A global analysis has placed South Africa among the countries worst hit by the health burden of high consumption of sugary drinks which, together with ultra-processed foods is also being cited in a US lawsuit by a diabetic teenager as a key contributor for chronic diseases (see Analysis in sidebar).
MedicalBrief writes that this comes as medical professionals express concern about the escalation in kidney stone cases among children, with some implicating ultra-processed foods as the culprit (story in sidebar).
A recent study has highlighted the escalation in global health inequalities, with the fastest growth in linked diseases being detected in Africa – where sugary drinks were tied to more than one in five new diabetes cases and more than one in 10 new heart disease cases.
Worldwide, said the researchers, sugary drinks are responsible for more than 2.2m new cases of diabetes and 1.1m new cases of heart disease.
The study’s authors have called for a range of measures, including public health campaigns, regulation of sugary drink advertising and taxes on sugar-sweetened beverages.
The global analysis published in Nature Medicine revealed that in Latin America and the Caribbean, sugary drinks contributed to almost a quarter (24%) of new type 2 diabetes cases in 2020, but sub-Saharan Africa has seen the greatest percentage increase in cases from 1990 to 2020 cases.
South Africa, Colombia and Mexico have been particularly hard hit, according to the researchers at Tufts University in the US.
Sugary drinks were responsible for almost half (48%) of all new diabetes cases in Colombia. Nearly one-third of all new diabetes cases in Mexico were linked to sugary drinks, which were also connected to more than a quarter (27.6%) of new diabetes cases and 14.6% of cases of cardiovascular disease in South Africa.
Sugary drinks are rapidly digested, causing a spike in blood-sugar levels with little nutritional value. Drinking them regularly over time leads to weight gain, insulin resistance and a host of metabolic issues tied to type 2 diabetes and heart disease.
Dariush Mozaffarian, one of the paper’s authors and director of Tuft’s Food is Medicine Institute, told The Guardian: “Sugar-sweetened beverages are heavily marketed and sold in low- and middle-income nations. Not only are these communities consuming harmful products, but they are also often less well equipped to deal with the long-term health consequences.”
About 830m people worldwide have diabetes, most of them living in low- and middle-income countries, according to the World Health Organisation. Unlike type 1, type 2 diabetes can be prevented.
Cardiovascular diseases are the leading cause of death globally, taking an estimated 17.9m lives each year. More than three-quarters of these deaths take place in low- and middle-income countries.
Dr Catherine Kanari, a non-communicable diseases specialist for Amref Health Africa in Kenya, said: “We are seeing a rise in the popularity of sugary drinks fuelled by influencer culture online. In urban centres, young people are targeted by social media influencers paid to promote branded sugary drinks to them, filling an information gap left by the lack of school-based nutrition education.”
She added: “Ultimately, a rise in diabetes cases risks straining our health system to beyond its limits.”
Study details
Burdens of type 2 diabetes and cardiovascular disease attributable to sugar-sweetened beverages in 184 countries
Laura Lara-Castor, Meghan O’Hearn, Dariush Mozaffarian et al.
Published in Nature Medicine on 6 January 2025
Abstract
The consumption of sugar-sweetened beverages (SSBs) is associated with type 2 diabetes (T2D) and cardiovascular diseases (CVD). However, an updated and comprehensive assessment of the global burden attributable to SSBs remains scarce. Here we estimated SSB-attributable T2D and CVD burdens across 184 countries in 1990 and 2020 globally, regionally and nationally, incorporating data from the Global Dietary Database, jointly stratified by age, sex, educational attainment and urbanicity. In 2020, 2.2 million (95% uncertainty interval 2.0–2.3) new T2D cases and 1.2 million (95% uncertainty interval 1.1–1.3) new CVD cases were attributable to SSBs worldwide, representing 9.8% and 3.1%, respectively, of all incident cases. Globally, proportional SSB-attributable burdens were higher among men versus women, younger versus older adults, higher- versus lower-educated adults, and adults in urban versus rural areas. By world region, the highest SSB-attributable percentage burdens were in Latin America and the Caribbean (T2D: 24.4%; CVD: 11.3%) and sub-Saharan Africa (T2D: 21.5%; CVD: 10.5%). From 1990 to 2020, the largest proportional increases in SSB-attributable incident T2D and CVD cases were in sub-Saharan Africa (+8.8% and +4.4%, respectively). Our study highlights the countries and subpopulations most affected by cardiometabolic disease associated with SSB consumption, assisting in shaping effective policies and interventions to reduce these burdens globally.
See more from MedicalBrief archives:
Sugary drinks make boys more prone to diabetes than girls – US study
Sweetened drinks pose greater diabetes risk than other sugary foods
Activists flag serious health risks as sugar tax increase is delayed again