Cardiovascular risk and dietary sugar intake: is the link so sweet?

Luciana Mucci, Francesca Santilli, Chiara Cuccurullo, Giovanni Davì

Soft drinks and sugar-sweetened beverages have been targeted as one of the primary culprits in the escalating rates of obesity and diabetes and reduction of added sugars is considered between the goals to achieve in order to promote cardiovascular health and to reduce deaths from cardiovascular causes. Many reliable mechanisms, such as dislypidemia, inflammation and enhanced oxidative stress, have been proposed to support a causal link between sugar sweetened beverages intake and cardiovascular risk, but the ultimate underlying pathways remain to be determined in adequately designed studies. Furthermore, while epidemiological evidence strongly supports an association between sugar sweetened beverages consumption and obesity, type 2 diabetes mellitus or cardiovascular risk, incongruous findings yielded by clinical trials, or formal meta-analyses make difficult to draw firm conclusions in this regard. Further and rigorous studies are needed to better understand the role of sugar sweetened beverages in the etiology of cardiovascular diseases and to better address the warnings and decisions of regulatory authorities on public health worldwide.