Sweetened Beverages Fueling Excessive Sugar Intake, Cardiometabolic Problems Globally

Added sweeteners in beverages are increasing sugar intake internationally.

Increased sugar intake, especially due to certain beverages, is sweetening the global diet, thereby causing more cardiometabolic health problems, according to a Personal View published in The Lancet Diabetes and Endocrinology.

In the United States today, approximately 68% of available packaged food and beverage products have caloric sweeteners, 74% have caloric and low-calorie sweeteners, and 5% have only low-calorie sweeteners, the authors noted

“Extensive meta-analyses show that the risk of weight gain and other cardiometabolic problems, especially diabetes, resulting from added sugars in beverages is substantial and that the risk increases with the amount consumed,” wrote Barry Popkin, PhD, of the School of Public Health, Carolina Population Center, University of North Carolina, and Corinna Hawkes, PhD, of the City University of London.

The researchers compared nutritional data from around the world to find the trends in sales of sugar-sweetened beverages and calculate calories sold per person per day and volume sold per person per day.

They found that North America and Latin America are the largest consumers of sugar-sweetened beverages. Sales are beginning to decline in North America, Australia, and Western Europe, the authors noted, but consumption is still high in low- and middle-income countries like Latin America, the Caribbean, Africa, the Middle East, Asia, and Oceania.

Due the major health risks associated with sugar-sweetened beverage intake, the World Health Organization (WHO) is promoting health initiatives to help reduce consumption of these beverages. Some governments have also implemented taxation to regulate sugar intake, which has decreased consumption in some countries, including Mexico, Finland, Hungary, and France.

Other government health initiatives include reducing the availability of sugar-sweetened beverages in schools, placing restrictions on marketing campaigns that appeal to children, and using front-of-pack labeling.

There have also been some successful public awareness campaigns, like the Pouring on the Pounds campaign in New York City that used posters, videos, and slogans with the goal of reducing the consumption of sugar-sweetened beverages.

“The evaluation of not only sugar taxes, but also new marketing controls and front-of-pack labeling, is important and represents one of the next frontiers,” the authors wrote. “Namely, can these policies effectively reduce consumption of sugar-sweetened beverages and intake of total added sugars?”

The authors noted that although sugar-sweetened beverage intake rates have decreased in some countries, governments should still be aware of rising sales in sport and energy drinks with added sugars. There is also limited evidence concerning beverages with low-calorie sweeteners and fruit juices, but future research could indicate whether these are an appropriate substitute for sugar-sweetened beverages.


  1. Popkin BM and Hawkes C. Sweetening of the Global Diet, Particularly Beverages: Patterns, Trends, and Policy Responses. Lancet. 2015;doi:10.1016/S2213-8587(15)00419-2.