Burdens of type 2 diabetes and cardiovascular disease attributable to sugar-sweetened beverages in 184 countries
Authors: Lara-Castor Laura , O’Hearn Meghan , Cudhea Frederick , Miller Victoria , Shi Peilin , Zhang Jianyi , Sharib Julia R. , Cash Sean B. , Barquera Simon , Micha Renata , Mozaffarian Dariush ,   Global Dietary Database, Trichopoulou Antonia , Bas Murat , Ali Jemal Haidar , El-Kour Tatyana , Krishnan Anand , Misra Puneet , Hwalla Nahla , Janakiram Chandrashekar , Lipoeto Nur Indrawaty , Musaiger Abdulrahman , Pourfarzi Farhad , Alam Iftikhar , Termote Celine , Memon Anjum , Vossenaar Marieke , Mazumdar Paramita , Rached Ingrid , Rovirosa Alicia , Zapata María Elisa , Kelishadi Roya , Asayehu Tamene Taye , Oduor Francis , Boedecker Julia , Aluso Lilian , Marconi Emanuele , D’Addezio Laura , Piccinelli Raffaela , Sette Stefania , Ortiz-Ulloa Johana , Meenakshi J. V. , Grosso Giuseppe , Waskiewicz Anna , Khan Umber S. , Brown Kenneth , Andersen Lene Frost , Thanopoulou Anastasia , Malekzadeh Reza , Calleja Neville , Nicolau Anca Ioana , Tudorie Cornelia , Ocke Marga , Etemad Zohreh , Nsour Mohannad Al , Waswa Lydiah M. , Hashemian Maryam , Nurk Eha , Arsenault Joanne , Lopez-Jaramillo Patricio , Sibai Abla Mehio , Damasceno Albertino , Lanerolle Pulani , Arambepola Carukshi , Lopes Carla , Severo Milton , Lunet Nuno , Torres Duarte , Tapanainen Heli , Lindstrom Jaana , Virtanen Suvi , Palacios Cristina , Barengo Noel , Roos Eva , Jordan Irmgard , Duante Charmaine , Cerdena Corazon , Angeles-Agdeppa Imelda , Desnacido Josie , Capanzana Mario , Misra Anoop , Khouw Ilse , Ng Swee Ai , Delgado Edna Gamboa , Caballero Mauricio T. , Otero Johanna , Lee Hae-Jeung , Koksal Eda , Guessous Idris , Lachat Carl , Henauw Stefaan De , Rahbar Ali Reza , Tedstone Alison , Ling Annie , Hopping Beth , Leclercq Catherine , Haerpfer Christian , Hotz Christine , Pitsavos Christos , van Oosterhout Coline , Bradshaw Debbie , Trichopoulos Dimitrios , Gauci Dorothy , Fernando Dulitha , Sygnowska Elzbieta , Vartiainen Erkki , Farzadfar Farshad , Zajkas Gabor , Swan Gillian , Ma Guansheng , Ibrahim Hajah Masni , Sinkko Harri , Sioen Isabelle , Gaspoz Jean-Michel , Odenkirk Jillian , Bundhamcharoen Kanitta , Nelis Keiu , Zarina Khairul , Biro Lajos , Johansson Lars , Riley Leanne , Yap Mabel , Inoue Manami , Szabo Maria , Ovaskainen Marja-Leena , Lee Meei-Shyuan , Chan Mei Fen , Cowan Melanie , Kandiah Mirnalini , Kally Ola , Jonsdottir Olof , Palmer Pam , Orfanos Philippos , Asciak Renzo , Templeton Robert , Don Rokiah , Yaakub Roseyati , Selamat Rusidah , Yusof Safiah , Al-Zenki Sameer , Hung Shu-Yi , Beer-Borst Sigrid , Wu Suh , Lukito Widjaja , Hadden Wilbur , Cao Xia , Ma Yi , Lai Yuen , Hjdaud Zaiton , Ali Jennifer , Gravel Ron , Tao Tina , Veerman Jacob Lennert , Arici Mustafa , Panagiotakos Demosthenes , Li Yanping , Pekcan Gülden , Anzid Karim , Khadilkar Anuradha , Ekbote Veena , Kovalskys Irina , Nimmathota Arlappa , Laxmaiah Avula , Nagalla Balakrishna , Ginnela Brahmam , Rajkumar Hemalatha , Meshram Indrapal , Polasa Kalpagam , Iacoviello Licia , Bonaccio Marialaura , Costanzo Simona , Martin-Prevel Yves , Jitnarin Nattinee , Pan Wen-Harn , Hsieh Yao-Te , Olivares Sonia , Tejeda Gabriela , Hadziomeragic Aida , Ngoan Le Tran , de Moura Souza Amanda , Illescas-Zarate Daniel , Huybrechts Inge , de Brauw Alan , Moursi Mourad , Zeba Augustin Nawidimbasba , Maghroun Maryam , Sarrafzadegan Nizal , Mohammadifard Noushin , Keinan-Boker Lital , Goldsmith Rebecca , Shimony Tal , Keding Gudrun B. , Mastiholi Shivanand C. , Mwangi Moses , Kombe Yeri , Bukania Zipporah , Alissa Eman , Al-Daghri Nasser , Sabico Shaun , Jeewon Rajesh , Gulliford Martin , Diba Tshilenge S. , Oh Kyungwon , Park Sihyun , Yun Sungha , Cho Yoonsu , Al-Hooti Suad , Luangphaxay Chanthaly , Douangvichit Daovieng , Siengsounthone Latsamy , Marques-Vidal