Soft drinks, including sugar-free, linked to increased risk of early death. By Nicola Davis. theguardian.com.  September 03, 2019. Drink more water, say experts as they argue study proves need for curbs on consumption. People who regularly consume soft drinks have a higher risk of an early death, researchers have found, with the trend seen for both sugared and artificially sweetened drinks.

 Experts said more research was needed into how artificial sweeteners might affect health. Photograph: Jeff J Mitchell/Getty ImagesWhile experts say the study cannot prove soft drinks are a driver of an increased risk of death, they say the work – which is the largest study of its kind – supports recent public health efforts to reduce consumption of soft drinks, such as the UK’s sugar tax.
“Our results for sugar-sweetened soft drinks provide further support to limit consumption and to replace them with other healthier beverages, preferably water,” said Dr Neil Murphy, a co-author of the research from the International Agency for Research on Cancer, part of the World Health Organisation.

Get Society Weekly: our newsletter for public service professionals Read moreMurphy said more research was needed to unpick possible mechanisms by which artificial sweeteners might affect health.
“For artificially sweetened soft drinks, ours is the third large study published this year that has reported positive associations with all-cause deaths,” he said.
Writing in the journal Jama Internal Medicine, Murphy and colleagues report how they analysed data from more than 450,000 people, 70% of whom were women, across 10 European countries including the UK. Participants had an average age of just over 50, and those with health conditions such as cancer, heart disease or diabetes at the outset were not included in the analysis.
Individuals joined the study between 1992 and 2000 and were then followed up for an average of 16 years, during which time more than 41,600 deaths were recorded.
When participants signed up they were asked a number of questions about aspects of their lifestyle such as exercise, smoking and weight as well as diet and nutrition – including their average consumption of drinks such as fizzy drinks, fruit squash and energy drinks. Fruit juice consumption was not included.
The results show 9.3% of those who drank less than one glass of soft drink a month died during the study, compared with 11.5% of those who drank two or more 250ml glasses a day.
The team say that once factors such as body mass index, diet, physical activity, smoking and education were taken into account, that translates to a 17% higher risk of death among those consuming two glasses a day compared with those drinking less than one glass a month.
The trend was seen for both sugar-sweetened and artificially sweetened beverages. Similar results were seen for both men and women.

Sugar in fruit juice may raise risk of cancer, study finds Read moreWhile sugary drinks have previously been linked to obesity, the researchers say that did not fully explain the association of high consumption with an increased risk of death.
When the team looked at specific causes of death they found frequent consumption of artificially sweetened soft drinks was associated with a higher risk of death from circulatory diseases, while sugar-sweetened soft drinks were associated with a higher risk of death from digestive disease. Soft drinks overall were also associated with a greater risk of death from Parkinson’s disease.
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Murphy said it might be possible that those frequently consuming artificially sweetened drinks have a sweet tooth and might be eating more sugary snacks, but that there was no sign of such an effect in the data.
Dr Mathilde Touvier of Inserm, the French national institute of health and medical research, welcomed the latest study.
The results “definitely strengthen the recommendations of public health authorities to limit artificially [sweetened] beverages – and not only sugary drinks”, she said, adding that some advisers to public health bodies were questioning the scientific evidence behind a tax on sugary drinks.
However, the latest study has a number of limitations, including that participants were only asked about their drinks and lifestyle at one point in time, and the study relies on self-reporting.
Amelia Lake, a professor in public health nutrition at Teesside University, said the finding that artificially sweetened drinks were associated with an increased risk of death was interesting, not least since they were often marketed as “healthier” than sugary drinks.
“It is definitely an area that we need to have more evidence and a clear message about,” she said.
She added that the study reinforced the need to increase the availability of the best alternative: water. “We need to make it easy for people to choose the healthier option,” said Lake.______________________________________________________________________________________________________________________________Read also: Soft drinks associated with risk of death in population-based study in 10 European countries. eurekalert.org. September 03, 2019. Bottom Line: Greater consumption of soft drinks, including both sugar- and artificially sweetened, was associated with increased risk of overall death in a population-based study of nearly 452,000 men and women from 10 European countries.
 Drinking two or more glasses per day (compared with less than one glass per month) of total soft drinks, sugar-sweetened soft drinks and artificially sweetened soft drinks was associated with higher risk of death from all causes during an average follow-up of 16 years in which 41,693 deaths occurred. 
The study group included participants from Denmark. France, Germany, Greece, Italy, the Netherlands, Norway, Spain, Sweden and the United Kingdom. Soft drink consumption was collected on food questionnaires or in interviews at baseline from 1992 to 2000. 
Also among the findings was a higher risk of death from circulatory diseases associated with consuming two or more glass per day of total and artificially sweetened soft drinks, and a higher risk of death from digestive diseases associated with drinking one or more glass per day of total and sugar-sweetened soft drinks. 
No association was observed between soft drink consumption and overall cancer death. Limitations of the study include its observational design, which makes causal inferences impossible, and there was only a single assessment of soft drink consumption. Study authors suggest the findings support public health initiatives to limit soft drink consumption.
Authors: Neil Murphy, Ph.D., of the International Agency for Research on Cancer, Lyon, France, and coauthors
(doi:10.1001/jamainternmed.2019.2478)
Editor’s Note: The article includes conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.