Sucrose, commonly referred to as sugar, plays a role in the etiology of type II diabetes and obesity, leading to associations between intake and mortality. There are conflicting reports regarding the health effects of sugar replacements, particularly those of a synthetic origin. It is possible the effect of sucrose, or a replacement, could be modified by intake source, for example beverage versus baked goods. In the beverage category the relative merits of unsweetened fruit juice, sucrose sweetened, artificially sweetened, and also supplementation with the newer plant derived natural non-sucrose sweeteners, are unclear.
Jill P. Pell of the University of Glasgow, UK, led a study of all-cause mortality in the UK Biobank dataset stratified by consumption of total sugar, sugar-sweetened beverages, 100% fruit or vegetable juices and artificially sweetened beverages. The results were published in the journal BMC medicine.
There were 198,285 study participants included of which 2% died over a mean follow-up period of 7 years. Sugar-sweetened beverages were consumed by 33%, artificially sweetened drinks by 21%, and fruit or vegetable juice by 52%.
The highest quintile of total sugar consumption was associated with all-cause mortality after adjustment for potential confounders. There was also evidence of a dose-response relationship between consumption of sugar-sweetened beverages and all-cause mortality after adjustment for potential confounders.
Consumption of unsweetened fruit juice showed a negative trend, that is it reduced all cause mortality.
Daily consumption of artificially sweetened beverages was not associated with higher all-cause mortality overall, however under certain conditions a statistical significance was reached. Five different statistical models were applied and one produced a significant result in the greater than two artificially sweetened beverages per day category, in a subset of participants.
A limitation of this study is that it did not consider the newer plant derived non-sucrose natural sweeteners such as stevia. Sugar consumption was self-reported, relying on memory of the previous day, and the term sugar was likely to have been interpreted very broadly by the participants. In 38% of participants only a single day was recorded.
“Our study demonstrated that consumption of sugar sweetened beverages was associated with all-cause mortality. However, this could not be attributed to their sugar-content alone since the association was independent of total sugar intake and total energy intake, and fruit/vegetable juice consumption was not associated with a higher risk of death in spite of similar levels of sugar and total energy intake,” concluded the authors