Mortality outcomes associated with intake of fast-food items and sugar-sweetened drinks among older adults in the Vitamins and Lifestyle (VITAL) study

Public Health Nutr. 2016 Dec;19(18):3319-3326. doi: 10.1017/S1368980016001518. Epub 2016 Jun 24.


Objective: To evaluate associations of fast-food items (FFI) and sugar-sweetened drinks (SSD) with mortality outcomes including deaths due to any cause, CVD and total cancers among a large sample of adults.

Design: Using a prospective design, risk of death was compared across baseline dietary exposures. Intakes of FFI and SSD were quantified using a semi-quantitative FFQ (baseline data collected 2000-2002). Deaths (n 4187) were obtained via the Washington State death file through 2008, excluding deaths in the first year of follow-up. Causes of death were categorized as due to CVD (I00-I99) or cancer (C00-D48). Cox models were used to estimated hazard ratios (HR) and 95 % CI.

Setting: The Vitamins and Lifestyle (VITAL) study among adults living in Western Washington State.

Subjects: Men and women (n 69 582) between 50 and 76 years of age at baseline.

Results: Intakes of FFI and SSD were higher among individuals who were younger, female, African-American, American Indian or Alaska Native, Asian-American or Pacific Islander, of lower educational attainment, and of lower income (P<0·0001 for all). Higher risk of total mortality was associated with greater intake of FFI (HR=1·16; 95 % CI 1·04, 1·29; P=0·004; comparing highest v. lowest quartile) and SSD (HR=1·19; 95 % CI 1·08, 1·30; P<0·0001; comparing highest v. lowest quartile). Higher intake of FFI was associated with greater cancer-specific mortality while an association with CVD-specific mortality was suggested. Associations between intake of SSD and cause-specific mortality were less clear.

Conclusions: Intake of FFI and SSD has a detrimental effect on future mortality risk. These findings may be salient to socially patterned disparities in mortality.

Keywords: Fast-food items; Mortality; Sugar-sweetened drinks.

MeSH terms

  • Aged
  • Beverages / adverse effects*
  • Cardiovascular Diseases / mortality
  • Diet Surveys
  • Diet*
  • Fast Foods / adverse effects*
  • Female
  • Humans
  • Life Style
  • Male
  • Middle Aged
  • Mortality*
  • Neoplasms / mortality
  • Nutritive Sweeteners / adverse effects*
  • Prospective Studies
  • Sugars
  • Washington


  • Nutritive Sweeteners
  • Sugars