|First author (year), country, study name||Population and recruitment||Follow-up (years)||Exposure and assessment method||Outcome and assessment method||Covariates and stratification||Findings*||+/0/−†|
|Bes-Rastrollo (2010),59 Spain, SUN Project||10 162 Spanish university graduates; convenience sampling||4.4||SSB intake separated into thirds; FFQ||Weight change (kg) (continuous), weight gain ≥3 kg (OR), incident obesity (HR); self reported||Adjusted for age, alcohol intake, baseline BMI, dietary intake, physical activity, sex, sitting, smoking, total energy intake, TV viewing||Consumption of SSB was associated with greater weight gain in the group with the highest intake relative to the group with the lowest. However, there was no association with risk of developing obesity||+/0|
|Colditz (1990),76 USA, Nurses’ Health Study||31 940 married registered female nurses aged 30-55 years; consecutive sampling||4||Sucrose (g/day); FFQ||Weight gain (kg) (continuous); self reported||Adjusted for age, baseline BMI, total energy intake||Sucrose intake not significantly associated with weight gain at follow-up||0|
|Dhingra (2007),60 USA, Framingham Offspring Study||4028 middle aged adults, mean age 51-56 years, whose parents were in the Framingham Heart Study; random sampling used in original Framingham Heart Study cohort||4||SSSD (0, <1, ≥1, ≥2 servings/day); questionnaire||Incident obesity (BMI ≥30) and incident high WC (men ≥102 cm, women ≥88 cm) (OR); measured||Adjusted for age, baseline BMI/WC, dietary intake, glycaemic index, physical activity, sex, smoking, total energy intake||Compared with no SSSD intake, SSSD consumption was associated with incident obesity (1 serving/day: OR 1.21 (95% CI 0.90 to 1.62); ≥1: 1.31 (1.02 to 1.68); ≥2: 1.50 (1.06 to 2.11)). SSSD consumption was significantly associated with developing a high WC across the intake categories (1: 1.25 (1.02 to 1.54); ≥1: 1.40 (1.08 to 1.83); ≥2: 1.30 (1.09 to 1.56))||+|
|Drapeau (2004),61 Canada, Québec Family Study||248 adults aged 18-65 years, living within 80 km radius of Québec; convenience sampling||5.9||Self perceived change (increase, maintenance, or decrease) in the intake of sugar, sweet foods, and SSSD; questionnaire||Change in weight (kg), BF (%), sum of 6 skinfolds (cm), WC (cm) (all continuous); measured||Adjusted for age, body weight indicators at baseline, change in dietary intake, change in physical activity||In unadjusted ANCOVA analyses, participants reporting an increase in intake of sugar/sweet foods had a significantly higher increase in WC and sum of 6 skinfolds than those reporting a decrease (P<0.05), while no differences were seen for weight change or BF (%). No differences were seen for any body weight indicators after an increase in SSSD consumption. In adjusted regression analyses, an increase in consumption of sugar/sweet foods was significantly associated with an increased in WC (0.16 cm) and sum of 6 skinfolds (1.62 cm; both P=0.03)||+/0|
|French (1994),62 USA, Healthy Worker Project||1639 working men (mean age 39.1 years, SD 9.8) and 1913 women (mean age 37.3 years, SD 0.7) participating in an intervention study of smoking cessation and obesity prevention; convenience sampling of worksites, random sampling of workers||2||Sweet foods and SSSD (servings/week); FFQ||Weight change (in pounds) (continuous); measured||Adjusted for dieting behaviour at baseline and follow-up, baseline intake of sweets/SSSD, baseline weight, education, intervention group, marital status, occupation, smoking, worksite; stratified by sex||Consumption of sweet foods was associated with weight gain over time in both men and women. Each serving/week of sweet foods at baseline was associated with an weight increase of 0.28 pounds (0.13 kg, SE 0.04 kg) and 0.19 pounds (0.09 kg, 0.04 kg) in women and men, respectively, over the 2 years (both P≤0.02). No significant association was seen between SSSD intake and weight gain||+|
|Halkjaer (2004),63 Denmark, MONICA||2275 Danish adults aged 30, 40, 50, or 60 years; random sampling||6||Intake of sweet foods divided into fifths; FFQ||Change in WC (cm) (continuous); measured||Adjusted for age, alcohol intake, baseline BMI and current BMI, baseline hip circumference, baseline WC, change in dietary intake, education, physical activity, smoking; stratified by sex||No relation was seen between sweet foods consumption and WC||0|
