Sugar-sweetened beverages consumption increases the risk of metabolic syndrome and its components in adults: Consistent and robust evidence from an umbrella review

• Published in: Clinical nutrition ESPEN 2023-10, Vol.57, p.655-664
• Main Authors: Tran, Quang Duc, Nguyen, Thi Hoa Huyen, Le, Cu Linh, Hoang, Lan Van, Vu, Thi Quynh Chi, Phan, Ngoc Quang, Bui, Thi Thuy
• Format: Article
• Language: English
• Subjects: Adult; clinical nutrition; Diabetes Mellitus, Type 2; dose response; Drinks; Europe; Humans; Hyperlipidemia; Hypertension; issues and policy; meta-analysis; Metabolic syndrome; Metabolic Syndrome - epidemiology; Metabolic Syndrome - etiology; MetS; noninsulin-dependent diabetes mellitus; Obesity; Prospective Studies; risk factors; Sugar-Sweetened Beverages; Type 2 diabetes; Umbrella review
• ISSN: 2405-4577; 2405-4577
• DOI: 10.1016/j.clnesp.2023.08.001

Sugar-sweetened beverages (SSBs) are potential modifiable risk factors for reducing the risk of metabolic syndrome (MetS); however, there is a lack of an umbrella review that robustly synthesizes the evidence. This review aims to synthesize the evidence linking habitual SSBs intake with MetS in adults, emphasizing the need for policy and regulatory actions. Four databases were comprehensively searched for relevant meta-analyses of prospective studies up to July 2023. Two authors independently conducted the screening for eligibility, data extraction, and quality assessment. The outcome of interest was MetS in adults, encompassing its component conditions. The present review was registered with PROSPERO (CRD42023402549). Of the 16 eligible meta-analyses identified, 30 summary estimates were obtained for the impact of SSBs consumption on obesity, type 2 diabetes, hypertension, and MetS. Seven were rated as ‘High’ methodological quality, with the rest classified as ‘Moderate’ and ‘Low’ quality, consisting of three and six references, respectively. A comparison of the highest and lowest levels of SSBs consumption revealed an increased risk of 18% (95% CI: 13%–24%), 12% (95% CI: 11%–14%), 29% (95% CI: 25%–32%), and 29% (95% CI: 7%–52%) for obesity, hypertension, type 2 diabetes, and MetS, respectively. Consistently, the findings from dose–response analyses are in agreement with and corroborate the existing evidence that SSBs are a significant risk factor for the development of MetS and its related conditions. Noticeably, the quality of evidence was predominantly deemed as highly suggestive and convincing. Moreover, consensus on specific criteria to identify studies related to SSBs in literature searching was lacking, and most primary studies were conducted in developed countries and Europe. Our findings suggest that more rigorous and targeted policy interventions are warranted to curtail SSBs consumption, in order to alleviate the global burden of MetS. Despite the significant impact of sugar-sweetened beverages (SSBs) on human health outcomes and the wealth of data on beverage consumption in countries worldwide, the absence of umbrella reviews providing a comprehensive assessment of the impact of SSBs on metabolic syndrome (MetS) is noteworthy. By synthesizing the results of 16 systematic reviews and meta-analyses of prospective studies, our study findings support and strengthen the current body of evidence that SSBs represent a significant risk factor for MetS