Association of sweetened beverages consumption with all-cause mortality risk among Dutch adults: the Lifelines Cohort Study (the SWEET project)

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  • Novita D Naomi
  • Elske M Brouwer-Brolsma
  • Marion E C Buso
  • Sabita S Soedamah-Muthu
  • Joanne A Harrold
  • Jason C G Halford
  • Raben, Anne
  • Johanna M Geleijnse
  • Edith J M Feskens

Purpose: Examined associations between sugar-sweetened beverages (SSB), low/no-calorie beverages (LNCB), and fruit juice (FJ) consumption and all-cause mortality in Dutch adults. 

Methods: Data of 118,707 adults participating (mean age = 45 years; 60% was women) the Lifelines Cohort Study were prospectively analyzed. Dietary intake was assessed using a validated food-frequency questionnaire. Participants’ vital status was followed-up until February 2022 via the National Personal Records Database. Associations between beverages of interest and all-cause mortality risk were investigated using restricted cubic spline and Cox proportional hazard regression analyses, including substitution analyses. Models were adjusted for demographics, lifestyle, and other dietary factors. 

Results: During follow-up (median = 9.8 years), a total of 2852 (2.4%) deaths were documented. Median (IQR) of SSB, LNCB, and FJ consumption were 0.1 (0.0–0.6), 0.1 (0.0–0.6), and 0.2 (0.0–0.6) serving/day, respectively. Dose–response analyses showed linear associations between SSB, LNCB, and FJ consumption and mortality risk. For each additional serving of SSB and LNCB, HRs of all-cause mortality risk were 1.09 (95% CI 1.03–1.16) and 1.06 (95% CI 1.00–1.11). Replacing SSB with LNCB showed a nonsignificant association with a lower mortality risk, particularly in women (HR 0.91, 95% CI 0.81–1.01). Finally, an inverse association between FJ and all-cause mortality was observed at moderate consumption with HR of 0.87 (95% CI 0.79–0.95) for > 0–2 servings/week and HR of 0.89 (95% CI 0.81–0.98) for > 2–< 7 servings/week when compared to no consumption. 

Conclusions: Our study showed adverse associations between SSB consumption and all-cause mortality. Replacing SSB with LNCB might be associated with lower mortality risk, particularly in women. Moderate intake of FJ was associated with lower all-cause mortality risk.

TidsskriftEuropean Journal of Nutrition
Udgave nummer2
Sider (fra-til)797-806
Antal sider10
StatusUdgivet - 2023

Bibliografisk note

CURIS 2023 NEXS 055

Funding Information:
This EU-project under the acronym “SWEET” has received funding from the European Union’s Horizon 2020 research and innovation programme under Grant agreement No 774293. The Lifelines initiative has been made possible by subsidy from the Dutch Ministry of Health, Welfare and Sport, the Dutch Ministry of Economic Affairs, the University Medical Center Groningen (UMCG), Groningen University and the Provinces in the North of the Netherlands (Drenthe, Friesland, Groningen). The funders had no role in the study design, data collection, data analysis and interpretation, writing the report, or the decision to submit the article for publication. The authors wish to acknowledge the services of the Lifelines Cohort Study, the contributing research centers delivering data to Lifelines, and all the study participants.

Funding Information:
SSS has received unrestricted grants from the Global Dairy Platform, Dairy Research Institute, and Dairy Australia for a meta-analysis on cheese and blood lipids as well as a meta-analysis of dairy and mortality. SSS has also received the Wiebe Visser International Dairy Nutrition Prize and has received recent research funding for epidemiological studies on dairy products and cardiometabolic diseases from the Dutch Dairy Association and the Danish Dairy Research Foundation. JCGH is a member of the International Sweeteners and Mars Scientific Advisory Boards and have received honorariums from the International Sweeteners association together with AR. JCGH and JAH are also conducting the SWITCH trial funded by the American Beverage Association. AR has received an honorarium from Unilever. In the past, EJMF has received an unrestricted grant from Friesland Campina and from European Beer Institute and conducted a study on added sugar and individual sugars partly funded by Kenniscentrum Suiker en Gezondheid (2011). Other authors declare they have no conflicts of interest to be disclosed.

Publisher Copyright:
© 2022, The Author(s).

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