|Halkjaer (2006 and 2009),64 65 Denmark, Danish Diet, Cancer and Health Study||20 126 men and 22 570 women aged 50-64 years, living in greater Copenhagen or Aarhus areas; consecutive sampling||5.3||Jams, sugars and syrups (250 kJ/day), SSSD (250 kJ/day), and energy intake from foods with added sugar (MJ/day); FFQ||Change in WC (cm/5 years) (continuous); measured at baseline, self reported at follow-up||Adjusted for age, alcohol intake, baseline BMI and WC, energy intake from other sources, physical activity, smoking||Intake of jams, syrups, sugars, or SSSD was not associated with change in WC in women or men. In women only, energy intake from foods with added sugar at baseline was significantly associated with a 5 year increase in WC (per MJ/day: 0.39 cm increase (95% CI 0.18 to 0.60); P<0.001)||+ (women only)|
|Hendriksen (2011),66 Holland, MORGEN-EPIC||11 111 adults aged 20-64 years, living in Amsterdam, Maastricht, or Doetinchem; random sampling||4.9/9.9||Sweets (418 kJ/day) and cakes (418 kJ/day) intake; FFQ||Annual weight change (g/year) (continuous); self reported||Adjusted for age, baseline weight and height, dietary intake, duration of follow-up, education, physical activity, sex, smoking, SSSD intake, total energy intake||No association between weight change and consumption of sweets or cakes was seen||0|
|Kvaavik (2004),67 Norway, Oslo Youth Study||371 Norwegian adults aged 23-27 years who participated in a school based intervention study 10 years previously; convenience sampling||8||Long term intake of SSSD (low consumption (<3 times/week at first and second follow-up), high consumption (≥3 times/week at first and second follow-up), or inconsistent consumption); questionnaire||Prevalent overweight (BMI ≥25) or obesity (BMI ≥30) at second follow-up (OR); self reported||Adjusted for baseline (adolescent) BMI; stratified by sex||No associations were seen between long term consumption of SSSD and overweight or obese status||0|
|Mozaffarian (2011),68 USA, Nurses’ Health Study I and II, Health Professionals Follow-up Study||50 422 married registered female nurses aged 30-55 years, 47 898 registered female nurses aged 24-44 years, and 120 877 male health professionals aged 40-75 years; consecutive sampling||4||Increase in consumption (servings/day) of SSB, FJ, sweets, or desserts; FFQ||Weight gain (in pounds) over 4 year periods (continuous); self reported||Adjusted for age, baseline BMI, change in alcohol intake, change in dietary intake, change in physical activity, change in smoking, change in TV viewing, sleep duration||In pooled analysis, each serving/day increase in SSB intake was associated with a 1 pound increase in weight (0.45 kg (95% CI 0.36 to 0.53); P<0.001). Each serving/day increase in FJ was associated with a 0.31 pound increase in weight (0.14 kg (0.06 to 0.21); P<0.001). Each serving/day increase in sweets or desserts was associated with a 0.41 pound increase in weight (0.19 kg, 0.07 to 0.30; P<0.001)||+|
|Nooyens (2005),69 Holland, Doetinchem Cohort Study||288 men aged 50-60 years, attending a municipal health clinic; consecutive sampling||5||Change in intake of SSSD (glasses/day); FFQ||Change in body weight (kg/year) and change in WC (cm/year) (both continuous); measured||Adjusted for age, alcohol intake, dietary intake, occupation, physical activity, retirement status, smoking, total energy intake||In unadjusted analyses, an increase in SSSD intake from baseline to follow-up was positively associated with change in body weight and WC (per glass/day increase, β 0.2 and 0.16, respectively; both P≤0.04). After adjustment, associations were rendered non-significant (both P≥0.05)||+/0|
|Odegaard (2010),70 Singapore, Singapore Chinese Health Study||43 580 Hokkien and Cantonese speaking Singaporeans aged 45-74 years, residing in housing estates built by the government; consecutive sampling||5.7||Intake of SSSD and intake of fruit drinks or FJ (servings per week or per month); FFQ||Weight change (kg) (continuous); self reported||Adjusted for age, alcohol intake, BMI, dialect, dietary intake, education, person years, sex, smoking, year of interview||Participants in the highest category of SSSD consumption (>2 servings/week) had a significant increase in weight (0.53 kg) compared with those who did not consume SSSD or reported only monthly consumption (P<0.001). There was no association between intake of fruit drinks/FJ and change in mean weight between baseline and follow-up. A test for interaction between SSSD intake and weight gain over time was significant (P=0.007)||+ (SSSD), 0 (FJ)|
