Sugar-Sweetened Beverages
Sugar-sweetened beverages (SSBs) featured article
Sugar-sweetened beverages (SSB) include commonly consumed products such as soda, sports drinks, and energy drinks; coffee, tea, and water with added sugars; and some fruit juices, although not all nutrition experts agree on fruit juice’s inclusion as an SSB. While the consumption of SSBs has declined in recent decades, they remain a leading contributor to sugar intake among people living in the United States.
While the over-consumption of sugar from any source is harmful for health, SSBs present a physiologically unique risk to health due to a converging set of factors. Because they contain no supporting food matrix to slow absorption, SSBs are rapidly absorbed by the gut and cause blood sugar spikes. Sugars from fruits and vegetables are packaged with a matrix of fiber and micronutrients that reduce the rate of digestion. This slow digestion and absorption reduces blood sugar spikes and supports better glycemic control. Additionally, many SSBs [exceed the recommended maximum daily...
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In this clip, Dr. Rhonda Patrick explains how ultra-processed foods impact appetite, inflammation, and long-term disease risk.
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In this clip, Dr. Rhonda Patrick discusses seven ways to reduce inflammation, including diet, supplements, omega-3s, heat stress, and sulforaphane.
Topic Pages
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Sugar-sweetened beverages (SSBs)
Sugar-Sweetened Beverages and sugar-sweetened beverages (SSBs) are terminological synonyms denoting drinks formulated with added caloric sweeteners.
News & Publications
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Sugar-sweetened beverages may help colorectal cancer spread by changing how tumor cells use energy doi.org
Sugar-sweetened beverages are linked to a higher risk of developing colorectal cancer, but their impact on how the disease progresses after cancer onset is less clear. To address this, scientists tested whether the two main sugars found in soft drinks—glucose and fructose—directly promote the spread of colorectal cancer to the liver, and what biological processes could explain it.
The researchers used human colorectal cancer cells, lab-grown mini-tumors, and mouse models of metastasis. They compared what happened when the cells and animals were exposed to a mixture of glucose and fructose (which reflects high‑fructose corn syrup or sucrose) with exposure to glucose alone.
The addition of fructose to glucose altered colorectal cancer cell behanvior:
- In cell culture experiments, glucose plus fructose made certain colorectal cancer cell lines move and invade through a barrier more readily, while their growth rate stayed the same.
- In mice, the same sugar mix caused more liver tumors to form, even though the original intestinal tumors were unchanged in size.
- The effect depended on an enzyme called sorbitol dehydrogenase, or SORD, which helps cells convert sugars into other molecules.
- Tumors from people with colorectal cancer had higher SORD levels than normal colon tissue, particularly in higher‑grade tumors and in some metastatic cohorts.
- Disabling SORD in cancer cells stopped the sugars from promoting spread. Mice given SORD-deficient cells developed far fewer liver tumors, despite the same sugar exposure.
- Inside cells, glucose and fructose together caused SORD to work in reverse, turning fructose into sorbitol and increasing a chemical balance known as the NAD⁺ to NADH ratio, which controls how cells process energy.
- This change sped up energy metabolism and activated the mevalonate pathway, a chain of reactions that makes cholesterol and other fat-related molecules that help cancer cells move and spread. Drugs called statins, which block this pathway, reduced metastasis in the mice.
When tumor cells rely on glucose alone, their main energy pathway, called glycolysis, can slow down because they run low on a molecule called NAD⁺. Adding fructose appears to change that. Through the enzyme SORD, fructose is converted into sorbitol, in a reaction that restores NAD⁺. This renewal of NAD⁺ allows glycolysis to continue efficiently, allowing the cells to draw more energy and carbon building blocks from glucose. Those extra resources can then feed into other pathways that help cancer cells move and spread.
The study was done in cells and animals, so it does not prove the same effect happens in humans. Still, it offers a biological explanation for how frequent intake of sugar-sweetened beverages could worsen colorectal cancer. The authors suggest that limiting such drinks may reduce colorectal cancer mortality or metastasis risk, and that drugs targeting SORD or the pathways it controls could one day help slow cancer spread. In this clip, Peter Attia goes in depth on cancer and explains why aggressive screening is essential.
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Daily sweetened drink intake raises diabetes risk: 23% for sugar-sweetened, 38% for artificially sweetened. https://www.sciencedirect.com/science/article/pii/S126236362500059X
While sugar-sweetened drinks are a leading source of excess dietary sugar, artificially sweetened alternatives—often seen as healthier—are now under scrutiny for their potential harms, with many studies suggesting that both contribute to long-term metabolic disease. A recent study found that daily consumers of sugar-sweetened drinks had a 23% higher risk of type 2 diabetes, while those drinking artificially sweetened beverages daily faced a 38% higher risk.
