Editorial: Sweetened Beverages and All-Cause Mortality


What is the link between sugary beverage consumption and increased all-cause mortality

Pineapple juice
Pineapple juice

We have long suspected that there is a link between sugar-sweetened beverages consumption and multiple illnesses and even premature death.  Sugar consumption has long believed to be a risk for metabolic syndrome, obesity, heart disease, diabetes type II, stroke, cancer, and hypertension.  The problem is that the evidence supporting this hypothesis has been limited until recently.

I have written multiple articles on the link between heart disease and sugar consumption.  High consumption of sugar-sweetened beverages is associated with coronary heart disease risk factors and possibly diabetes type 2. The most recent post reviewed research from 2018.  The research indicates that sugar-sweetened beverages appear to be an independent risk for heart disease.  It was not the first or last article that I will write on the evils of sugar or the diseases it is linked.  

Is the consumption of sugary beverages (ie, sugar-sweetened beverages and fruit juices) associated with an increased mortality risk?  The answer appears to be yes!  A cohort study from 2019 appears to support this theory​[1]​.  In the study, nearly 14K black and white adults were observed for a mean of 6.0 years. The study was performed using using dietary recall and death reports. The researchers found that each additional 12-oz serving per day of sugary beverages was associated with an 11% higher all-cause mortality risk. Also, each additional 12-oz serving/d of fruit juice was associated with a 24% higher all-cause mortality risk. Similar associations were not observed for sugary beverage consumption and coronary heart disease mortality.

So what is the link? One possible reason is that their similar sugar content has the same adverse metabolic effects on lipids and central fat deposition. Sugar increases cholesterol and thus would increase mortality. This theory is somewhat suysp[ect based on the fact that cardiac mortality was not elevated. Another explanation is that sugary beverages, including fruit juice, could replace calories from foods with higher more diverse nutritional value.

The bottom line: The results of this study suggest higher consumption of sugary beverages, including fruit juice, is associated with increased mortality. Not only did the elevated mortality appear to be associated with 100% fruit juice as well as sugar-sweetened beverages, but it also appears that fruit juice might cause a higher risk. More research is needed. Based on prior research, I suspect the cardiac mortality finding is an anomaly. Sugar is also an empty calorie so I would recommend reducing consumption to help with weight loss so use this as motivation.


  1. [1]
    L. J. Collin, S. Judd, M. Safford, V. Vaccarino, and J. A. Welsh, “Association of Sugary Beverage Consumption With Mortality Risk in US Adults,” JAMA Netw Open, p. e193121, May 2019 [Online]. Available: http://dx.doi.org/10.1001/jamanetworkopen.2019.3121
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About the Author

I am a family physician who has served in the US Army. In 2016, I found myself overweight, out of shape, and unhealthy, so I made a change to improve my health. This blog is the chronology of my path to better health and what I have learned along the way.

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