In the ever-evolving field of nutrition science, a compelling piece of research recently featured in the Current Developments in Nutrition journal meticulously combed through 20 clinical trials to decode the cardiovascular implications tied to our drink choices[1]. The drinks under the microscope included a broad spectrum from the morning ritual of tea and coffee, the mid-day boost from fruit juices and energy drinks, to the evening unwind with alcohol, and the ubiquitous presence of sugar-sweetened or artificially sweetened drinks in our diets.
The findings of this meta-analysis bring to light the stark reality of long-term indulgence in sugar-sweetened drinks and alcohol. The data pointed towards a noticeable uptick in cardiovascular mortality risks for both genders associated with these liquid temptations. The narrative around fruit juices, teeming with natural sugars, and the adrenaline-pumping energy drinks, however, remains hazy due to a gap in comprehensive data.
Parallel to this, the American Journal of Clinical Nutrition unfurled the results of another investigation, setting the stage with 100,000 adults to scrutinise if an active lifestyle could shield the heart against the onslaught of sugary and artificially sweetened liquid drinks[2].
Despite the participants engaging in regular physical activity, those who frequently succumbed to the allure of sweetened drinks, more than twice a week, were flagged for a heightened cardiovascular disease risk. This revelation underscores a critical narrative: while exercise stands as a bastion for heart health, its protective cloak might not completely guard against the repercussions of a high sugary drink intake.
This isn’t to say that every sip of a sugar-sweetened beverage spells doom. The research didn’t venture into the occasional enjoyment of these drinks, suggesting that a total clampdown on sugar isn’t the takeaway message. Rather, it’s an invitation to cultivate awareness around the sugar content of the beverages that can become part of peoples’ daily habits.
A further meta-analysis, this time in the Frontiers Nutrition Journal supports the understanding that the relationship between beverage consumption and health risks is intricate, with varying levels of intake significantly altering risk profiles for several conditions[3]. This complexity is especially notable in the context of sugar-sweetened drinks (SSDs) and artificially sweetened drinks (ASDs), each having distinct implications for individuals and public health.
For SSDs, the data presents a concerning trend: with every additional serving consumed daily, individuals face an 8% uptick in the risk of all-cause mortality. This statistic underscores the profound impact that seemingly small increases in SSD consumption can have on overall health and longevity. The high sugar content in these beverages contributes to a range of metabolic abnormalities that could explain this elevated mortality risk, including insulin resistance, inflammation, and obesity, all of which are known risk factors for a spectrum of chronic diseases.
ASDs, on the other hand, offer a different but equally troubling picture. Higher consumption levels of these beverages are linked to a 14% increased risk of hypertension, a key risk factor for cardiovascular diseases including heart attack and stroke. The mechanisms through which ASDs may contribute to hypertension remain a topic of ongoing research, with hypotheses including the impact on the gut microbiota, insulin sensitivity, and weight gain.
SSDs also impact sleep
Research published in Sleep Health has also shown that there is an association between self-reported sleep duration and sugar-sweetened SSD consumption among adults[4]. Adults who slept 5 hours or less per night had a 21% higher consumption of SSDs, particularly caffeinated sugary beverages. On the other hand, longer sleepers (≥9 hours) consumed fewer servings of coffee and water. This relationship between short sleep and increased intake of SSDs suggests a potential impact on physical health, although the directionality of this relationship requires further investigation.
Studies such as the one published in the American Journal of Lifestyle Medicine have also found a positive association between high added sugar intake and poor quality of sleep[5]. Consuming foods high in added sugar has been linked to decreased sleep duration and satisfaction, particularly in adolescents. This relationship underscores the potential impact of dietary choices, specifically added sugar intake, on sleep quality and overall health.
Mitigating the desire for SSDs
Incorporating protein-rich foods, fibre-rich fruits like berries, and healthy fats into your diet can help reduce the desire for sugary drinks by curbing hunger, satisfying cravings, and providing essential nutrients that support overall health.
Magnesium has been found to potentially reduce the desire for sugary beverages. Research in Scientific Reports suggests that magnesium plays a role in various bodily functions, including the breakdown of sugars and the regulation of insulin activity. Some studies have indicated a link between magnesium intake and the risk of type 2 diabetes, highlighting the potential benefits of magnesium in managing blood sugar levels and insulin resistance. Additionally, magnesium deficiency has been associated with conditions like fatigue, nausea, heart disease, and metabolic syndrome, emphasising the importance of maintaining adequate magnesium levels for overall health[6].
Magnesium deficiency is specifically worth paying attention to. According to one study, up to 50 percent of people may have a magnesium deficiency[7]. Meanwhile, an article published in Nutrients noted that magnesium deficiency is associated with increased stress, anxiety, and depression — mental health effects that can in turn impede quality slumber[8].
Comment
For nutrition professionals, these studies serve as a poignant reminder of the complex interplay between diet, lifestyle, and health outcomes. They complement the call for a balanced approach to nutrition, where moderation, healthy whole foods and mindfulness in consumption patterns align with physical activity to forge a robust defence against cardiovascular and other chronic diseases.
References
[1] Bhandari B, Zeng L, Grafenauer S, Schutte AE, Xu X. Long-Term Consumption of 6 Different Beverages and Cardiovascular Disease-Related Mortality: A Systematic Review and Meta-Analysis of Prospective Cohort Studies. Curr Dev Nutr. 2024 Feb 8;8(3):102095.
[2] Pacheco LS, Tobias DK, Li Y, Bhupathiraju SN, Willett WC, Ludwig DS, Ebbeling CB, Haslam DE, Drouin-Chartier JP, Hu FB, Guasch-Ferré M. Sugar- or artificially-sweetened beverage consumption, physical activity, and risk of cardiovascular disease in US adults. medRxiv [Preprint]. 2023 Apr 24:2023.04.17.23288711.
[3] Li B, Yan N, Jiang H, Cui M, Wu M, Wang L, Mi B, Li Z, Shi J, Fan Y, Azalati MM, Li C, Chen F, Ma M, Wang D, Ma L. Consumption of sugar sweetened beverages, artificially sweetened beverages and fruit juices and risk of type 2 diabetes, hypertension, cardiovascular disease, and mortality: A meta-analysis. Front Nutr. 2023 Mar 15;10:1019534
[4] Prather AA, Leung CW, Adler NE, Ritchie L, Laraia B, Epel ES. Short and sweet: Associations between self-reported sleep duration and sugar-sweetened beverage consumption among adults in the United States. Sleep Health. 2016 Dec;2(4):272-276.
[5] Alahmary SA, Alduhaylib SA, Alkawii HA, Olwani MM, Shablan RA, Ayoub HM, Purayidathil TS, Abuzaid OI, Khattab RY. Relationship Between Added Sugar Intake and Sleep Quality Among University Students: A Cross-sectional Study. Am J Lifestyle Med. 2019 Aug 23;16(1):122-129.
[6] Ebrahimi Mousavi S, Ghoreishy SM, Hemmati A, Mohammadi H. Association between magnesium concentrations and prediabetes: a systematic review and meta-analysis. Sci Rep. 2021 Dec 22;11(1):24388.
[7] Al Alawi AM, Majoni SW, Falhammar H. Magnesium and Human Health: Perspectives and Research Directions. Int J Endocrinol. 2018 Apr 16;2018:9041694.
[8] Razzaque MS. Magnesium: Are We Consuming Enough? Nutrients. 2018 Dec 2;10(12):1863
