Sweetened Beverages vs Heart Disease: What's Bad for the Goose . . .

As much as I enjoy a sugar-sweetened beverage every now & then, I really can't think of a good reason to consume one over plain water.  In fact, in an observational study published almost 3 years ago in the American Journal of Clinical Nutrition, the authors linked regular consumption (>2 servings/d) to a greater risk of heart disease in women after following 88,52 participants in the Nurses' Health Study and assessing food frequency questionnaires 7 times over 24 years.

You've all probably heard the old adage, what's good for the good is good for the gander.  In a new analysis published yesterday of the male corollary to the NHS, 42,883 men were followed for 22 years in the Health Professionals Follow-up with food frequency questionnaire completed every 4 years.  As expected, consumption of sugar-sweetened beverages, but not artificially sweetened ones, was associated with a greater risk of heart disease in men, similar to earlier findings for the fairer sex.

Because this study is one of observation & correlation, rather than causation, we have to be very careful to look for weaknesses in the design & statistical analysis.  For instance, the authors excluded anyone with a history of diabetes, prior vascular disease (heart attack, stroke, angina, bypass surgery, etc), and cancer.  Those who reported excessively high or low caloric intakes were also excluded.

Beverage intake was broken down into quartiles while the authors also took into account age, smoking status, physical activity, alcohol consumption, multivitamin use, family history of heart disease, weight gain/loss, energy intake, and body mass index.  The authors adjusted for other possible dietary factors according to adherence to a healthy eating pattern.  And to exclude subclinical factors, the authors ignored any heart disease that occurred in the first 4 years of the study.  Finally, the authors took into account markers for heart disease such as triglycerides, cholesterol & blood pressure.

And despite every factor they attempted to use to explain away the association between sugar-sweetened beverage consumption and heart disease in men, the authors couldn't. Remember that this study doesn't prove causation, just correlation.  However, it's conclusions are consistent with those already published - drink more water!

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