Researchers analyzed data from more than 36,000 adults aged 40 to 69 years in the Melbourne Collaborative Cohort Study. Participants reported how often they drank sweetened beverages, ranging from less than once a month to once or more daily. The researchers accounted for a wide range of factors, including diet, physical activity, obesity, and socioeconomic status.
The analysis identified a clear association between frequent intake of sweetened beverages and a higher risk of type 2 diabetes. People who consumed sugar-sweetened beverages daily were 23% more likely to develop the disease, while those who drank artificially sweetened beverages daily faced an 83% higher risk. Even after accounting for differences in body weight and fat distribution, the elevated risk linked to artificially sweetened drinks remained statistically significant—at 38%. In total, more than 1,700 new cases of type 2 diabetes were recorded during the study period, with the highest rates observed among those who consumed sweetened beverages most frequently.
These findings suggest that both sugar and artificially sweetened beverages play a role in the development of type 2 diabetes, independent of obesity. Artificial sweeteners may harm the gut, too, ultimately influencing metabolic health. Learn more in this clip featuring Dr. Eran Elinav.
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Sugar-sweetened beverages are linked to 9.8% of new type 2 diabetes cases and 3.1% of new cardiovascular disease cases globally. www.nature.com
Sugar-sweetened beverages contribute to weight gain and increase the risk of severe health concerns, such as type 2 diabetes and cardiovascular disease. A recent study revealed that in 2020, sugar-sweetened drinks were linked to 2.2 million new cases of type 2 diabetes and 1.2 million new cases of cardiovascular disease globally.
Researchers utilized the Global Dietary Database to assess the global, regional, and national effects of type 2 diabetes and cardiovascular disease associated with sugar-sweetened beverage consumption in 184 countries, comparing data from 1990 to 2020. They also considered factors such as age, sex, education, and whether people lived in urban or rural areas to provide further context for the findings.
They found that sugar-sweetened beverages were associated with 9.8% of new type 2 diabetes cases and 3.1% of new cardiovascular disease cases in 2020. The burden was greatest in Latin America and the Caribbean, where sugar-sweetened beverages accounted for 24.4% of type 2 diabetes cases and 11.3% of cardiovascular disease cases. Sub-Saharan Africa also experienced a marked increase in type 2 diabetes and cardiovascular disease related to sugar-sweetened beverages over the past three decades.
These findings suggest that sugar-sweetened beverages have deleterious effects on human health and underscore the need for targeted interventions to reduce their consumption. Learn more about sugar-sweetened beverages in our overview article.
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Drinking more than eight sugar-sweetened drinks a week increases the risk of cardiovascular diseases by up to 31%. pubmed.ncbi.nlm.nih.gov
It’s no surprise that sugar-sweetened drinks can contribute to weight gain, dental problems, and metabolic impairments. But emerging evidence suggests they can also harm your heart. A recent study found that consuming more than eight sugar-sweetened drinks weekly increases the risk of various cardiovascular diseases by as much as 31%.
Researchers investigated links between sugar intake and cardiovascular disease among nearly 70,000 people. They asked participants about their sugar intake from various sugar-sweetened foods and drinks. Then, using national disease registers, they ascertained the incidence of various cardiovascular diseases, including ischemic and hemorrhagic stroke, myocardial infarction (heart attack), heart failure, aortic stenosis (narrowing of the aorta), atrial fibrillation (abnormal heart rhythm), and abdominal aortic aneurysm (ballooning of the major blood vessel in the abdomen).
They found that the risk of developing cardiovascular disease varied according to disease type and sugar source. However, drinking more than eight sugar-sweetened beverages weekly carried the greatest risk, increasing a person’s chances of ischemic stroke by 19%, heart failure by 18%, atrial fibrillation by 11%, and abdominal aortic aneurysms by 31%.
The investigators posited that sugar in beverages is readily metabolized, increasing its potential for harm. Learn more about the health effects of sugar-sweetened beverages in our overview article.
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Xylitol is a sugar alcohol commonly used as a sugar substitute in various processed foods, such as chewing gum and candies. A recent study found that xylitol consumption may increase the risk of major cardiovascular events. However, these findings should be interpreted with caution.
