Soft drink intake and the risk of metabolic syndrome: A systematic review and meta-analysis

Int J Clin Pract. 2017 Feb;71(2). doi: 10.1111/ijcp.12927. Epub 2017 Jan 10.


Background: It is unclear whether consumption of sugar- or artificially sweetened beverages is independently associated with the development of metabolic syndrome. A systematic review and meta-analysis was performed to evaluate whether soft drink consumption is associated with the development of metabolic syndrome.

Methods: Medline and EMBASE were searched in November 2015 for studies which considered soft drink (sugar-sweetened beverage [SSB] and artificially sweetened beverage [ASB]) intake and risk of metabolic syndrome. Pooled risk ratios for adverse outcomes were calculated using inverse variance with a random effects model, and heterogeneity was assessed using the I2 statistic.

Results: A total of 12 studies (eight cross-sectional, four prospective cohort studies) with 56 244 participants (age range 6-98 years) were included in the review. Our pooled analysis found that soft drink intake is associated with metabolic syndrome. This relationship is shown in cross-sectional studies of SSB consumption (RR 1.46, 95% CI 1.18-1.91) and both cross-sectional and prospective studies of ASB consumption (RR 2.45; 95% CI 1.15-5.14; RR 1.32, 95% CI 1.21-1.44, respectively). However, pooled results of prospective cohort studies of SSB consumption found no association between intake and risk of developing metabolic syndrome.

Conclusions: Sugar-sweetened beverage and ASB intake are both associated with metabolic syndrome. This association may be driven by the fact that soft drink intake serves as a surrogate for an unhealthy lifestyle, or an adverse cardiovascular risk factor profile.

Keywords: meta-analysis; metabolic syndrome; sweetened beverages.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Carbonated Beverages*
  • Dietary Sucrose / adverse effects*
  • Humans
  • Metabolic Syndrome / epidemiology*
  • Metabolic Syndrome / etiology
  • Nutrition Assessment
  • Risk Factors
  • Sweetening Agents / adverse effects*


  • Dietary Sucrose
  • Sweetening Agents