A SYSTEMATIC REVIEW: SUGAR-SWEETENED BEVERAGES AS A SOURCE OF DIETARY CARBOHYDRATES AND THEIR ROLE IN OBESITY

Raynald G. Escota¹ Jeiem Raian A. Manalo¹ John Paul M. Miranda¹ Gecelene C. Estorico¹; ²

doi:10.5281/zenodo.21399251

Abstract

Obesity is a growing global public health concern that is closely associated with unhealthy dietary patterns,
particularly the frequent consumption of sugar-sweetened beverages (SSBs), which are a major source of added
sugars and excess caloric intake. As obesity and metabolic diseases continue to increase worldwide, understanding
the health effects of SSB consumption is essential for developing effective prevention and intervention strategies.
This systematic review examined the effects of sugar-sweetened beverage consumption on obesity, body weight,
and metabolic health. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses
(PRISMA) guidelines, peer-reviewed English-language articles were identified through systematic searches of
multiple scientific databases. From an initial pool of 850 records, duplicate removal, title and abstract screening,
and full-text eligibility assessment resulted in 10 high-quality studies that met the predefined inclusion criteria.
The certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development and
Evaluation (GRADE) framework to synthesize the findings. Results indicate that frequent consumption of sugarsweetened beverages is consistently associated with increased body weight, elevated body mass index (BMI),
obesity, and adverse metabolic health outcomes across children and adults. High intake of SSBs contributes to
excessive energy consumption and is associated with increased risks of type 2 diabetes mellitus and cardiovascular
disease. Global estimates further indicate that SSB consumption contributed to approximately 2.2 million new
cases of type 2 diabetes mellitus and 1.2 million new cases of cardiovascular disease in 2020. Conversely,
replacing SSBs with water or other non-caloric beverages improved weight management and metabolic health,
while sugar-sweetened beverage taxation reduced beverage purchases and consumption. Overall, excessive
consumption of sugar-sweetened beverages adversely affects body weight and metabolic health, emphasizing the
importance of healthier beverage choices and evidence-based public health policies to reduce the global burden
of obesity and related chronic diseases.

Keywords

Sugar-sweetened beverages, Obesity, Body weight, Body mass index, Metabolic health, Type 2 diabetes mellitus, Cardiovascular disease, Dietary carbohydrates, Added sugars, Beverage substitution, Public health, Obesity prevention

References

[1] de Ruyter, J. C., Olthof, M. R., Seidell, J. C., & Katan, M. B. (2012). A trial of sugar-free or sugar-sweetened
beverages and body weight in children. New England Journal of Medicine, 367 (15), 1397–1406.
https://doi.org/10.1056/NEJMoa1203034
[2] Ebbeling, C. B., Feldman, H. A., Chomitz, V. R., Antonelli, T. A., Gortmaker, S. L., Osganian, S. K., &
Ludwig, D. S. (2012). A randomized trial of sugar-sweetened beverages and adolescent body weight. New
England Journal of Medicine, 367 (15), 1407–1416. https://doi.org/10.1056/NEJMoa1203388
[3] Laverty, A. A., Magee, L., Monteiro, C. A., Saxena, S., & Millett, C. (2015). Sugar and artificially sweetened
beverage consumption and adiposity changes: National longitudinal study. International Journal of
Behavioral Nutrition and Physical Activity, 12, 137. https://doi.org/10.1186/s12966-015-0297-5
[4] Malik, V. S., Pan, A., Willett, W. C., & Hu, F. B. (2013). Sugar-sweetened beverages and weight gain in
children and adults: A systematic review and meta-analysis. The American Journal of Clinical Nutrition, 98
(4), 1084–1102. https://doi.org/10.3945/ajcn.113.058362
[5] Malik, V. S., Popkin, B. M., Bray, G. A., Després, J. P., & Hu, F. B. (2010). Sugar-sweetened beverages,
obesity, type 2 diabetes mellitus, and cardiovascular disease risk. Circulation, 121 (11), 1356–1364.
https://doi.org/10.1161/CIRCULATIONAHA.109.876185
[6] Nguyen, M., Jarvis, S. E., Chiavaroli, L., Mejia, S. B., Zurbau, A., Khan, T. A., & Sievenpiper, J. L. (2023).
Sugar-sweetened beverage consumption and weight gain in children and adults: A systematic review and
meta-analysis of prospective cohort studies and randomized controlled trials. The American Journal of
Clinical Nutrition, 117 (1), 1–15. https://doi.org/10.1016/j.ajcnut.2022.11.008
[7] Qi, Q., Chu, A. Y., Kang, J. H., Jensen, M. K., Curhan, G. C., Pasquale, L. R., Ridker, P. M., Hunter, D. J.,
Willett, W. C., Rimm, E. B., Chasman, D. I., Hu, F. B., & Qi, L. (2012). Sugar-sweetened beverages and
genetic risk of obesity. New England Journal of Medicine, 367 (15), 1387–1396.
https://doi.org/10.1056/NEJMoa1203039
[8] Te Morenga, L., Mallard, S., & Mann, J. (2013). Dietary sugars and body weight: Systematic review and
meta-analyses of randomised controlled trials and cohort studies. BMJ, 346, e7492.
https://doi.org/10.1136/bmj.e7492
[9] Tobiassen, P. A., et al. (2024). Substitution of sugar-sweetened beverages with non-caloric alternatives and
weight change: A systematic review of randomized trials and meta-analysis. Obesity Reviews, 25 (3),
e13652. https://doi.org/10.1111/obr.13652
[10] Vartanian, L. R., Schwartz, M. B., & Brownell, K. D. (2007). Effects of soft drink consumption on nutrition
and health: A systematic review and meta-analysis. American Journal of Public Health, 97 (4), 667–675.
https://doi.org/10.2105/AJPH.2005.083782