More Americans now drink sugar-sweetened sodas, sport drinks and fruit drinks daily, and this increase in consumption has led to more diabetes and heart disease over the past decade, researchers reported at the American Heart Association's 50th Annual Conference on Cardiovascular Disease Epidemiology and Prevention.

Using the Coronary Heart Disease (CHD) Policy Model, a well-established computer simulation model of the national population age 35 and older, researchers estimate that the increased consumption of sugar-sweetened beverages between 1990 and 2000 contributed to 130,000 new cases of diabetes, 14,000 new cases of coronary heart disease (CHD), and 50,000 additional life-years burdened by coronary heart disease over the past decade.

Sugar-sweetened soda, sport and fruit drinks (not 100 percent fruit juice) contain equivalent calories, ranging from 120 to 200 per drink, and thus play a role in the nation's rising tide of obesity, researchers said. Previous research has linked daily consumption of these sugary beverages to an increased risk of diabetes, even apart from excessive weight gain.

"The CHD model allows us to incorporate data from other studies that demonstrate an association between daily consumption of sugared beverages and diabetes risk; we can then translate this information into estimates of the current diabetes and cardiovascular disease that can be attributed to the rise in consumption of these drinks," said Litsa Lambrakos, M.D., study lead investigator and internal medicine resident at the University of California-San Francisco.

The prospective simulation model draws on data from major epidemiological studies, including the Framingham Heart Study, The Nurses Health Study and the National Health and Nutrition Examination Survey (NHANES).

Through the model, the researchers estimate the additional disease caused by the drinks has increased coronary heart disease healthcare costs by 300-550 million U.S. dollars between 2000-2010. This figure likely underestimates the true costs because it does not account for the increased costs associated with the treatment and care of patients with diabetes alone. Over the last decade, at least 6,000 excess deaths from any cause and 21,000 life-years lost can be attributed to the increase in sugar-sweetened drinks.

Health policy experts suggest curbing the consumption of sugared drinks through an excise tax of 1 cent per ounce of beverage, which would be expected to decrease consumption by 10 percent.

"If such a tax could curb the consumption of these drinks, the health benefits could be dramatic," said Kirsten Bibbins-Domingo, M.D., Ph.D., senior author of the study and associate professor of medicine at the University of California, San Francisco.

The authors are currently examining the impact of various approaches to reducing consumption of sugary beverages. "We want to make the general public more aware of the adverse health outcomes of consuming these drinks over time," Lambrakos said. "We want to help support disease prevention and curb consumption of these drinks that lead to poor health outcomes and increased healthcare costs for the average American."

"The American Heart Association recommends a dietary pattern that is rich in fruit, vegetables, low-fat or fat free dairy products, high-fiber whole grains, lean meat, poultry and fish," said Robert H. Eckel, M.D., past president of the American Heart Association, and professor of medicine at the Anschutz Medical Campus of the University of Colorado Denver. "Always consider overall diet in the context of energy balance and make sure foods and drinks high in added sugars are not taking the place of foods with essential nutrients."

The American Heart Association recommends an upper limit of half of the discretionary calorie allowance from added sugars, which for most American women is no more than 100 calories per day and for most American men is no more than 150 calories per day from added sugars. Sugar-sweetened beverages should be limited to 450 calories or less per week (36oz), based on a 2000 calorie per day diet.

Other co-authors are: Pamela Coxson, Ph.D. and Lee Goldman, M.D., M.P.H. Author disclosures are on the abstract.

Karen Astle
American Heart Association