Researchers analyzed metabolic markers in blood samples from more than 1,100 people undergoing elective cardiac evaluations and measured blood xylitol levels in more than 2,100 healthy volunteers. Then, they assessed the effects of xylitol on platelet function and clot formation. Finally, they gave 10 healthy volunteers a xylitol-sweetened drink to determine how xylitol consumption influenced platelet function.
They found that people with the highest xylitol levels had a 57% higher risk of a major cardiovascular event than those with the lowest levels. Xylitol increased several markers of platelet reactivity and clot formation.
Xylitol and its relationship with platelet coagulation.
Study link: https://t.co/dSYmWwDZPT
Xylitol is a sugar alcohol commonly used as a sugar substitute in various processed foods, such as chewing gum and candies. A recent study found that xylitol consumption may increase the risk of major cardiovascular events.
Researchers analyzed metabolic markers in blood samples from more than 1,100 people undergoing elective cardiac evaluations and measured blood xylitol levels in more than 2,100 healthy volunteers. Then, they assessed the effects of xylitol on platelet function and clot formation. Finally, they gave 10 healthy volunteers a xylitol-sweetened drink to determine how xylitol consumption influenced platelet function.
They found that people with the highest xylitol levels had a 57% higher risk of a major cardiovascular event than those with the lowest levels. Xylitol increased several markers of platelet reactivity and clot formation.
These findings suggest that xylitol increases cardiovascular risks; however, they should be interpreted with caution. Learn more about this study and its interpretation in this recent Q&A with Dr. Rhonda Patrick.
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Increased intake of sugar-sweetened drinks raises cardiovascular disease risk by 18 percent with each additional serving, regardless of physical activity. ajcn.nutrition.org
Sugar-sweetened beverages encompass a wide variety of drinks, including soft drinks/sodas, sports drinks, energy drinks, and coffees. People who are physically active often consume sugar-sweetened sports drinks to replenish the electrolytes lost during exercise. While this can be beneficial during prolonged, intense physical activities, the added sugar content in many sports drinks might not be necessary for routine exercise or for people engaging in moderate physical activity. A recent study found that for every additional serving of sugar-sweetened beverages consumed daily, the risk of cardiovascular disease increased by 18 percent for physically active people and 12 percent for those who were inactive.
The study involved more than 105,000 adults enrolled in the Nurses' Health Study and the Health Professionals Follow-up Study who were healthy at the time of enrollment. Researchers gathered information from the participants regarding their physical activity, cardiovascular health, and consumption of sugar-sweetened beverages.
They found that participants who consumed more than two servings of sugar-sweetened beverages per day were 21 percent more likely to develop cardiovascular disease than those who rarely or never consumed them. For each additional serving of sugar-sweetened beverages consumed daily, the risk of cardiovascular disease increased by 18 percent for people who met physical activity guidelines and by 12 percent for those who did not, indicating that physical activity did not compensate for high sugar-sweetened beverage consumption. Participants who did not meet physical activity guidelines and consumed two or more servings per week of sugar-sweetened beverages were 47 percent more likely to develop cardiovascular diseases than those who were physically active and rarely or never drank them.
These findings suggest that consuming sugar-sweetened beverages markedly increases a person’s risk for cardiovascular disease. Furthermore, physical activity does not offset this risk. Learn more about the health effects of sugar-sweetened beverages in our overview article.
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Sugar-sweetened drinks linked to increased visceral fat www.sciencedaily.com
Sugar-sweetened beverage intake increases visceral fat.
Subcutaneous fat is stored just beneath the skin. Commonly associated with a “pear” shape, subcutaneous fat may protect against some diseases. Visceral fat, on the other hand, is stored in the abdominal cavity close to internal organs such as the liver, pancreas, and intestines. An excess of visceral fat, often referred to as central obesity or abdominal obesity, is commonly associated with an “apple” shape and an increased risk of developing many chronic diseases. Findings from a 2016 study suggest that sugar-sweetened beverage intake increases visceral fat deposition.
Sugar-sweetened beverages include commonly consumed products such as soda, sports drinks, energy drinks, and other beverages that contain added sugars. Many sugar-sweetened beverages exceed the recommended maximum daily added sugar intake of 25 grams in a single serving. They are the leading contributor to sugar intake among people living in the United States.
The investigation involved 1,160 participants enrolled in the Third Generation of the Framingham Heart Study who underwent repeated computed tomography scans (approximately six years apart) to assess the amount of fat in their abdominal region, including subcutaneous fat and visceral fat. Participants provided information about their dietary intake, physical activity, overall health, and whether they smoked. Investigators categorized the participants according to their sugar-sweetened beverage or diet soda intake, ranging from non-consumers (drinking none to less than one serving per month) to daily consumers (drinking one or more servings per day.
