The Longitudinal Effect of Sugar-Sweetened Beverage Consumption and Risk of All-Cause and Cause-Specific Mortality in Korean Adults: Results From the Health Examinees Study.

Objective: High consumption of sugar-sweetened beverages (SSBs) is associated with an increased risk of all-cause and cardiovascular disease (CVD) mortality; however, the data and results for Asian populations, particularly in Korea, are limited and unclear. Therefore, this research aimed to investigate the association between types of SSB consumption and risk of all-cause and cause-specific mortality in South Korean adults.

Methods: This prospective study included Korean adults aged 40 to 79 who participated in the Health Examinees Study. The baseline survey was conducted from 2004 to 2013, and death data were obtained until December 2022. A food frequency questionnaire was used to assess SSB intake, and all-cause, CVD, and cancer mortality were estimated. The SSB included total SSB, soda, and other drinks (Korean traditional SSB).

Results: A total of 126,856 participants were included (mean [standard deviation]: age, 53.1 [8.3] years; 82,311 [64.9%] women). During a mean follow-up of 11.0 years, 5741 all-cause, 936 CVD, and 2662 cancer deaths were recorded. Increased soda consumption was associated with higher all-cause mortality (1-3 servings/wk: hazard ratio [HR], 1.125; 95% confidence interval [CI], 1.003-2.263; ≥3 servings/wk: HR, 1.190, 95% CI, 1.011-1.401), compared with low soda intake (never-<1 serving/wk). However, there was no association between total SSB consumption and other drinks with all-cause and cause-specific mortality. In the dose-response analysis, a trend in which a higher risk of all-cause and CVD cancers was observed with increasing soda intake.

Conclusion: In this large prospective study, soda intake of >1 serving/wk was associated with an increased risk of all-cause mortality among Korean adults. However, there was no association between total SSB or other drinks and mortality. As the consumption of SSBs increases in the Korean population, appropriate control strategies are needed to reduce SSB consumption and the disease burden.