Abstract
BACKGROUND It is unclear whether consumption of sugar- or artificially sweetened beverages is independently associated with the development of metabolic syndrome. A systematic review and meta-analysis was performed to evaluate whether soft drink consumption is associated with the development of metabolic syndrome. METHODS Medline and EMBASE were searched in November 2015 for studies which considered soft drink (sugar-sweetened beverage [SSB] and artificially sweetened beverage [ASB]) intake and risk of metabolic syndrome. Pooled risk ratios for adverse outcomes were calculated using inverse variance with a random effects model, and heterogeneity was assessed using the I2 statistic. RESULTS A total of 12 studies (eight cross-sectional, four prospective cohort studies) with 56 244 participants (age range 6-98 years) were included in the review. Our pooled analysis found that soft drink intake is associated with metabolic syndrome. This relationship is shown in cross-sectional studies of SSB consumption (RR 1.46, 95% CI 1.18-1.91) and both cross-sectional and prospective studies of ASB consumption (RR 2.45; 95% CI 1.15-5.14; RR 1.32, 95% CI 1.21-1.44, respectively). However, pooled results of prospective cohort studies of SSB consumption found no association between intake and risk of developing metabolic syndrome. CONCLUSIONS Sugar-sweetened beverage and ASB intake are both associated with metabolic syndrome. This association may be driven by the fact that soft drink intake serves as a surrogate for an unhealthy lifestyle, or an adverse cardiovascular risk factor profile.
