Sugar-Sweetened Beverages and Adverse Human Health Outcomes: An Umbrella Review of Meta-Analyses of Observational Studies

Our aim was to conduct an umbrella review of evidence from meta-analyses of observationalstudies investigating the link between sugar-sweetened beverage consumption and human healthoutcomes. Using predefined evidence classification criteria, we evaluated evidence from 47 meta-analyses encompassing 22,055,269 individuals. Overall, 79% of these analyses indicated directassociations between greater sugar-sweetened beverage consumption and higher risks of adversehealth outcomes. Convincing evidence (class I) supported direct associations between sugar-sweetened beverage consumption and risks of depression, cardiovascular disease, nephrolithiasis,type 2 diabetes mellitus, and higher uric acid concentrations. Highly suggestive evidence (class II)supported associations with risks of nonalcoholic fatty liver disease and dental caries. Out ofthe remaining 40 meta-analyses, 29 were graded as suggestive or weak in the strength of ev-idence (classes III and IV), and 11 showed no evidence (class V). These findings inform andprovide support for population-based and public health strategies aimed at reducing sugary drinkconsumption for improved health