Although the benefits of physical activity are many, and well documented, a new study shows that physical activity’s benefits cannot entirely undo the risk imparted if a person drinks sugar sweetened beverages.

 Researcher Jean-Philippe Drouin-Chartier, author of a new study by the T Chan School of Public Health says, “the marketing strategies for these drinks often show active people drinking these beverages. It suggests that sugary drink consumption has no negative effects on health if you’re physically active. Our research aimed to assess this hypothesis.”

Sugar-sweetened beverages are a major source of excessive  sugar intake in the American diet. And consumption of soda and other sweetened beverages has been associated with a higher risk of cardiovascular disease.


For this new study researchers studied the data from 100,000 adults over a 30 yer period. Their data showed that consuming sugar-sweetened beverages more than twice a week raised their risk of cardiovascular disease. They then analyzed what the beneficial effects of exercise might be in those people who consumed sugary drinks. They found that those who engaged in the standard recommended amount of exercise to lower cardiovascular disease risk-2/12 hrs./week did offer some protection against cardiovascular disease but the benefit  was limited.

Dr. Drouin-Chartier stated, “physical activity reduces the risk of cardiovascular disease associated with sugar-sweetened beverages by half, but it does not fully eliminate it. Replacing sugar-sweetened beverages by diet drinks is good, because it reduces the amount of sugar. But the best drink option remains water.”

Lorena Pacheco, a colleague in the research says, “our findings provide further support for public health recommendations and policies to limit people’s intake of sugar-sweetened beverages, as well as to encourage people to meet and maintain adequate physical activity levels.”

It is important to note that the sugar consumption given to subjects in the study — twice a week — is not very high but it is enough to be significantly associated with the risk of cardiovascular disease. If a person’s consumption is every day, as it is for many Americans, the risk of cardiovascular disease is even greater.

Artificially sweetened drinks, as an alternative to sugar-sweetened beverages,are an improvement as  their consumption was not associated with a higher risk of cardiovascular disease. Water would still be preferred as a better beverage.

the Journal Advances in Nutrition in 2021 presented a scientific review
Intake of Sugar-Sweetened and Low-Calorie Sweetened Beverages and Risk of Cardiovascular Disease: A Meta-Analysis and Systematic Review


This comprehensive review  outlines  the extensive evidence that sugar-sweetened beverages are detrimental to one’s health and are particularly  associated with a higher risk of cardiovascular disease, the leading cause of death throughout the world.

They seek to explain the biological mechanism by which sugar-containing beverages cause this risk of cardiovascular disease by considering what happens in the body when quickly absorbed sugars, (such as corn syrup in sodas) are ingested. The quickly absorbed sugar causes an increase in blood glucose and an increase in insulin production as a result. This increase in insulin is shown to  elevate inflammatory biomarkers and overall body inflammation, which are both linked to the development of  cardiovascular and other disease. Even though there has been a lowering of the consumption of these beverages over the last twenty years because of public awareness of sugar’s  known negative effects, sugar sweetened beverages are still the single largest source of added sugar in the Average American’s diet.

The evidence for the association with the intake of sweetened beverages and cardiovascular disease risk is supported by the fact that other factors that go along with excess intake of these sweets such as weight gain (2), type 2 diabetes(3) , and elevated uric acid levels and gout are also associated  (54). They are also associated with obesity (55.56.57.), and elevated blood pressure.

The term Sugar-sweetened beverages (SSBs) includes carbonated and noncarbonated soft drinks such as soda,  sports/energy drinks and fruit-flavored drinks that are sweetened by sugars such as high-fructose corn syrup and sucrose. SSBs  contains few nutrients and are low in nutritional quality (1). There has been a lot  of attention paid to the study of the  health effects of SSBs because the regualr overconsumption SSBs has been associated with a higher risk of obesity (2), and the associated conditions-  type 2 diabetes (3), and the metabolic syndrome (4).  The published Dietary Guidelines for Americans, state that the consumption of added sugars should be less than <10% of total daily energy intake (5). Seemingly, even less than that would be only better. Low-calorie sweetened beverages (LCSBs), which contain the non caloric substitutes such as aspartame, and sucralose, are widely used as alternatives to SSBs due to their providing sweet flavor without the calories. It should be noted, however that the advise to see water as the better beverage may be more than just a logical thought, but based on potential health problems that may be associated with these sweeteners.

This study also aimed to examine the associations between sugar containing beverages and non sugar sweetened beverages with regard to the risk of total Cardiovascular disease, measuring coronary artery disease and stroke, in both men and women from the data obtained by two large studies.

They again confirmed the expected associated higher risk of sugar containing beverages with Cardiovascular disease -coronary disease and stroke , whereas alternatively sweetened beverage intake has no or a slightly higher risk of CVD (cardiovascular disease). They were able to further support the hypothesis that  physical activity is associated with a lower risk of total CVD, CAD, and stroke. And finally they also confirmed that  meeting physical activity guidelines will not eliminate the adverse risk of total CVD, associated with sugar containing beverages.

   The intake of artificially sweetened beverages has increased in the United States. They are thought to be a healthier alternative-( “diet” rather than “regular” sodas)  as a strategy to help control  intake of excess calories . Studies regarding  the long-term impact of artificially sweetened beverages on cardiovascular risk  CVD have thus far been been inconclusive and conflicting (60). A recent meta-analysis of randomized controlled trials indicated that replacing sugar with nonnutritive sweeteners leads to weight reduction (61), which tended to show cardiovascular benefits for low-calorie sweeteners when compared with caloric sweeteners.  However, the relevant evidence has been systematically reviewed and found to be equivocal (6566).Some  studies have suggested that Low calorie sweeteners may be associated with a higher risk of obesity and cardiometabolic diseases because low-calorie sweeteners may actually cause a preference for sweets, which may lead to excess calories intake and obesity (63) or biochemical changes which promote glucose intolerance (64),

The national library of Medicine has published the review ,Artificial sweeteners as a sugar substitute: Are they really safe? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4899993/

Although there may be a clearer case for the use of non sugar containing sweeteners for those who are obese  and need  to cut their calorie intake, and for those with diabetes to cut their sugar intake, their use in the population at large may still be questionable with regard to problems that may be lurking with their habitual use. In summary perhaps we can’t beat nature’s water for the title of “Most Preferred Beverage” !
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