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 R. Sharib; Sean B. Cash; Simon Barquera; Renata Micha; Masoud Mirzaei; Laetitia Nikiema; Mark Manary; Johanna M. Geleijnse; David Balfour; Claudette Mitchell; Ibrahim Elmadfa; Alexa Meyer; Gordon Zello; Getahun Ersino; Carol Henry; Regina Fisberg; Sheila Skeaff; Shu Wen Ng; Linda Adair; Elizabeth Yakes Jiménez; Corina Aurelia Zugravu; Foong Ming Moy; Lluis Serra-Majem; Ingibjorg Gunnarsdottir; Inga Thorsdottir; Laufey Steingrimsdottir; Wolfgang Stuetz; Laila Eleraky; Riitta Freese; Maijaliisa Erkkola; Liisa Korkalo; Aminul Haque; Nancy F. Krebs; K. Michael Hambidge; Julie M. Long; Ranil Jayawardena; Indu Waidyatilaka; Ute Nöthlings; Ute Alexy; Tor Strand; Angelica María Ochoa Avilés; Silvia Johana Ortiz Ulloa; Dariush Mozaffarian; Rubina Hakeem; Antonia Trichopoulou

doi:10.1038/s41591-024-03345-4

Burdens of type 2 diabetes and cardiovascular disease attributable to sugar-sweetened beverages in 184 countries

Laura Lara Castor (First Author)
, Meghan O’Hearn
, Frederick Cudhea
, Victoria Miller
, Peilin Shi
, Jianyi Zhang
, Julia R. Sharib
, Sean B. Cash
, Simon Barquera
, Renata Micha
, Masoud Mirzaei
, Laetitia Nikiema
, Mark Manary
, Johanna M. Geleijnse
, David Balfour
, Claudette Mitchell
, Ibrahim Elmadfa
, Alexa Meyer
, Gordon Zello
, Getahun Ersino

Carol Henry, Regina Fisberg, Sheila Skeaff, Shu Wen Ng, Linda Adair, Elizabeth Yakes Jiménez, Corina Aurelia Zugravu, Foong Ming Moy, Lluis Serra-Majem, Ingibjorg Gunnarsdottir, Inga Thorsdottir, Laufey Steingrimsdottir, Wolfgang Stuetz, Laila Eleraky, Riitta Freese, Maijaliisa Erkkola, Liisa Korkalo, Aminul Haque, Nancy F. Krebs, K. Michael Hambidge, Julie M. Long, Ranil Jayawardena, Indu Waidyatilaka, Ute Nöthlings, Ute Alexy, Tor Strand, Angelica María Ochoa Avilés, Silvia Johana Ortiz Ulloa, Dariush Mozaffarian, Rubina Hakeem, Antonia Trichopoulou (Last Author)

Universidad de Cuenca

Tufts University
University of Washington
Food Systems for the Future Institute
McMaster University
Population Health Research Institute, Ontario
Brigham and Women’s Hospital
Instituto Nacional de Salud Publica
University of Thessaly
Shahid Sadoughi University of Medical Sciences
World Health Organization
Washington University St. Louis
Wageningen University & Research
University of the Southern Caribbean
University of Vienna
University of Saskatchewan
Universidade de São Paulo
University of Otago
University of North Carolina at Chapel Hill
University of New Mexico
Carol Davila University of Medicine and Pharmacy
University of Malaya
University of Las Palmas de Gran Canaria
University of Iceland
University of Hohenheim
University of Helsinki
University of Dhaka
University of Colorado Anschutz Medical Campus
University of Colombo
University of Bonn
University of Bergen
Ziauddin University
National and Kapodistrian University of Athens
Academy of Athens

Research output: Contribution to journal › Article › peer-review

80 Scopus citations

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.

Original language	English
Article number	e003585
Pages (from-to)	552-564
Number of pages	13
Journal	Nature Medicine
Volume	31
Issue number	2
DOIs	https://doi.org/10.1038/s41591-024-03345-4
State	Published - 6 Jan 2025

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

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10.1038/s41591-024-03345-4

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Lara Castor, L., O’Hearn, M., Cudhea, F., Miller, V., Shi, P., Zhang, J., Sharib, J. R., Cash, S. B., Barquera, S., Micha, R., Mirzaei, M., Nikiema, L., Manary, M., Geleijnse, J. M., Balfour, D., Mitchell, C., Elmadfa, I., Meyer, A., Zello, G., ... Trichopoulou, A. (2025). Burdens of type 2 diabetes and cardiovascular disease attributable to sugar-sweetened beverages in 184 countries. Nature Medicine, 31(2), 552-564. Article e003585. https://doi.org/10.1038/s41591-024-03345-4

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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 andsubpopulations most affected by cardiometabolic disease associated with SSB consumption, assisting in shaping effective policies and interventions to reduce these burdens globally.",

