title: Estimated Global, Regional, and National Disease Burdens Related to Sugar-Sweetened Beverage Consumption in 2010.
abstract: BACKGROUND
  Sugar-sweetened beverages (SSBs) are consumed globally and contribute to adiposity. However, the worldwide impact of SSBs on burdens of adiposity-related cardiovascular diseases (CVDs), cancers, and diabetes mellitus has not been assessed by nation, age, and sex.
  
  
  RESULTS
  We modeled global, regional, and national burdens of disease associated with SSB consumption by age/sex in 2010. Data on SSB consumption levels were pooled from national dietary surveys worldwide. The effects of SSB intake on body mass index and diabetes mellitus, and of elevated body mass index on CVD, diabetes mellitus, and cancers were derived from large prospective cohort pooling studies. Disease-specific mortality/morbidity data were obtained from Global Burden of Diseases, Injuries, and Risk Factors 2010 Study. We computed cause-specific population-attributable fractions for SSB consumption, which were multiplied by cause-specific mortality/morbidity to compute estimates of SSB-attributable death/disability. Analyses were done by country/age/sex; uncertainties of all input data were propagated into final estimates. Worldwide, the model estimated 184 000 (95% uncertainty interval, 161 000-208 000) deaths/y attributable to SSB consumption: 133 000 (126 000-139 000) from diabetes mellitus, 45 000 (26 000-61 000) from CVD, and 6450 (4300-8600) from cancers. Five percent of SSB-related deaths occurred in low-income, 70.9% in middle-income, and 24.1% in high-income countries. Proportional mortality attributable to SSBs ranged from <1% in Japanese >65 years if age to 30% in Mexicans <45 years of age. Among the 20 most populous countries, Mexico had largest absolute (405 deaths/million adults) and proportional (12.1%) deaths from SSBs. A total of 8.5 (2.8, 19.2) million disability-adjusted life years were related to SSB intake (4.5% of diabetes mellitus-related disability-adjusted life years).
  
  
  CONCLUSIONS
  SSBs are a single, modifiable component of diet that can impact preventable death/disability in adults in high-, middle-, and low-income countries, indicating an urgent need for strong global prevention programs.
authors.affiliation: From Friedman School of Nutrition Science & Policy, Tufts University, Boston, MA (G.M.S., R.M., D.M.); Department of Global Health and Population, Harvard School of Public Health, Boston, MA (S.K.); Institute for Health Metrics and Evaluation, University of Washington, Seattle (S.L.); and Departments of Global Environmental Health and Biostatistics and Epidemiology, School of Public Health, Imperial College London, United Kingdom (M.E.). Gitanjali.Singh@Tufts.edu.
authors.forename: Gitanjali M
authors.initials: GM
authors.lastname: Singh
authors.affiliation: From Friedman School of Nutrition Science & Policy, Tufts University, Boston, MA (G.M.S., R.M., D.M.); Department of Global Health and Population, Harvard School of Public Health, Boston, MA (S.K.); Institute for Health Metrics and Evaluation, University of Washington, Seattle (S.L.); and Departments of Global Environmental Health and Biostatistics and Epidemiology, School of Public Health, Imperial College London, United Kingdom (M.E.).
authors.forename: Renata
authors.initials: R
authors.lastname: Micha
authors.affiliation: From Friedman School of Nutrition Science & Policy, Tufts University, Boston, MA (G.M.S., R.M., D.M.); Department of Global Health and Population, Harvard School of Public Health, Boston, MA (S.K.); Institute for Health Metrics and Evaluation, University of Washington, Seattle (S.L.); and Departments of Global Environmental Health and Biostatistics and Epidemiology, School of Public Health, Imperial College London, United Kingdom (M.E.).
authors.forename: Shahab
authors.initials: S
authors.lastname: Khatibzadeh
authors.affiliation: From Friedman School of Nutrition Science & Policy, Tufts University, Boston, MA (G.M.S., R.M., D.M.); Department of Global Health and Population, Harvard School of Public Health, Boston, MA (S.K.); Institute for Health Metrics and Evaluation, University of Washington, Seattle (S.L.); and Departments of Global Environmental Health and Biostatistics and Epidemiology, School of Public Health, Imperial College London, United Kingdom (M.E.).
authors.forename: Stephen
authors.initials: S
authors.lastname: Lim
authors.affiliation: From Friedman School of Nutrition Science & Policy, Tufts University, Boston, MA (G.M.S., R.M., D.M.); Department of Global Health and Population, Harvard School of Public Health, Boston, MA (S.K.); Institute for Health Metrics and Evaluation, University of Washington, Seattle (S.L.); and Departments of Global Environmental Health and Biostatistics and Epidemiology, School of Public Health, Imperial College London, United Kingdom (M.E.).
authors.forename: Majid
authors.initials: M
authors.lastname: Ezzati
authors.affiliation: From Friedman School of Nutrition Science & Policy, Tufts University, Boston, MA (G.M.S., R.M., D.M.); Department of Global Health and Population, Harvard School of Public Health, Boston, MA (S.K.); Institute for Health Metrics and Evaluation, University of Washington, Seattle (S.L.); and Departments of Global Environmental Health and Biostatistics and Epidemiology, School of Public Health, Imperial College London, United Kingdom (M.E.).
authors.forename: Dariush
authors.initials: D
authors.lastname: Mozaffarian
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001628:Beverages / Q000009:adverse effects* / Q000191:economics; D015331:Cohort Studies; D017281:Cost of Illness; D019422:Dietary Sucrose / Q000009:adverse effects* / Q000191:economics; D002149:Energy Intake; D005260:Female; D014943:Global Health / Q000191:economics / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D009749:Nutrition Surveys / Q000191:economics / Q000639:trends*; D009765:Obesity / Q000191:economics / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D012307:Risk Factors; D013549:Sweetening Agents / Q000009:adverse effects / Q000191:economics
chemical_list: D019422:Dietary Sucrose; D013549:Sweetening Agents
keywords: cardiovascular diseases; diabetes mellitus; diet; obesity