CoChat
Sign Up
Cited by 421Nutritional Studies and DietDiet, Metabolism, and DiseaseBiochemical Analysis and Sensing Techniques

Long-Term Consumption of Sugar-Sweetened and Artificially Sweetened Beverages and Risk of Mortality in US Adults

Open access
Malik, Vasanti S., Li, Yanping, Pan, An, De Koning, Lawrence, Schernhammer, Eva, Willett, Walter C., Hu, Frank B.·2019·Circulation
DOI 10.1161/circulationaha.118.037401PMC PMC6488380
Open this paper in CoChat — free account

Abstract

Background: Whether consumption of sugar-sweetened beverages (SSBs) or artificially sweetened beverages (ASBs) is associated with risk of mortality is of public health interest. Methods: We examined associations between consumption of SSBs and ASBs with risk of total and cause-specific mortality among 37 716 men from the Health Professional’s Follow-up study (from 1986 to 2014) and 80 647 women from the Nurses’ Health study (from 1980 to 2014) who were free from chronic diseases at baseline. Cox proportional hazards regression was used to estimate hazard ratios and 95% confidence intervals. Results: We documented 36 436 deaths (7896 cardiovascular disease [CVD] and 12 380 cancer deaths) during 3 415 564 person-years of follow-up. After adjusting for major diet and lifestyle factors, consumption of SSBs was associated with a higher risk of total mortality; pooled hazard ratios (95% confidence intervals) across categories (<1/mo, 1–4/mo, 2–6/week, 1-<2/d, and ≥2/d) were 1.00 (reference), 1.01 (0.98, 1.04), 1.06 (1.03, 1.09), 1.14 (1.09, 1.19), and 1.21 (1.13, 1.28; P trend <0.0001). The association was observed for CVD mortality (hazard ratio comparing extreme categories was 1.31 [95% confidence interval, 1.15, 1.50], P trend <0.0001) and cancer mortality (1.16 [1.04, 1.29], P trend =0.0004). ASBs were associated with total and CVD mortality in the highest intake category only; pooled hazard ratios (95% confidence interval) across categories were 1.00 (reference), 0.96 (0.93, 0.99), 0.97 (0.95, 1.00), 0.98 (0.94, 1.03), and 1.04 (1.02, 1.12; P trend = 0.01) for total mortality and 1.00 (reference), 0.93 (0.87, 1.00), 0.95 (0.89, 1.00), 1.02 (0.94, 1.12), and 1.13 (1.02, 1.25; P trend = 0.02) for CVD mortality. In cohort-specific analysis, ASBs were associated with mortality in NHS (Nurses’ Health Study) but not in HPFS (Health Professionals Follow-up Study) ( P interaction, 0.01). ASBs were not associated with cancer mortality in either cohort. Conclusions: Consumption of SSBs was positively associated with mortality primarily through CVD mortality and showed a graded association with dose. The positive association between high intake levels of ASBs and total and CVD mortality observed among women requires further confirmation.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1161/circulationaha.118.037401

Cites

39 of 39 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • In a prospective cohort study of 118 363 people followed for 34 years in the US, consumption of two or more servings of sugar sweetened beverages a day was linked with a 21% higher risk of total mortality (hazard ratio 1.21, 1.13 to 1.28), a 31% higher risk of cardiovascular disease mortality (1.31, 1.15 to 1.50), and a 16% higher risk of cancer mortality (1.16, 1.04 to 1.29).

    “After adjustment for diet and lifestyle confounders, the consumption of two or more servings of sugar sweetened beverages a day was linked with a 21% (hazard ratio 1.21, 1.13 to 1.28) higher risk of total mortality, a 31% (1.31, 1.15 to 1.50) higher risk of cardiovascular disease mortality, and a 16% (1.16, 1.04 to 1.29) higher risk of cancer mortality.147”

    From Dietary sugar consumption and health: umbrella review (2023) · cites this paper as [147]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

2 of the 41 references couldn’t be matched to a known paper.

Cited by

Sorted by citations

Related

Authors
Malik, V. S., Li, Y., Pan, A., De Koning, L., Schernhammer, E., Willett, W. C., & Hu, F. B.
Affiliations
  • Harvard University (US)
  • Huazhong University of Science and Technology (CN)
  • Departments of Pathology and Laboratory Medicine, Community Health Sciences and Pediatrics, University of Calgary, Alberta, Canada (L.D.K.).
  • Brigham and Women's Hospital (US)
ORCID
Venue
Circulation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2019-04-30
Volume
139
Issue
18
Pages
2113-2125
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
DOI
10.1161/circulationaha.118.037401
PMC
PMC6488380
OpenAlex
W2921424591
Cited by
421
References
41
Citations by year
2026: 26 · 2025: 38 · 2024: 60 · 2023: 56 · 2022: 82 · 2021: 69 · 2020: 55 · 2019: 34 · 2012: 1
FWCI
55.23
Type
journal article
Language
en
Open access
Locations
  • Circulation (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health
  • National Heart, Lung, and Blood Institute (R01HL060712, R01HL035464, R01HL034594, R01HL088521)
  • National Cancer Institute (P01CA087969, UM1CA176726, P01CA055075, UM1CA186107, UM1CA167552)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
  • Health Sciences › Nursing › Nutrition and Dietetics › Biochemical Analysis and Sensing Techniques
Keywords
sugar-sweetened beverages, artificially sweetened beverages, mortality risk, cardiovascular mortality, cancer mortality, all-cause mortality, beverage consumption, Health Professionals Follow-up Study, Nurses' Health Study, dietary risk factors, sugar-sweetened beverage tax
MeSH terms
Sugars, Artificially Sweetened Beverages, Adult, Aged, Cardiovascular Diseases, Female, Follow-Up Studies, Humans, Male, Middle Aged, Mortality, Neoplasms, Risk Factors, Sweetening Agents, United States

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review