In response to "Sugar-Sweetened Beverage Consumption and Incident Cardiovascular Risk Factors: The Multi-Ethnic Study of Atherosclerosis," an abstract released and to be presented on Wednesday at the American Heart Association's Scientific Sessions 2011, the American Beverage Association issued the following statement:
This type of study cannot show that drinking sugar-sweetened beverages causes increased risk for cardiovascular disease. It simply looks at associations between the two, which could be the result of numerous other confounding factors. The American Heart Association states that two of the major risk factors for heart disease are increasing age and family history of cardiovascular disease. Yet this study, which looked at people ages 45 to 84, did not control for either factor. Furthermore, participants who consumed two or more sugar-sweetened beverages per day at the beginning of the study already had a number of risk factors for cardiovascular disease. And while overweight or obesity are known cardiovascular disease risk factors, the evidence that one type of food or beverage causes heart disease simply is not there.
In addition, a previous peer-reviewed and published paper looking at the very same data concluded that, 'Although our primary analyses focused on diet soda intake, we also estimated corresponding risks for metabolic syndrome and type 2 diabetes according to consumption of sugar-sweetened soda. Data showed no significant associations between sugar-sweetened beverage consumption and risk of either health condition.'"
It's important to keep things in perspective. This is an oral report presented at a scientific meeting. It is not a peer-reviewed study published in a scientific journal.
The authors themselves note that they look at association, which is not the same as proving cause and effect.
Furthermore, there are numerous limitations of this report, including:
The authors used a food frequency questionnaire, which may not accurately reflect serving size and therefore will not accurately assess total intake.
Participants were asked about beverage consumption at the beginning of the study only. They also were asked only about consumption of "regular soft drinks, soda, sweetened mineral water (not diet), and nonalcoholic beer." This type of question may bias the results. Much more reliable answers would be obtained if the question was "what type of beverages do you typically consume."
The report did not discuss other important variables such as total dietary history, amount of total fat consumed, amount of caloric expenditure, consumption of other carbohydrates, amount of alcohol consumed, smoking history or changes in medications - any of which could increase cardiovascular disease risk.
Participants who consumed two or more sugar-sweetened beverages per day at the beginning of the study already had a number of risk factors for cardiovascular disease.
Only 6 percent of the total population studied, or 258 participants, consumed two or more sugar-sweetened beverages per day. The authors noted as a limitation that only "a small number of participants developed risk factors of interest, particularly high triglycerides." However, the median level reported was well below that identified as a risk factor for cardiovascular disease. The actual incidence of high triglycerides and impaired fasting glucose in this group of women who consumed two or more sugar-sweetened beverages per day was not disclosed.
No significant relationships were found for weight gain, LDL or HDL cholesterol, or incidence of diabetes in either men or women who consumed two or more sugar-sweetened beverages per day.
The results of this report are inconsistent with the known scientific literature as there was no report of increased risk for this already known at-risk population.
At the beginning of the study, some participants who consumed between one and two, or two or more, sugar-sweetened beverages per day participated in no intentional exercise, a major risk factor for cardiovascular disease.
Heart disease is a complex problem with no single cause and no simple solution.
According to the American Heart Association, the major risk factors for heart disease are increasing age, gender (being male), genetics (including race), smoking and being overweight or obese.
When it comes to risk for heart disease, there is nothing unique about the calories from added sugars, or sugar-sweetened beverages for that matter. In fact, this has been confirmed by the Institute of Medicine.
While many risk factors are beyond our control, there are things we can do - including not smoking, maintaining an appropriate body weight and being physically fit - to help mitigate risk for heart disease.
If we truly want to reduce the incidence of heart disease, health professionals as well as other stakeholders must educate Americans about the risk factors and encourage people not to smoke (or not to start smoking) and maintain a healthy weight by balancing calories consumed - which includes eating a sensible, balanced diet - with calories burned by engaging in regular physical activity.
The American Beverage Association is the trade association representing the broad spectrum of companies that manufacture and distribute non-alcoholic beverages in the United States. For more information on ABA, please visit the association's Web site at www.ameribev.org or call the ABA communications team at (202) 463-6770.