Most deaths occurred in middle- to low-income countries, the Harvard
The findings are surprising because "we often think of this as a problem only
in high-income countries, like the US," said lead researcher Gitanjali Singh, a
research fellow at Harvard School of Public Health, in Boston.
She said her findings, presented at an American Heart Association
meeting in New Orleans, point to a need for policies that curb people's sugary
NY trying to ban large drinks
One such effort, in New York City, is currently in the spotlight. Last week,
a judge struck down Mayor Michael Bloomberg's controversial limit on large
sweetened sodas and other sugary beverages, one day before the rule was to go
into effect. Bloomberg said he would appeal the decision and defended his plan,
which would have limited the size of sugary drinks sold at restaurants, food
carts and theatres to 16 ounces.
Singh said that's not the only type of measure officials could take. Others
could include taxing sugar-added drinks, or limiting advertising of the
beverages to children.
But "anti-soda" moves are a tough sell - not only because the beverage
industry and many consumers resist. It's also hard to pin ill health effects on
one component of people's diets, even if it's a nutritionally dubious one.
These latest findings do not prove that sugary drinks kill people. They only
show a correlation between high consumption and deaths from heart disease,
diabetes and certain cancers.
"This type of study cannot prove cause-and-effect," said Lona Sandon, an
assistant professor of clinical nutrition at the University of Texas
Southwestern Medical Center at Dallas.
"Sugary beverage consumption is often paired with other unhealthy food
choices or behaviours," said Sandon, who was not involved in the study. "Chronic
diseases, such as heart disease and diabetes, are the result of many factors,
not just excess sugar intake."
'Everyone should limit sugar'
That said, everyone should be limiting added sugar - from drinks and food -
Sandon stressed. "We just do not need added sugar that is empty calories," she
The beverage industry also weighed in on the findings.
"This [study], which is neither peer-reviewed nor published, is more about
sensationalism than science," the American Beverage Association (ABA) said in a
"In no way does it show that consuming sugar-sweetened beverages causes
chronic diseases such as diabetes, cardiovascular disease or cancer - the real
causes of death among the studied subjects," the ABA added. "The researchers
make a huge leap when they illogically and wrongly take beverage intake
calculations from around the globe and allege that those beverages are the cause
of deaths which the authors themselves acknowledge are due to chronic
What the research found
Study author Singh agreed that for any one person, many factors go into the
risk of developing heart disease, cancer or other chronic conditions. But she
said that on the "population level," it is still possible to estimate the number
of deaths attributable to sugary drink consumption.
To do that, she and her colleagues used national nutrition surveys from
around the world to gauge how high people's sugary drink intake was in each
country. Then they estimated how sugar-added drinks affected obesity levels in
those countries. Finally, Singh said, they turned to data on how obesity sways
people's risk of heart disease, type 2 diabetes and certain cancers - such as
breast, colon and pancreatic cancers.
Overall, they estimate that upwards of 180 000 deaths were "attributable to"
sugary drink consumption in 2010. That included more than 130 000 from diabetes,
about 45 000 from heart disease and stroke, and 4 600 from various cancers.
As for sugary drink intake, young Cuban men beat the rest of the world: Men
younger than 45 typically downed more than five servings per day. And in
general, Latin America and the Caribbean had the most deaths linked to
"This sheds light on the linear connection between sugary drink consumption
and deaths," said Dr Suzanne Steinbaum, a cardiologist and director of Women and
Heart Disease at Lenox Hill Hospital in New York City. She was not involved in
She agreed that it's difficult to blame deaths on high-sugar drinks alone.
But she also said the findings highlight one important, and simple, move that
people can make to improve their diets.
'Stay away from sweetened drinks'
"Make this one change, to stay away from sugar-sweetened beverages,"
Steinbaum said. "Is it the only fix? Certainly not." But, she added, replacing
even one sugary drink a day with water can cut a significant amount of
Steinbaum also noted that sodas are not the only culprit. "Often, these fruit
juices that people think are healthy are loaded with sugar," she said.
One of the big concerns in the sugary-drink "war" is that many children and
teenagers are downing huge amounts of liquid calories. Because this study
focused on deaths from chronic diseases, Singh said it says nothing about the
potential health effects on kids across the globe.
"We need research to figure out how high their consumption of sugary drinks
really is," Singh said, "and to see how it affects their health."
The ABA countered that it is daily caloric intake, not high-calorie
beverages, that really matters. "When it comes to risk for heart disease, there
is nothing unique about the calories from added sugars, or sugar-sweetened
beverages for that matter," the group said.
Study results presented at medical meetings are generally considered
preliminary until they undergo peer review to be published in a journal.
The American Heart Association has advice
on cutting sugar.