|Palmer (2008),71 USA, Black Women’s Health Study||43 960 African American women aged 21-69 years; convenience sampling||6||Change in intake of SSSD and change in intake of fruit drinks (servings/day); FFQ||Weight gain (kg) (continuous); self reported||Adjusted for baseline age and BMI, dietary intake and change in dietary intake, education, family history of diabetes, physical activity and change in physical activity, smoking and change in smoking||Compared with women who reduced intake of SSSD (≥1 to ≤1 servings/day), those who increased intake (≤1 to ≥1) gained significantly more weight over the 6 year follow-up (4.1 kg (SD 0.22) v 6.8 kg (0.28); P<0.01). No significant associations were noted between weight gain and change in fruit drink intake||+ (SSSD)|
|Parker (1997),72 USA, Pawtucket Heart Health Program||465 adults aged 18-64 years, participating in a community based programme for cardiovascular disease prevention; random sampling||4||Intake of sugar (sucrose; g/day) and sweets (servings/week); FFQ||Weight change (kg) (continuous); measured||Adjusted for age, BMI, physical activity, smoking, total energy intake||Intake of sucrose and sweets at baseline was not associated with change in weight at follow-up||0|
|Schulz (2002),73 Germany, EPIC-Potsdam Cohort||17 396 adults aged 19-70 years, enrolled in EPIC in Potsdam; convenience sampling||2.2||100 g/day increments in intake of sweets, cakes, and biscuits; SSSD; and desserts. FFQ||Weight change (OR; kg/year; large gain (≥2), small gain (1-2), stable (gain or loss of 1), small loss (1-2), large loss (≥2); self reported||Adjusted for age, baseline weight and height, change in dietary intake, education, life and health contentment, drugs use, prevalent diabetes, prevalent stroke, weight cycling history; stratified by sex||Per 100 g/day higher increment in intake of sweets at baseline, men were more likely to have a large gain or small loss in weight than remain stable (OR 1.48 and 1.43, respectively; both P<0.05). In men, SSSD intake at baseline was positively associated with large weight gain (OR 1.03), small weight loss (1.02) and large weight loss (1.03; all P<0.05). Per 100 g/day higher increment in intake of sweets or cakes/biscuits at baseline, women were less likely to have a large loss in weight than remain stable (0.67 and 0.88, respectively; both P<0.05). In women, SSSD intake at baseline was positively associated with large weight loss (1.02, P<0.05)||+ and −|
|Schulze (2004),74 USA, Nurses’ Health Study II||51 603 registered female nurses aged 24-44 years; consecutive sampling||4||Change in consumption of SSSD, fruit drinks, FJ (from ≤1 time/week to ≥1 time/day, ≥1 time/day to ≤1 time/week, consistently ≤1 time/week, consistently ≥1 time/day); FFQ||Weight change (kg) and BMI change (both continuous); self reported||Adjusted for baseline values of age, alcohol intake, BMI, dietary intake, oral contraceptive use, physical activity, postmenopausal hormone use, and smoking, and changes in all variables over time||Women who increased consumption of SSSD gained more weight and reported a higher BMI at follow-up than those who decreased consumption or maintained a high or low intake (all P<0.001). Similarly, women who increased consumption of fruit drink/FJ gained more weight than those who decreased consumption (P<0.001)||+|
(only in women who increased intake)
ANCOVA=analysis of covariance; BF=body fat; FFQ=food frequency questionnaire; FJ=100% fruit juice; HR=hazard ratio; OR=odds ratio; SE=standard error; SD=standard deviation; SSSD=sugar sweetened soft drinks; SSB=sugar sweetened beverages (including cordials, energy drinks, fruit drinks, iced tea, soft drinks); TV=television; WC=waist circumference.
*Most adjusted results are reported unless otherwise stated.
†Higher sugar intake positively associated with weight gain (+), not associated with weight gain (0), and negatively associated with weight gain (−).