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Life Guide U.S. essentials
English

Don't drink sugary drinks, and switching to sugar-free doesn't solve it

  • High value
  • Evidence A
  • Buys life
  • Disputed
  • Free
  • Takes minutes
  • Some willpower

In plain words

People who drink two or more sweet drinks a day have about a 20% higher chance of dying over the same period than people who almost never drink them. For one to two a day, it is more than 10% higher. Switching to sugar-free shows no benefit either: people who drink two or more artificially sweetened drinks a day are actually about a quarter higher.

Cost

Free, and it takes no time. Switching to plain water or unsweetened tea even saves money. The hard part is breaking the habit of sweet drinks, sugar-free ones included.

What you get

Two large U.S. studies followed groups of people (observational, not assigning groups), about 118,000 (11.8万) people with 36,000 (3.6万) deaths. People who drank 2 or more servings a day had about 21% higher risk of death than people who drank less than 1 serving a month (HR 1.21). For 1–2 servings a day it was about 14% higher (HR 1.14). The European EPIC study, also observational, followed 450,000 (45万) people in 10 countries. Comparing those who drank 2 or more glasses a day with those who drank less than 1 a month: sugar-sweetened soft drinks were about 8% higher (HR 1.08, 95% CI 1.01–1.16). Artificially sweetened drinks (the sugar-free versions) were about 26% higher (HR 1.26, 1.16–1.35). All soft drinks combined were about 17% higher (HR 1.17, 1.11–1.22).

Notes

The dispute is about sugar-free drinks. The association for artificially sweetened drinks is even stronger than for sugary ones, which is very likely cause and effect running backward: people who are already overweight or have diabetes are the ones who switch to the sugar-free version. So don't conclude from this that sweeteners are more toxic. But it does show that there is no evidence for the idea that “switching to sugar-free makes it safe.” Plain water or unsweetened tea is the safest choice. Also, these studies only followed people and did not run trials that assigned groups, and people who drink a lot of sweet drinks tend to have worse lifestyles anyway, so the numbers may be too large.

Evidence grade
A : Specific numbers from meta-analyses, large cohorts or randomized trials; for law and policy, the statute or official text.
Sources
  1. Malik VS 等 (2019). Long-Term Consumption of Sugar-Sweetened and Artificially Sweetened Beverages and Risk of Mortality in US Adults. Circulation. https://doi.org/10.1161/CIRCULATIONAHA.118.037401
  2. Mullee A, Romaguera D, Pearson-Stuttard J, et al. (2019). Association Between Soft Drink Consumption and Mortality in 10 European Countries. JAMA Internal Medicine, 179(11), 1479-1490. https://doi.org/10.1001/jamainternmed.2019.2478

Mentioned in

Translated from the Chinese original. Original book, section 2, tip 7. This section is about health and medicines. It is general information, not a substitute for a doctor’s diagnosis or prescription. Content may be out of date and rules differ by place. When you actually deal with an agency, a doctor or a court, follow what local officials, doctors and lawyers tell you. Disclaimer