Sweetened Beverages and Disease
The new research links artificially sweetened beverages to significant gastrointestinal problems and increased risk of Parkinson’s disease, two conditions Lustig says have never been seen before in this type of research.
But he says more research is needed to confirm causation, not merely correlation. “It’s early, and you’re not going to get heads or tails out of it,” Lustig said. The recent research also only asked people at the beginning of the study about their beverage consumption, including whether they drink one a month or two or more every day.
There’s plenty of wiggle room in the middle. Experts say further research should have follow-up questions about whether those patterns remained consistent or changed over time.
Dr. Anton Bilchik, a professor of surgery and chief of gastrointestinal research at John Wayne Cancer Institute at Providence Saint John’s Health Center in California, says excess sugar intake is associated with obesity, which is a major risk factor for cardiovascular disease and cancer.
Read more: Can sugary fruit juices raise cancer risk?
However, he notes there are other links between sugar and cardiovascular disease that aren’t well understood.
“All sugary drinks, regardless of the source, in excess of four drinks [per] day is associated with an increased risk of both cardiovascular disease and cancer,” said Bilchik. “Low-calorie drinks, while containing less sugar, also carry an increased risk.”
Daily Sugar Intake
The American Heart Association recommends that men should consume no more than 9 teaspoons of added sugar a day, and women should have no more than 6 teaspoons of added sugar.
Many popular sweetened drinks, including juices, contain well more than those amounts in a single serving. According to the Harvard T.H. Chan of Public Health, 12 ounces of soda or orange juice contains 10 teaspoons of sugar. In addition, orange soda has 11 teaspoons of sugar. Cranberry juice cocktail has 12.
If you order a venti white chocolate mocha with whipped cream at a coffee shop, it packs about 18 teaspoons of sugar.
“Ideally, no sugar is the best amount, but that is not realistic for the majority of us,” Dr. Sanjiv Patel, a cardiologist at Memorial Care Heart & Vascular Institute at Orange Coast Medical Center in California, told said.
But experts say not consuming drinks high in sugar every day is one of the easiest ways to prevent excess sugar in a person’s diet. Such a lifestyle change can decrease a person’s risk for preventable diseases such as obesity, diabetes, heart attack, and stroke.
“Bottom line, no matter what drink you take, excessive consumption is a problem,” says Patel. “High overall sugar intake from any drink like coffee with sugar, juices, can lead to problems.” Ultimately, experts recommend people drink water and other unsweetened beverages to avoid cardiac and other health problems.