Author:
Chen Zhangling,Wei Cheng,Lamballais Sander,Wang Kang,Mou Yuchan,Xiao Yichao,Luo Fei,Bramer Wichor M.,Voortman Trudy,Zhou Shenghua
Abstract
Abstract
Background
Artificially sweetened beverages (ASB) are consumed globally, but their impact on overall health remains uncertain. We summarized published associations between ASB intake with all-cause and cause-specific mortality.
Methods
We searched Medline, Embase, Web of Science, and Cochrane CENTRAL databases until August 2023. Random effect meta-analysis was conducted to calculate pooled risk ratios (RRs) and 95% confidence intervals (95%CIs) for highest versus lowest categories of ASB consumption in relation to all-cause and cause-specific mortality. Linear and non-linear dose-response analyses were also performed.
Results
Our systematic review and meta-analysis included 11 prospective cohort studies. During a median/mean follow-up period of 7.0 to 28.9 years, 235,609 deaths occurred among 2,196,503 participants. Intake of ASB was associated with higher risk of all-cause and CVD mortality with pooled RRs (95%CIs) of highest vs. lowest intake categories of 1.13 (1.06, 1.21) (I2 = 66.3%) for all-cause mortality and 1.26 (1.10, 1.44) (I2 = 52.0%) for CVD mortality. Dose-response analysis revealed a non-linear association of ASB with all-cause mortality (pnon−linearity = 0.01), but a linear positive association with CVD mortality (pnon−linearity = 0.54). No significant association was observed for ASB intake and cancer mortality. Moreover, a secondary meta-analysis demonstrated that replacing 1 serving/day of sugary sweetened beverages (SSB) with ASB was associated with 4–6% lower risk of all-cause and CVD mortality. Per NutriGrade, the evidence quality for associations between ASB intake with all-cause and CVD mortality was moderate.
Conclusions
Higher intake of ASB was associated with higher risk of all-cause and CVD mortality, albeit a lower risk than for SSB.
Systematic review registration
PROSPERO registration no. CRD42022365701.
Funder
National Natural Science Foundation of China
Scientific Research Program of FuRong Laboratory
Publisher
Springer Science and Business Media LLC
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