Sugar-sweetened beverages and cardio-metabolic disease risks

Curr Opin Clin Nutr Metab Care. 2013 Jul;16(4):478-84. doi: 10.1097/MCO.0b013e328361c53e.


Purpose of review: Sucrose-sweetened beverages (SSB) have for decades been implicated in cardiometabolic diseases. The purpose of this review is to summarize recent epidemiological but particularly recent human intervention studies on the metabolic effects associated/induced by SSB.

Recent findings: Recent epidemiological studies support the positive association between SSB intake and enhanced risk for metabolic syndrome, type 2 diabetes, coronary heart diseases, and stroke. From the human intervention studies rather similar results are obtained with enhanced accumulation of fat in the liver, muscle, and in the visceral fat depot induced by SSB. Moreover, SSB induces enhanced levels of circulating triglycerides and enhanced de-novo lipogenesis in the liver. The specific effect of SSB on body weigh/obesity is still not completely elucidated but SSB enhances body weight/fat mass even though not to a significant degree in all studies. Concerning the mechanisms for SSB to induce these metabolic aberrations most of the studies are in agreement with the fact that it is mainly fructose (free or as part of the sucrose molecule) that is the main driver of these metabolic aberrations presumably primarily by inducing lipid synthesis in and release from the liver.

Summary: There are now convincing evidences for enhanced cardiometabolic risk after higher intake of SSB where both epidemiological studies and human intervention studies are pointing in the same direction. A so-called 'well tolerated' intake of SSB is not determined. Accordingly, intake of SSB should generally be reduced as much as possible to improve the health of the population.

Publication types

  • Review

MeSH terms

  • Beverages / analysis*
  • Body Weight
  • Cholesterol / blood
  • Coronary Disease / etiology
  • Coronary Disease / physiopathology
  • Diabetes Mellitus, Type 2 / etiology
  • Diabetes Mellitus, Type 2 / physiopathology
  • Dietary Sucrose / administration & dosage
  • Dietary Sucrose / adverse effects
  • Fructose / administration & dosage
  • Fructose / adverse effects
  • Humans
  • Intra-Abdominal Fat / metabolism
  • Liver / drug effects
  • Liver / pathology
  • Metabolic Syndrome / etiology
  • Metabolic Syndrome / physiopathology
  • Obesity / etiology
  • Obesity / physiopathology
  • Observational Studies as Topic
  • Risk Factors
  • Sweetening Agents / adverse effects*
  • Sweetening Agents / analysis*
  • Triglycerides / blood


  • Dietary Sucrose
  • Sweetening Agents
  • Triglycerides
  • Fructose
  • Cholesterol