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Sugar-sweetened beverages and cardio-metabolic disease risks

Richelsen, Bjørn

Current Opinion in Clinical Nutrition & Metabolic Care: July 2013 - Volume 16 - Issue 4 - p 478–484
doi: 10.1097/MCO.0b013e328361c53e
CARBOHYDRATES: Edited by Luc Tappy and Bettina Mittendorfer

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.

Department of Internal Medicine and Endocrinology, Aarhus University Hospital, Aarhus, Denmark

Correspondence to Bjørn Richelsen, Department of Internal Medicine and Endocrinology, MEA, Aarhus University Hospital, Tage-Hansens Gade 2, 8000 Aarhus C, Denmark. E-mail:

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins