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Title: Association Between Soft Drink Consumption and Mortality in 10 European Countries
Author: Mullee, Amy
Romaguera, Dora
Pearson Stuttard, Jonathan
Viallon, Vivian
Stepien, Magdalena
Freisling, Heinz
Fagherazzi, Guy
Mancini, Francesca Romana
Boutron-Ruault, Marie-Christine
Kuhn, Tilman
Kaaks, Rudolf
Boeing, Heiner
Aleksandrova, Krasimira
Tjønneland, Anne
Halkjær, Jytte
Overvad, Kim
Weiderpass, Elisabete
Skeie, Guri
Parr, Christine L.
Quirós, J. Ramón
Agudo, Antonio
Sánchez, María José
Amiano, Pilar
Cirera, Lluís
Ardanaz, Eva
Khaw, Kay-Tee
Tong, Tammy Y. N.
Schmidt, Julie A.
Trichopoulou, Antonia
Martimianaki, Georgia
Karakatsani, Anna
Palli, Domenico
Agnoli, Claudia
Tumino, Rosario
Sacerdote, Carlotta
Panico, Salvatore
Bueno de Mesquita, H. Bas
Verschuren, W. M. Monique
Boer, Jolanda M. A.
Vermeulen, Roel C. H.
Ramne, Stina
Sonestedt, Emily
Van Guelpen, Bethany
Holgersson, Pernilla Lif
Tsilidis, Konstantinos K.
Heath, Alicia K.
Muller, David C.
Riboli, Elio
Gunter, Marc J.
Murphy, Neil
Keywords: Mortalitat
Issue Date: 1-Nov-2019
Publisher: Amer Medical Assoc
Abstract: IMPORTANCE Soft drinks are frequently consumed, but whether this consumption is associated with mortality risk is unknown and has been understudied in European populations to date. OBJECTIVE To examine the association between total, sugar-sweetened, and artificially sweetened soft drink consumption and subsequent total and cause-specific mortality. DESIGN, SETTING, AND PARTICIPANTS This population-based cohort study involved participants (n = 451743 of the full cohort) in the European Prospective Investigation into Cancer and Nutrition (EPIC), an ongoing, large multinational cohort of people from 10 European countries (Denmark, France, Germany, Greece, Italy, the Netherlands, Norway, Spain, Sweden, and the United Kingdom), with participants recruited between January 1, 1992, and December 31, 2000. Excluded participants were those who reported cancer, heart disease, stroke, or diabetes at baseline; those with implausible dietary intake data; and those with missing soft drink consumption or follow-up information. Data analyses were performed from February 1, 2018, to October 1, 2018. EXPOSURE Consumption of total, sugar-sweetened, and artificially sweetened soft drinks. MAIN OUTCOMES AND MEASURES Total mortality and cause-specific mortality. Hazard ratios (HRs) and 95% CIs were estimated using multivariable Cox proportional hazards regression models adjusted for other mortality risk factors. RESULTS In total, 521 330 individuals were enrolled. Of this total, 451743 (86.7%) were included in the study, with a mean (SD) age of 50.8 (9.8) years and with 321081 women (71.1%). During a mean (range) follow-up of 16.4 (11.1 in Greece to 19.2 in France) years, 41693 deaths occurred. Higher all-cause mortality was found among participants who consumed 2 or more glasses per day (vs consumers of <1 glass per month) of total soft drinks (hazard ratio [HR],1.17; 95% CI, 1.11-1.22; P < .001), sugar-sweetened soft drinks (HR, 1.08; 95% CI, 1.01-1.16; P = .004), and artificially sweetened soft drinks (HR,1.26; 95% CI, 1.16-1.35; P < .001). Positive associations were also observed between artificially sweetened soft drinks and deaths from circulatory diseases (>= 2 glasses per day vs <1 glass per month; HR,1.52; 95% CI, 1.30-1.78; P < .001) and between sugar-sweetened soft drinks and deaths from digestive diseases (>= 1 glass per day vs <1 glass per month; HR,1.59; 95% CI, 1.24-2.05; P < .001). CONCLUSIONS AND RELEVANCE This study found that consumption of total, sugar-sweetened, and artificially sweetened soft drinks was positively associated with all-cause deaths in this large European cohort; the results are supportive of public health campaigns aimed at limiting the consumption of soft drinks.
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It is part of: Jama Internal Medicine, 2019-11-01, vol. 179, num. 11, p. 1479-1490
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Appears in Collections:Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

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