Total, sugar-sweetened, and artificially sweetened beverage consumption is associated with all-cause mortality, according to study results published in JAMA Internal Medicine.

Investigators conducted a population-based cohort study across 10 European countries to determine the association between soft drink intake and mortality. Individuals who reported a history of cancer, heart disease, stroke, or diabetes at baseline were excluded from participation. The primary outcomes were total and cause-specific mortality.

Of the 521,300 people enrolled, 451,743 were included in the study (mean age, 50.8; 71.1% women). There were 41,693 reported deaths in the 16.4-year mean follow-up; 43.2% of these deaths were from cancer, 21.8% were from circulatory diseases, and 2.9% were from digestive diseases. Compared with individuals who consumed <1 glass of soft drink per month (low consumption), all-cause mortality was higher among individuals who drank ≥2 glasses per day of total soft drinks (hazard ratio [HR], 1.17), sugar-sweetened soft drinks (HR, 1.08), and artificially sweetened soft drinks (HR, 1.26).

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Compared with low consumption (<1 glass per month) of artificially sweetened soft drinks, consumption of ≥2 glasses per day was positively associated with death from circulatory disease (HR, 1.52). In addition, the consumption of ≥2 glasses per day of artificially sweetened soft drinks was positively associated with death from digestive diseases compared with low consumption (HR, 1.59).

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“The role of BMI in the soft drink consumption and mortality outcomes association is complex, with adiposity likely a mediating and confounding factor that varies by cause of death,” the investigators noted.

“Further studies are needed to investigate the possible adverse health effects of artificial sweeteners. The results of this study are supportive of ongoing public health campaigns aimed at reducing the consumption of soft drinks,” concluded the authors.


Mullee A, Romaguera D, Pearson-Stuttard J, et al. Association between soft drink consumption and mortality in 10 European countries [published online September 3, 2019]. JAMA Intern Med. doi:10.1001/jamainternmed.2019.2478