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Lara Castor, L, O’Hearn, M, Cudhea, F, Miller, V, Shi, P, Zhang, J, Sharib, JR, Cash, SB, Barquera, S, Micha, R, Mirzaei, M, Nikiema, L, Manary, M, Geleijnse, JM, Balfour, D, Mitchell, C, Elmadfa, I, Meyer, A, Zello, G, Ersino, G, Henry, C, Fisberg, R, Skeaff, S, Ng, SW, Adair, L, Jiménez, EY, Zugravu, CA, Moy, FM, Serra-Majem, L, Gunnarsdottir, I, Thorsdottir, I, Steingrimsdottir, L, Stuetz, W, Eleraky, L, Freese, R, Erkkola, M, Korkalo, L, Haque, A, Krebs, NF, Hambidge, KM, Long, JM, Jayawardena, R, Waidyatilaka, I, Nöthlings, U, Alexy, U, Strand, T, Ochoa Avilés, AM , Ortiz Ulloa, SJ, Mozaffarian, D, Hakeem, R & Trichopoulou, A 2025, 'Burdens of type 2 diabetes and cardiovascular disease attributable to sugar-sweetened beverages in 184 countries', Nature Medicine, vol. 31, no. 2, e003585, pp. 552-564. https://doi.org/10.1038/s41591-024-03345-4

TY - JOUR

T1 - Burdens of type 2 diabetes and cardiovascular disease attributable to sugar-sweetened beverages in 184 countries

AU - Lara Castor, Laura

AU - O’Hearn, Meghan

AU - Cudhea, Frederick

AU - Miller, Victoria

AU - Shi, Peilin

AU - Zhang, Jianyi

AU - Sharib, Julia R.

AU - Cash, Sean B.

AU - Barquera, Simon

AU - Micha, Renata

AU - Mirzaei, Masoud

AU - Nikiema, Laetitia

AU - Manary, Mark

AU - Geleijnse, Johanna M.

AU - Balfour, David

AU - Mitchell, Claudette

AU - Elmadfa, Ibrahim

AU - Meyer, Alexa

AU - Zello, Gordon

AU - Ersino, Getahun

AU - Henry, Carol

AU - Fisberg, Regina

AU - Skeaff, Sheila

AU - Ng, Shu Wen

AU - Adair, Linda

AU - Jiménez, Elizabeth Yakes

AU - Zugravu, Corina Aurelia

AU - Moy, Foong Ming

AU - Serra-Majem, Lluis

AU - Gunnarsdottir, Ingibjorg

AU - Thorsdottir, Inga

AU - Steingrimsdottir, Laufey

AU - Stuetz, Wolfgang

AU - Eleraky, Laila

AU - Freese, Riitta

AU - Erkkola, Maijaliisa

AU - Korkalo, Liisa

AU - Haque, Aminul

AU - Krebs, Nancy F.

AU - Hambidge, K. Michael

AU - Long, Julie M.

AU - Jayawardena, Ranil

AU - Waidyatilaka, Indu

AU - Nöthlings, Ute

AU - Alexy, Ute

AU - Strand, Tor

AU - Ochoa Avilés, Angelica María

AU - Ortiz Ulloa, Silvia Johana

AU - Mozaffarian, Dariush

AU - Hakeem, Rubina

AU - Trichopoulou, Antonia

PY - 2025/1/6

Y1 - 2025/1/6

N2 - 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 andsubpopulations most affected by cardiometabolic disease associated with SSB consumption, assisting in shaping effective policies and interventions to reduce these burdens globally.

AB - 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 andsubpopulations most affected by cardiometabolic disease associated with SSB consumption, assisting in shaping effective policies and interventions to reduce these burdens globally.

KW - Cardiovascular diseases

KW - Diabetes mellitus

KW - Female

KW - Humans

KW - Young adults

KW - Sweetened beverages

UR - https://www.scopus.com/pages/publications/85214369271

UR - https://pubmed.ncbi.nlm.nih.gov/39762424/

UR - https://www.nature.com/articles/s41591-024-03345-4

U2 - 10.1038/s41591-024-03345-4

DO - 10.1038/s41591-024-03345-4

M3 - Artículo

C2 - 39762424

AN - SCOPUS:85214369271

SN - 1078-8956

VL - 31

SP - 552

EP - 564

JO - Nature Medicine

JF - Nature Medicine

IS - 2

M1 - e003585

ER -

Burdens of type 2 diabetes and cardiovascular disease attributable to sugar-sweetened beverages in 184 countries

Abstract

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Correction to: Burdens of type 2 diabetes and cardiovascular disease attributable to sugar-sweetened beverages in 184 countries (Nature Medicine, (2025), 31, 2, (552-564), 10.1038/s41591-024-03345-4)

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