Pedro , Vollenweider Peter , Rybak Constance , Luke Amy , Rojroongwasinkul Nipa , Piaseu Noppawan , Sundram Kalyana , Koster Jeremy , Baykova Donka , Abedi Parvin , Sandjaja Sandjaja , Fadzil Fariza , Bukhary Noriklil Bukhary Ismail , Bovet Pascal , Chen Yu , Sawada Norie , Tsugane Shoichiro , Rangelova Lalka , Petrova Stefka , Duleva Vesselka , Siamusantu Ward , Szponar Lucjan , Chang Hsing-Yi , Sekiyama Makiko , Bao Khanh Le Nguyen , Boindala Sesikeran , Ati Jalila El , Silva Ivonne Ramirez , Dommarco Juan Rivera , Sanchez-Romero Luz Maria , Barquera Simon , Rodríguez-Ramírez Sonia , Ikeda Nayu , Zaghloul Sahar , Houshiar-rad Anahita , Mohammadi-Nasrabadi Fatemeh , Abdollahi Morteza , Chuah Khun-Aik , Mahdy Zaleha Abdullah , Eldridge Alison , Ding Eric L. , Kruger Herculina , Henjum Sigrun , Suarez-Ortegon Milton Fabian , Al-Hamad Nawal , Janská Veronika , Tayyem Reema , Tedla Bemnet , Mirmiran Parvin , Richter Almut , Mensink Gert , Wieler Lothar , Hoffman Daniel , Salanave Benoit , Chiplonkar Shashi , Fernandez Anne , Naska Androniki , Ridder Karin De , Kim Cho-il , Kuriyan Rebecca , Swaminathan Sumathi , Garriguet Didier , Lindroos Anna Karin , Lemming Eva Warensjo , Sipinen Jessica Petrelius , Moraeus Lotta , Dastgiri Saeed , Vaask Sirje , Karupaiah Tilakavati , Zohoori Fatemeh Vida , Esteghamati Alireza , Noshad Sina , Abumweis Suhad , Mwaniki Elizabeth , Anderson Simon G. , Chileshe Justin , Mwanza Sydney , Marques Lydia Lera , Aguero Samuel Duran , Oleas Mariana , Posada Luz , Ochoa Angelica , Preston Alan Martin , Shamsuddin Khadijah , Shariff Zalilah Mohd , Jan Bin Jan Mohamed Hamid , Manan Wan , Poh Bee Koon , Abbott Pamela , Pakseresht Mohammadreza , Sharma Sangita , Strand Tor , Alexy Ute , Nöthlings Ute , Waidyatilaka Indu , Jayawardena Ranil , Long Julie M. , Hambidge K. Michael , Krebs Nancy F. , Haque Aminul , Korkalo Liisa , Erkkola Maijaliisa , Freese Riitta , Eleraky Laila , Stuetz Wolfgang , Steingrimsdottir Laufey , Thorsdottir Inga , Gunnarsdottir Ingibjorg , Serra-Majem Lluis , Moy Foong Ming , Zugravu Corina Aurelia , Jimenez Elizabeth Yakes , Adair Linda , Ng Shu Wen , Skeaff Sheila , Fisberg Regina , Henry Carol , Ersino Getahun , Zello Gordon , Meyer Alexa , Elmadfa Ibrahim , Mitchell Claudette , Balfour David , Geleijnse Johanna M. , Manary Mark , Nikiema Laetitia , Mirzaei Masoud , Hakeem Rubina 
Published: January 2025

Abstract
The consumption of sugar-sweetened beverages (SSBs) is associated with type 2 diabetes (T2D) and cardiovascular diseases (CVD). However, an updated and comprehensive assessment of the global burden attributable to SSBs remains scarce. Here we estimated SSB-attributable T2D and CVD burdens across 184 countries in 1990 and 2020 globally, regionally and nationally, incorporating data from the Global Dietary Database, jointly stratified by age, sex, educational attainment and urbanicity. In 2020, 2.2 million (95% uncertainty interval 2.0–2.3) new T2D cases and 1.2 million (95% uncertainty interval 1.1–1.3) new CVD cases were attributable to SSBs worldwide, representing 9.8% and 3.1%, respectively, of all incident cases. Globally, proportional SSB-attributable burdens were higher among men versus women, younger versus older adults, higher- versus lower-educated adults, and adults in urban versus rural areas. By world region, the highest SSB-attributable percentage burdens were in Latin America and the Caribbean (T2D: 24.4%; CVD: 11.3%) and sub-Saharan Africa (T2D: 21.5%; CVD: 10.5%). From 1990 to 2020, the largest proportional increases in SSB-attributable incident T2D and CVD cases were in sub-Saharan Africa (+8.8% and +4.4%, respectively). Our study highlights the countries and subpopulations most affected by cardiometabolic disease associated with SSB consumption, assisting in shaping effective policies and interventions to reduce these burdens globally.