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