They found that sugar-sweetened beverage intake was associated with visceral fat gain in a dose-dependent manner, with daily consumers gaining 29 percent more visceral fat over a six-year period than non-consumers. These findings held true even after accounting for the participants' age, gender, physical activity, body mass index, and other factors. Drinking diet soda was not associated with visceral fat gain.
These findings suggest that drinking sugar-sweetened beverages increases visceral fat, potentially contributing to an increased risk of chronic disease. Learn more about sugar-sweetened beverages in our overview article.
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Added sugars decrease metabolic health, survival, competitive ability, and reproduction in mice at human-relevant doses. www.sciencedaily.com
Average sugar consumption in the United States has increased 50 percent since the 1970s, due in part to the use of high fructose corn syrup in beverages and other processed foods. The mechanisms by which added sugars lead to metabolic diseases such as obesity, type 2 diabetes, cardiovascular disease, and fatty liver disease have been explored in research using mouse models; however, the dose of sugar used in these animal studies is usually much larger than what is normally consumed by people. Authors of this report investigated the effects of human-relevant doses of added sugars on health and behavior in mice.
Mouse models are a useful tool in research because mice can be kept in environments where their exposure to light, food, socialization, and other environmental inputs is completely controlled, minimizing variation between mice when exposed to a dietary intervention. However, these highly controlled environments, combined with large doses of experimental foods, often limit the generalizability of mouse research for human health. Organismal performance assays, which use seminatural conditions to put experimental animals in direct competition with each other, more accurately measure survival, competitive ability, and reproduction (common measures of evolutionary fitness) in response to environmental exposures.
The investigators fed one group of mice a diet containing 25 percent of calories from a 1:1 mixture of fructose and glucose, the same ratio of sugars found in beverages and processed foods containing high fructose corn syrup. They fed a second group of mice a control diet in which the added sugars were replaced with cornstarch and fiber. Both groups of mice consumed their respective diets and lived in controlled environments for 26 weeks before entering the organismal performance assay, upon which all mice consumed the high-sugar diet. The researchers observed mice as they competed for territory, resources, and mates for 26 to 32 weeks.
Female mice fed a high sugar diet prior to entering the organismal performance assay were twice as likely to die than female mice fed a normal diet. Male mice fed a high sugar diet controlled 26 percent less territory and produced 25 percent less offspring compared to mice fed a normal diet prior to entering the organismal performance assay. A high-sugar diet increased fasting cholesterol levels and decreased glucose tolerance.
The authors concluded that a high sugar diet decreased survival, competitive ability, and reproduction in mice and led to metabolic dysfunction. This study was the first to use organismal performance assays in combination with an environmental intervention and the first to demonstrate the negative health effects of added sugars in mice at human-relevant doses.
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High maternal sugar intake during lactation impairs cognitive development in breastfed infants. www.eurekalert.org
Breastfeeding has profound effects on an infant’s brain, greatly influencing their intellectual development. Evidence indicates that children and adolescents who were breastfed as infants score higher on intelligence tests than those who were not breastfed, even after taking maternal intelligence into consideration. However, components of a mother’s diet during lactation can counter the beneficial aspects of breastfeeding. Findings from a recent study suggest that sugar intake during lactation impairs cognitive development in breastfed infants.
The average person living in the United States consumes more than 500 calories per day in sugars, translating to roughly 100 pounds of sugar per year. High sugar consumption is associated with an increased risk for obesity, type 2 diabetes, and fatty liver disease.
The prospective observational study involved 88 mother-infant pairs. The authors of the study collected demographic data that included maternal age, pre-pregnancy body mass index, and education level, among others. The mothers reported how many times they breastfed their infants every day and provided information about what they had eaten in a 24-hour period (using dietary recalls) when their infants were one and six months old. The authors of the study tested the infants' cognitive development when the infants were 24 months old.
Analysis of the recalls indicated that the women consumed approximately 1,650 calories per day when their infants were one month old. More than 22 percent of these calories were from total sugar, and more than 13 percent were from added sugar, particularly fructose. The mothers consumed as many as five sugar-sweetened beverages or juices per day, which are high in fructose.
The authors found that higher maternal fructose consumption at one month postnatal was associated with worse infant developmental outcomes at 24 months postnatal. These findings held true even when considering maternal age, pre-pregnancy BMI, education level, caloric intake, infant age, sex, and birthweight.
The results of this study suggest that maternal sugar consumption during breastfeeding adversely affects infant cognitive development. The authors of the study conceded that the study’s design precluded determining causation.