ABSTRACT
Consumption of calorie-sweetened beverages has continued to increase and plays a role in the epidemic of obesity, the metabolic syndrome, and fatty liver disease. Data from the Global Burden of Disease Study, NHANES, and USDA dietary surveys are used to understand changes in sugar and fructose consumption in beverages. Meta-analyses, randomized clinical trials, and clinical studies were used to evaluate outcomes of beverage and fructose intake. About 75% of all foods and beverages contain added sugar in a large array of forms. Consumption of soft drinks has increased fivefold since 1950. Meta-analyses suggest that consumption of sugar-sweetened beverages is related to the risk of obesity, diabetes, cardiovascular risk factors, and the metabolic syndrome. Drinking two 16 ounce sugar-sweetened beverages per day for 6 months induced features of the metabolic syndrome and fatty liver in healthy human beings. Fructose increases blood pressure and serum lipids. Randomized, controlled trials in children and adults lasting 6 months to 2 years have shown that replacing the intake of sugar-sweetened soft drinks with low-energy drinks reduces weight gain or induces weight loss. Recent studies suggest a gene-SSB relationship in modulating weight gain.
