In response to "Added Sugar Intake and Cardiovascular Diseases Mortality Among US Adults," a paper published in the journal JAMA Internal Medicine, the American Beverage Association (ABA) issued the following statement:
"This study shows that adult consumption of added sugars has actually declined, as recently reported by the CDC. A significant part of that reduction is from decreased added sugars from beverages due, in part, to our member companies' ongoing innovation in providing more low- and no-calorie options. Furthermore, this is an observational study which cannot – and does not – show that cardiovascular disease is caused by drinking sugar-sweetened beverages."
Additional Background Information cited by the ABA:
On the Study:
- This study's findings do not establish causation, but rather show an association. Importantly, demonstrating association is not the same as establishing causation.
- The data used in this study is self-reported based on 24-hour recall recalls which can have methodological inaccuracies. Additionally, the authors did not use the most recent publicly available data for their analysis.
- The authors themselves note that their results have limitations. In fact, they state that "associations reported in our study may partially result from other unobserved confounding variables, from residual confounding, or other dietary variables."
- Also noted in the limitations is that there was no association between cardiovascular disease mortality and added sugar consumption in the Non-Hispanic black ethnic group – the group with the highest intakes of added sugar.
- The NHANES III Linked Mortality Files used by the authors do not include data after 2006. Thus, the authors could not analyze cardiovascular disease mortality after 2006, a period during which sugar consumption has been decreasing.
- The authors did not investigate any other dietary variables besides using Healthy Eating Index (HEI) scores. However, participants with a better HEI had a higher hazard ratio (HR) of cardiovascular disease mortality.
On Added Sugars Consumption:
- A recent CDC report shows that foods, not beverages, are the leading source of calories from added sugars in the diet of American adults, as well as children and adolescents.
On Heart Disease:
- Heart diseases are a complex set of problems with no single cause and no simple solution.
- 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. According to the National Heart, Lung and Blood Institute (NHLBI) of the National Institutes of Health, the major risk factors for heart disease are: high blood pressure, high blood cholesterol, diabetes, smoking, being overweight, being physically inactive, unhealthy diet and stress.
- Importantly, neither NHLBI nor the American Heart Association list sugar consumption as a risk factor for heart disease.
- 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 active - to help mitigate risk for heart disease.
On Related Commentary's Support for Taxing Sugar-Sweetened Beverages:
- Taxing sugar-sweetened beverages will not reduce obesity, nor will it have a truly meaningful impact on obesity-related health conditions such as diabetes, coronary disease or metabolic syndrome.
- Importantly, a wide range of factors contribute to these health conditions and singling out one ingredient – or one set of products - in such an overly simplistic manner only undermines efforts to combat these diseases.
- And, West Virginia and Arkansas are two states with an excise tax on soft drinks, yet both states rank among the 10 states with the highest obesity rates in the country, according to the Centers for Disease Control and Prevention.
The American Beverage Association is the trade association representing the broad spectrum of companies that manufacture and distribute non-alcoholic beverages in the U.S.