Does high sugar consumption exacerbate cardiometabolic risk factors and increase the risk of type 2 diabetes and cardiovascular disease?
Consumption of sugar has been relatively high in the Nordic countries; the impact of sugar intake on
metabolic risk factors and related diseases has been debated. The objectives were to assess the effect of sugar
intake (sugar-sweetened beverages, sucrose and fructose) on association with type 2 diabetes, cardiovascular
disease and related metabolic risk factors (impaired glucose tolerance, insulin sensitivity, dyslipidemia, blood
pressure, uric acid, inflammation markers), and on all-cause mortality, through a systematic review of
prospective cohort studies and randomised controlled intervention studies published between January 2000
and search dates. The methods adopted were as follows: the first search was run in PubMed in October 2010.
A second search with uric acid as risk marker was run in April 2011. The total search strategy was rerun in
April 2011 in SveMed. An update was run in PubMed in January 2012. Two authors independently selected
studies for inclusion from the 2,743 abstracts according to predefined eligibility criteria. The outcome was
that out of the 17 studies extracted, 15 were prospective cohort studies and two were randomised controlled
crossover trials. All of the studies included only adults. With respect to incident type 2 diabetes (nine studies),
four of six prospective cohort studies found a significant positive association for sugar-sweetened beverage
intake. In general, larger cohort studies with longer follow-up more often reported positive associations, and
BMI seemed to mediate part of the increased risk. For other metabolic or cardiovascular risk factors or
outcomes, too few studies have been published to draw conclusions. In conclusion, data from prospective
cohort studies published in the years 2000-2011 suggest that sugar-sweetened beverages probably increase the
risk of type 2 diabetes. For related metabolic risk factors, cardiovascular disease or all-cause mortality and
other types of sugars, too few studies were available to draw conclusions.
Keywords: sugar; fructose; sugar-sweetened beverages; systematic review; Nordic nutrition recommendations
(Published: 30 July 2012)
Citation: Food & Nutrition Research 2012. 56: 19104 - http://dx.doi.org/10.3402/fnr.v56i0.19104
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